Serum Protein Electrophoresis Patterns Research Articles

Utility of Immunofixation as a Follow-up to Select Abnormal Serum Protein Electrophoresis Patterns and Suggestions for Clinical Correlation

Utility of Immunofixation as a Follow-up to Select Abnormal Serum Protein Electrophoresis Patterns and Suggestions for Clinical Correlation

Serum protein electrophoresis patterns and misleading laboratory values in IgG4-RD: what the nephrologist should know.

Serum protein electrophoresis patterns and misleading laboratory values in IgG4-RD: what the nephrologist should know.

Reporting Practices of Serum Protein Electrophoresis in Pakistan - a Multicenter Survey.

Serum Protein Electrophoresis (SPE) is crucial for the diagnosis and follow-up of monoclonal gammopathy (MG), as it helps to separate and identify these paraproteins. Currently, Pakistan lacks standardized guidelines for SPE reporting and analytical performance. This survey aims to analyze reporting variations from Consultant Chemical Pathologists in Pakistani laboratories. This cross-sectional survey was conducted by the section of Chemical Pathology, Department of Pathology and Laboratory Medicine, at Aga Khan University Hospital, Karachi. A previously validated and published tool was used with some modifications to assess analytical techniques, reporting patterns, and interpretations provided with SPE by different laboratories. Frequency and percentages were calculated for each response and descriptive results were also evaluated. Differences between laboratories were also assessed qualitatively. Out of the eight laboratories contacted, seven participated in the survey, yielding a response rate of 87.5%. Immunofixation Electrophoresis (IFE) was used by all labs for serum immunotyping. All labs reported a new small abnormal band in patients with no known monoclonal gammopathy or with a known M-protein. Variations were found in terminologies used to label paraprotein, terminologies used to report normal and pathological SPE patterns, electrophoretic technique, methods for quantifying paraprotein in the gamma region on SPE and for albumin quantification. Similarly, the number of decimal places reported, reporting of multiple monoclonal proteins and small paraprotein in the beta region or monoclonal proteins less than 1 g/L, approach for screening, number of fractions reported in gamma region and reporting of interferences were also not standardized and var-iations were noticed. Our survey highlighted variations in practices of SPE reporting. These differences in laboratory practices could result in inconsistent test results, which could adversely affect patient care.

TOTAL PROTEIN, ALBUMIN AND SERUM PROTEIN ELECTROPHORESIS PATTERN OF ALCOHOLICS IN IKERE-EKITI, EKITI STATE

Plasma proteins such as albumin are indispensible in maintaining numerous essential roles of living cells. This objective of this study was to determine the total serum protein, albumin and serum protein electrophoresis pattern of alcoholics. One hundred samples comprising sixty (60) subjects (alcohol users) and forty controls (non-alcohol users) were recruited for this study. Total protein and albumin were determined using spectrophotometric methods and protein electrophoresis respectively. The results were presented in tables and chat as mean ± standard deviation. Statistical analysis was done using one way analysis of variance (ANOVA) and Student’s t-test using IBM SPSS version 24.0. A p-values of <0.05 was considered significant. The results obtained showed that the mean value of total protein in subjects and control was 50.22±8.44 g/L and 74.38±8.12 g/L, albumin was 30.89±5.05 g/L and 45.13±5.18 g/L, globulin was 19.33±6.11 g/L and 29.25±5.36 g/L, while albumin/globulin ratio was 1.6 and 1.54 respectively. Statistically, total protein, albumin and globulin were significantly lower (p<0.05) in subjects compared with control group. This study concludes that alcohol consumption significantly reduced the level of total protein, albumin and globulins. The combination of these parameters in combinations may be a useful indicator for identification and determination of severity of alcoholic liver diseases. Regular screening exercise of alcoholics should be carried out to detect individuals at risk of hepatic dysfunction.

