Abstract
We read with interest the article by Abadie et al1 and would like to add our observations that largely corroborate their findings. Abadie et al1 provide confirmatory data that renal reference intervals are required when interpreting the serum free light chain (FLC) ratio in patients suspected of having plasma cell dyscrasias. Because borderline ratios cause significant diagnostic confusion, we were interested to further characterize the clinical characteristics of patients who had borderline abnormal serum FLC ratios and no evidence of plasma cell dyscrasias or lymphoproliferative disorders. We performed a retrospective audit of FLC assays performed between January 1, 2006, and September 13, 2008, at 3 tertiary referral hospitals and correlated cases with borderline abnormal ratios (arbitrarily defined as 0.13–0.25 and 1.66–3.2, ie, 2 times …
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