{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:58:31Z","timestamp":1773467911445,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2012,8,20]]},"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>A review of practice to determine whether serum-free light chain (SFLC) assays are helpful in detecting underlying clonal B-cell disorders or amyloidosis in patients with primary antibody deficiency (PAD) and recurrent infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>SFLC were assayed by nephelometry (BN2 nephelometer, Siemens; FREELITE assay, Binding Site). We reviewed SFLC test results recorded in our regional laboratory over a 4-year time period; 20 adults with PAD were identified as having been tested on at least two occasions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 20 patients, 4 with PAD had abnormal serum-free kappa\/lambda (K\/L) ratios but no evidence of B-cell clonality. We also found extremely low levels of kappa and or lambda (below the limits of reliable detection) in 19\/20 PAD cases (mostly common variable immunodeficiency), such that in many, ratios were not calculable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The data suggest that the abnormal ratios are generated by an inability to produce and\/or secrete SFLCs, particularly kappa FLC. In this small initial study, we seek to highlight PAD cases where a suspicious K\/L ratio, typically with very low absolute quantities of SFLCs, most likely points to B-cell dysfunction, rather than to B lymphocyte clonality.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jclinpath-2012-201044","type":"journal-article","created":{"date-parts":[[2012,9,22]],"date-time":"2012-09-22T00:59:41Z","timestamp":1348275581000},"page":"1128-1131","source":"Crossref","is-referenced-by-count":11,"title":["Abnormalities of serum-free light chain in patients with primary antibody deficiency in the absence of B lymphocyte clonality"],"prefix":"10.1136","volume":"65","author":[{"given":"David Joseph","family":"Unsworth","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael John","family":"Wallage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esha","family":"Sarkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert John","family":"Lock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,9,21]]},"reference":[{"key":"2024052923501946000_65.12.1128.1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.307"},{"key":"2024052923501946000_65.12.1128.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2007.01368.x"},{"key":"2024052923501946000_65.12.1128.3","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1093\/clinchem\/48.9.1437","article-title":"Serum reference intervals and diagnostic ranges for free k and free l immunoglobulin light chains: Relative sensitivity for detection of monoclonal light chains","volume":"48","author":"Katzmann","year":"2002","journal-title":"Clin Chem"},{"key":"2024052923501946000_65.12.1128.4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0140-6736(85)91037-2","article-title":"Prospective study of cancer in patients with hypogammaglobulinaemia","volume":"1","author":"Kinlen","year":"1985","journal-title":"Lancet"},{"key":"2024052923501946000_65.12.1128.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.2003.02253.x"},{"key":"2024052923501946000_65.12.1128.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12457-9"},{"key":"2024052923501946000_65.12.1128.7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04433.x"},{"key":"2024052923501946000_65.12.1128.8","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02740806"},{"key":"2024052923501946000_65.12.1128.9","doi-asserted-by":"publisher","DOI":"10.1586\/ehm.10.13"},{"key":"2024052923501946000_65.12.1128.10","doi-asserted-by":"publisher","DOI":"10.1258\/000456307782268084"},{"key":"2024052923501946000_65.12.1128.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07456.x"},{"key":"2024052923501946000_65.12.1128.12","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-08-237651"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2012-201044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T12:49:01Z","timestamp":1717073341000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2012-201044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,21]]},"references-count":12,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2012,11,16]]},"published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1136\/jclinpath-2012-201044"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2012-201044","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,21]]}}}