Serum protein electrophoresis in Dirofilaria immitis naturally infected dogs: Latest news and a systematic literature review

According to the main Guidelines on canine heartworm disease (HWD) by the American and European Societies (i.e., AHS, ESDA, and ESCCAP), a correct diagnosis of Dirofilaria immitis infection should include the detection of circulating microfilariae in the whole blood and the adult antigens in serum or plasma sample. So far, scant data are available on laboratory abnormalities in dogs affected by HWD, although techniques including serum protein electrophoresis (SPEP) have proved to be useful for the diagnosis and monitoring of other vector-borne diseases, such as the canine leishmaniosis. Therefore, this study aims to evaluate the SPEP pattern in dogs naturally infected by D. immitis. Furthermore, a systematic review of the literature on this topic was carried out. Medical records from heartworm-positive dogs, of any sex, age, and breed and with available clinical examination and laboratory test results (i.e., complete blood count, serum biochemical profile, and SPEP) were retrospectively collected. If available, laboratory results obtained from dogs after treatment for HWD were also evaluated. When compared with the reference intervals, out of 30 dogs infected by D. immitis and enrolled, 63.3% (n = 19) had a lower percentage of albumin, and 80.0% (n = 24) had higher percentages of beta globulins, with beta-2, and especially beta-3 globulins the most frequently altered fractions. In terms of absolute values (g/dL), the proportion of dogs with hypoalbuminemia, and increased total globulin, alpha, beta- and gamma globulins were 4/30 (13.3%), 6/30 (20.0%), 2/30 (6.7%), 16/30 (53.3%) and 8/30 (26.7%), respectively. For 7 dogs, SPEP results evaluated three and six months after treatment with doxycycline (10 mg/kg BID for 4 weeks) were available. In these dogs a significant post-treatment increase in the percentage of albumin, alpha-2 globulin, and albumin/globulins ratio was observed, as well as a significant decrease both in the percentage and in the absolute value of total-, beta-, and beta-3 globulins. The systematic review of literature databases yielded a total of three studies that were considered eligible and included in the qualitative synthesis. This study provides novel information on SPEP alterations in dogs naturally infected by D. immitis. The evaluation of serum proteins and their electrophoretic pattern may represent an important diagnostic tool for a prompt and accurate diagnosis (e.g., differentiating infections in dogs sharing similar clinical signs and endemic in the same geographical area) and monitoring of HWD.

Characterization of serum protein electrophoresis patterns and C-reactive protein in canine tick-borne diseases

Background and Aim:Canine tick-borne diseases are important diseases with a worldwide distribution. In Thailand, the most important canine tick-borne diseases are ehrlichiosis, babesiosis, and hepatozoonosis. This study aimed to determine the serum protein electrophoresis patterns (SPEPs) and C-reactive protein (CRP) levels associated with Ehrlichia canis, Babesia canis, or Hepatozoon canis single infections.Materials and Methods:A total of 650 canine blood samples were collected from animal hospitals and clinics in Bangkok and its vicinity to examine health status and blood parasite infection. Suspected blood parasite infections were examined by buffy coat thin blood smear and confirmed by polymerase chain reaction. Normal dog and positive E. canis, B. canis, and H. canis single infections and serum protein profiles were determined by agarose gel electrophoresis. CRP concentration was measured by fluorescent immunoassay.Results:In dogs infected with E. canis, B. canis, and H. canis single infections, albumin levels and A/G ratios significantly decreased, whereas β2-globulin levels increased (p<0.05). The γ-globulin level significantly increased in E. canis and H. canis infections (p<0.05). A monoclonal gammopathy pattern wasi observed in E. canis and B. canis sngle infections, whereas β-γ bridging patterns and increased β- and γ-globulin fractions were found in H. canis single infections. The CRP level increased in dogs with blood parasite single infections and may be related to the pathogenesis of the infection.Conclusion:SPEPs and CRP levels can be used to monitor health status and blood parasite problems in infected dogs.

The Association between serum protein electrophoresis patterns and severity of patients infected with SARS-CoV-2 virus

Background:-The Coronavirus epidemic 2019 (COVID-19) is really a highly infectious sickness that is causing a huge danger to human life throughout the world. The induction of acute cytokine storm and immunosuppressive in COVID- 19 patients causes a rise in cytokines levels in the blood. Furthermore, the full extent of serum protein alterations in COVID-19 patients remains unclear. Patients and methods: -In a cross-sectional study, 80 SARS-CoV-2 virus-infected patients aged 18 to 80 were categorized according to severity of the infection and their serum protein electrophoresis assessment in relation to the severity of Covid-19. Results:-SPE for patients infected with the SARS-CoV-2 virus showed a significant difference in albumin, beta, and gamma and there was no significant relation with the α1 and α2 all in comparison between the subgroups themselves. Conclusion:-We conclude from the finding: albumin, beta, and gamma fractions showed a decrease in levels In conjunction with disease severity.

