Abstract
growing body of literature on the prognostic role of elevated poly- clonal serum free light chains (sFLCs) in clinical settings. Of note, increased polyclonal sFLCs have been detected in conditions that are characterized by chronic B-cell activation: rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, severe atopic and nonatopic asthma and dermatitis, idiopathic pulmonaryfibrosis, and chronic hypersensitivity pneumonitis. Furthermore, infections, dia- betesmellitus,renalimpairment,andinflammatoryboweldiseaseare significant known causes of polyclonal increase in sFLCs. 2,3 Because the incidence of these diseases increases with age, and aging is another cause of elevated polyclonal sFLCs, I would have expected that the authors 1 would include the presence of comorbidi- ties in their analysis. The sFLC half-life of only 2 to 6 hours would potentially indicate the immediate occurrence of B-cell dysfunction/ activity; thus, intrapatient variations are strictly correlated with the activity of the underlying disease and may be influenced by therapy. 3
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