Usefulness of serum globulin levels for discriminating patients with monoclonal gammopathies/ paraproteinemias

Introduction and Aim: The confirmatory step in diagnosis of monoclonal gammopathies is bone marrow biopsy and presence of M-protein in serum protein electrophoresis. These tests are relatively expensive &amp; invasive for screening and unavailable in low resource settings. Increased levels of serum globulin are clue to the diagnosis of monoclonal gammopathy. The aim of this study was to assess the relevance of serum globulin levels in discriminating between patients with &amp; without monoclonal gammopathies/ paraproteinemia.&#x0D; Materials and Methods: We retrospectively reviewed serum protein electrophoresis (SPE) and related investigations of patients suspected of monoclonal gammopathy. Reports with an M-band were considered as paraproteinemias, and those without as controls. ROC for sensitivities &amp; specificities for serum globulin levels were computed.&#x0D; Results: For the case-control study, median serum globulin values in cases were 4.4 (3.5-6.3) g/dL in males and 3.65 (3.33-5.0) g/dL in females. They were significantly higher than those with normal SPE pattern, with a p &lt;0.001. A cut-off value of 3.25 g/dL of globulin could distinguish between paraproteinemias and controls with a sensitivity of 82.1% and specificity of 85.4% in males; a sensitivity of 79.2%, a specificity of 76.7% for females. At a cut-off value of 3.4 g/dL, sensitivity was 77% and specificity 92.7% for males; sensitivity was 75% and specificity 83.7% for females. Alternatively, a cut-off value of 0.458 of globulin/total protein ratio could distinguish at a best sensitivity &amp; specificity of 80% and 89% in males; 83.3% and 83.7% in females.&#x0D; Conclusion: Serum globulin values and globulin/total protein ratio can reliably differentiate patients with paraproteinemias.

The effects of sex, body length, and different habitats on the serum protein electrophoresis of the broad-snouted caiman (Caiman latirostris).

Knowledge of mammalian inflammatory responses is vast; however, many aspects of the inflammatory response in non-mammalian vertebrates, such as reptiles, remain unclear, including those regarding acute-phase proteins (APPs). Recent studies have focused on the use of serum protein electrophoresis (SPE) to assess inflammatory responses in the broad-snouted caiman (Caiman latirostris) and other reptiles. The purpose of this study was to examine the effects of sex, body length, and different habitats on SPE patterns in Clatirostris using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A total of 40 animals of both sexes and varying body lengths were collected; of these, 23 were free-living in an industrial complex (site 1), and 17 were captive on a rural property (site 2). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was performed to fractionate different serum protein constituents. Sex affected protein levels, with females showing higher serum levels of total protein, as well as the 90-, 66-, and 58-kDa proteins compared with males. Similarly, body length affected protein levels, with male adults >1.70m in length showing the lowest serum levels of 152-, 58-, 54-, and 27-kDa proteins of all other animals. Finally, habitat affected protein levels, with animals at site 1 showing higher serum levels of 152- and 41-kDa proteins compared with those at site 2. This preliminary study was the first to evaluate the SPE of Clatirostris using SDS-PAGE. Further studies to identify the proteins in each band with more specific and sensitive techniques (eg, mass spectrometry) should be conducted to elucidate the standard of APPs in reptiles better.

Role of serum protein electrophoresis in clinically suspected cases of plasma cell dyscrasia

Background: Serum protein electrophoresis (SPE) and its pattern recognition is an excellent screening technique for the detection of paraproteinemias or monoclonal gammopathies. In this study, we assessed SPE patterns in all clinically suspected cases of plasma cell dyscrasia with usual and unusual clinical presentations and correlated with ancillary investigations. Method: We analysed serum protein electrophoresis (SPE) patterns in clinically suspected cases of plasma cell dyscrasia in 2 year duration. Based on SPE pattern these cases were divided into two groups: Group I, with M-component and Group II, without M-component. These cases were reviewed with respect to clinical presentation and correlated with immunofixation electrophoresis and bone marrow aspiration/biopsy findings wherever available, especially in the M band positive cases to differentiate multiple myeloma (MM) from the other conditions. Result: A total of 80 samples were received for SPE, out of these, 56.3% were clinically suspected to have plasma cell dyscrasia. Among these cases 60% were in group I and 40% were in group II. In group II, 39% cases were essentially non neoplastic after relevant investigations. In group I, M-band was observed in 88.9% cases in γ-region and 11.1% cases in β-region. The mean fraction of the M protein was 4.7g/dl with a range of 2.0g/dl to 9.8g/dl. In group II 72.2% showed polyclonal hypergammaglobulinemia, 22.2% showed normal electrophoretic pattern and 5.6% showed hypogammaglobulinemia. Bone marrow aspiration and biopsy were available in 88.9% of all suspected cases. Various haematological neoplasms observed in both the groups, their clinical presentations with interesting facets of the cases have been discussed. Conclusion: Serum protein electrophoresis is one of the most important diagnostic modality in clinical chemistry. It helps to resolve cases with bone marrow plasmacytosis particularly in differentiating between reactive non-neoplastic plasmacytic proliferations from clonal plasma cell disorders. Moreover, it also facilitates the work-up of cases with atypical presentations and thereby paves way to clinch the diagnosis in these ambiguous cases.

Serum protein electrophoresis pattern in patients living with HIV: frequency of possible abnormalities in Iranian patients

This prospective case-control study was conducted to evaluate abnormal serum protein electrophoresis (SPEP) patterns in patients living with human immunodeficiency virus (HIV) and its relation with disease severity markers and anti-retroviral treatment status. Thirty-seven HIV-positive patients and 24 healthy individuals were evaluated in the course of this study. The healthy HIV-negative individuals were selected as control group. Pregnant women, patients with malignancies, children, hepatitis B- and/or C-positive patients, those with a history of an autoimmune disease, or previous corticosteroid administration were excluded. SPEP-which detects serum levels of albumin, total protein, gammaglobulin-, CD4+ T-cell counts, viral load, and antiretroviral treatment status were assessed. Data were analyzed by SPSS™ software. Twelve patients (32 percent) demonstrated polyclonal gammopathy on SPEP, while only 1 (4 percent) healthy individual had the same pattern (P-value = 0.007). No statistically significant connection between SPEP patterns and antiretroviral treatment status was observed (P-value > 0.05). Interestingly no statistically significant relationship between CD4+ T-cell counts and polyclonal gammopathy was discerned. No statistically significant difference was observed between the two groups with regards to serum albumin and total protein levels. The serum albumin to total protein percentage, serum gamma globulin to total protein percentage, and serum albumin to globulin ratio was compared between the groups and a statistically significant difference was observed. Polyclonal gammopathy on SPEP is common among HIV-infected patients. Moreover, the SPEP patterns cannot be used as an indication of a patient's negative or positive response to treatment.

Distortion of Capillary Serum Protein Electrophoresis Pattern May Indicate Monoclonal Gammopathy of Undetermined Significance but Not Multiple Myeloma

Distortion of Capillary Serum Protein Electrophoresis Pattern May Indicate Monoclonal Gammopathy of Undetermined Significance but Not Multiple Myeloma

ELEKTROFORESIS PROTEIN SERUM PASIEN DENGAN KADAR PROTEIN NORMAL

Serum protein electrophoresis pattern can assist in diagnosis of liver disease, hematological disorders, renal disorders andgastrointestinal disease. Measurement of total protein level in the serum cannot detect any disorders in patient with normal limit ofserum total protein level. The aim of this study; was to evaluate the serum protein electrophoresis pattern in patient with normal limitsof serum protein level. This research was carried out by descriptive retrospective study using the electrophoresis data from patients'medical record at the Clinical Pathology Department, Dr. Hasan Sadikin General Hospital Bandung. The data of serum electrophoresis (bySebia gel electrophoresis) were grouped based on disease or disorders, and confirmed with the diagnosis derived from patient's medicalrecord. Inclusion criteria of samples if ; the electrophoresis data were available, serum total protein level within normal limits (6.4–8.3mg/dL), and the data of electrophoresis taken from medical record were taken from August 2006 until August 2008. The result foundso far was, there were 240 data of electrophoresis from patients with serum protein level within normal limits (6.4–8.3 mg/dL). theinterpretation of electrophoresis consist of: 1) inflammation (149 patients; 62.2% ; sensitivity 83.7%, specificity 86,5%) 2) Cirrhosis(46 patients ; 19.2% ; sensitivity 87.5% ; specificity 88.4%) 3) Nephritic syndrome (15 patients ; 6.2%; sensitivity 53%; specificity96.9% 4) Monoclonal gammophaty (15 patients(6.2% ; sensitivity 80% ; specificity 98.7%) 5) Normal pattern in 15 patient (6.2%).This study found abnormal serum protein electrophoresis pattern in the condition of inflammation, Cirrhosis, Nephritic Syndrome, andMonoclonal gammophaty. It can be concluded that many disorders could be detected in patient with serum protein level within normallimits such as: inflammation, cirrhosis, nephritis syndrome and monoclonal gammophaty by abnormal electrophoresis pattern

On the path to evidence-based reporting of serum protein electrophoresis patterns in the absence of a discernible monoclonal protein – A critical review of literature and practice suggestions

• Reporting SPE patterns and their implied clinical conditions that may or may not be related to monoclonal gammapthy is controversial;

Glycation gap: An additional tool for glycometabolic monitoring

BackgroundThe determination of glycated albumin (GA) has been suggested as an additional parameter having an independent added value respect to that of HbA1c. The determination of glycation gap (gg) has also been proposed, but few studies have addressed its potential impact in the routine evaluation of glycometabolic control. MethodsA total of 157 subjects presenting normal whole blood cell count, no hemoglobin variants, normal creatinine levels and serum protein electrophoresis patterns were studied. In a second phase, a total of 205 subjects with no restrictions as those of the first phase study, were analyzed. HbA1cwas measured by capillary electrophoresis, glycated albumin by an enzymatic method and their gg were then calculated. ResultsThe correlation between HbA1c and GA for the subjects of phase 1 was strong (r=0.8927) and significant correlation between gg and age was remarked (r=0.4486). We found 17.1% of phase 2 subjects with gg falling outside the 95% prediction intervals. Various clinical conditions seemed to affect these subjects, in our experience mostly often related to impaired renal function. ConclusionThe glycation gap may be useful to alert clinicians about patients under unstable glycemic control or when various pre-analytical conditions my affect the reliability of the measurement of GA or HbA1c.

Detection of Polyclonal Increases in Immunoglobulin G4 Subclass by Distinct Patterns on Capillary Serum Protein Electrophoresis: Diagnostic Pitfalls and Clinical Observations in a Study of 303 Cases.

Autoimmunity, hypersensitivity, and the recently recognized set of syndromes collectively termed immunoglobulin G4-related disease (IgG4-RD) may be associated with increased serum IgG4 levels. We reviewed our experience detecting increased IgG4 by distinct serum protein electrophoresis (SPEP) patterns. We studied 303 capillary SPEP cases with dome-like anodal γ changes and increased measured serum IgG4. IgG4 ranged from 208 to 6,670 mg/dL (normal, <201 mg/dL). Seventeen of 91 cases evaluated by immunosubtraction appeared monotypic (16 κ, 1 λ), but all five cases further analyzed by isoelectric focusing appeared polyclonal. Six cases with markedly increased IgG4 had presumptive evidence of IgG4-RD. Sixteen of 45 assessed patients had autoantibodies. Increased polyclonal IgG4 has a characteristic SPEP pattern that may mimic monoclonal gammopathy, even on immunosubtraction. κ Pseudo-restriction might reflect the naturally high κ/λ ratio of the IgG4 subclass. Autoantibodies were common, and the greatest IgG4 increases had clinical features of IgG4-RD.

Serum protein electrophoresis patterns in human immunodeficiency virus-infected individuals not on antiretroviral treatment.

B lymphocyte stimulation is described in human immunodeficiency virus (HIV) infection and results in ongoing immunoglobulin production with abnormal serum protein electrophoresis patterns. We hypothesized that serum protein electrophoresis patterns would be abnormal in untreated HIV subjects and correlate with markers of disease severity. Serum protein electrophoresis was performed on 70 HIV-positive, clinically well treatment-naïve subjects and 42 HIV-negative controls and correlated with markers of disease severity, namely CD4+ counts, viral loads, IgG and albumin. The mean age for both groups was 33 years, and female-to-male ratios were 4:1. All were of Black ethnicity. Mean CD4 counts ± SD for HIV group and controls were 419.5 ± 218.6 and 960.4 ± 378.5 cells/mm(3), respectively. Of the HIV-infected group, 44% showed polyclonal hypergammaglobulinaemia versus 10% of controls (P < 0.01). The HIV group had 27% with an abnormal pattern requiring immunofixation which revealed nine (12.5% of total) had oligoclonal bands, seven (10.3% of total) had polyclonal hypergammaglobulinaemia and three (4% of total) had monoclonal bands. CD4+ counts were lower in those with polyclonal hypergammaglobulinaemia or abnormal serum protein electrophoresis. Interestingly, viral load results showed no statistically significant differences. We found a remarkably high level (53%) of polyclonal hypergammaglobulinaemia in our untreated population compared with uninfected controls (10%). Only 4% of the HIV-positive group had a monoclonal band. Polyclonal hypergammaglobulinaemia correlated significantly with lower CD4+ counts. These results highlight the generalized B cell stimulation in untreated HIV infection. Future longitudinal studies will be important to determine the prognostic value of these findings.

Serum protein electrophoresis under effective control of HIV-1 disease progression.

In this report, we compared the serum protein electrophoresis (SPE) patterns in a subset of HIV-1-infected subjects who did not progress to AIDS without antiretroviral treatment with those in whose control of disease progression was achieved by highly active antiretroviral therapy (HAART). SPE and immunofixation electrophoresis were performed on Helena Electrophoresis System according to manufacturer's instructions. The percentage of SPE abnormalities, resembling chronic inflammation, was significantly higher in HIV-1-infected subject without HAART compared with those under HAART (p = 0.001). The majority of individuals under HAART showed evidence of oligoclonal bands on the γ-band against a polyclonal background compared with those without HAART but ß-γ-band bridging was more evident. Immunofixation pattern was consistent with oligoclonal hypergammaglobulinaemia of IgG kappa type, which was found to be more intense in group without HAART. HIV clinical status did not show appreciable effect on the SPE pattern in subjects without HAART. However, under effective HAART, subjects with better CD4 T-cell count were associated with higher γ-globulin band. In group without HAART, acute infection was found to be associated the higher γ-globulin fraction compared with chronic infection. The opposite was the case under effective HAART. HIV infected subjects that did not progress to AIDS were associated with markedly abnormal SPE pattern. Overall results reflect the host ability compensate defective cellular immunity in HIV-1 infection with humoral immune responses. These findings underscore the usefulness of SPE monitoring HIV disease management and identifying individuals that may not progress to full-blown AIDS in the absence of treatment.

Carbamazepine and Multiple Myeloma: Possible Interaction

To the Editor Epilepsy is the most common chronic neurological disease and patients are treated by various classes of antiepileptic drugs [1]. In addition to their acute side effects, there are long-term adverse effects of antiepileptic drugs [2]. Hemopoietic neoplasias such as lymphoma, multiple myeloma, and some solid cancers including lung, liver, pancreas, and gastrointestinal cancers are the malignant disorders most frequently discussed in relation to use of antiepileptic drugs [3,4]. The carcinogenic effect of carbamazepine is very limited. However, there are some case reports and series containing a limited number of cases of hypogammaglobulinemia, monoclonal gammopathy of undetermined significance (MGUS), and multiple myeloma [3,4,5,6,7,8,9,10,11]. We present here a 54-year-old woman with multiple myeloma with long exposure to carbamazepine. Vertebral fracture was detected and vertebroplasty was done urgently. There was no evidence of neurologic deficit. She had a history of 400 mg carbamazepine usage for more than 20 years due to idiopathic epilepsy. Laboratory examination showed total protein/albumin of 8.85/3.41 g/dL and calcium of 10.77 mg/dL (8.4-9.2); she had macrocytic anemia. Bence-Jones protein in the urine was not demonstrated. Protein electrophoresis showed an M-peak (Figure 1) with an elevated serum level of immunoglobulin G (IgG) of 2740 mg/dL. Immunoelectrophoresis revealed M-protein composed with a kappa chain. Bone marrow aspiration and biopsy showed 90% plasma cell infiltration and CD38 and kappa were positive. Cytogenetic analysis of bone marrow showed 17 p deletion (+), 13 q deletion (+), t (11;14), t (4;14). Histopathological examination of a vertebroplasty specimen revealed plasma infiltration. Carbamazepine usage was stopped and treatment was continued with valproic acid. A regimen containing bortezomib (1.3 g/m2), dexamethasone (40 mg), and zoledronic acid was prescribed. After 4 courses of chemotherapy, blood and bone marrow exams were normal. Stem cell transplantation was planned for consolidation. Carbamazepine-related multiple myeloma has been reported in a few case reports. It has been suggested that carbamazepine may cause the IgG type of M-protein multiple myeloma, MGUS, and hypogammaglobulinemia [5,6,9,11,12]. Our patient was younger than is usual for multiple myeloma. We can speculate that the exposure to an extrinsic factor may be associated with younger age in this case. The relationships among the duration of use of antiepileptic drugs, cumulative dose of antiepileptic drugs, and development of multiple myeloma are not known completely. In our case, multiple myeloma developed after 20 years of carbamazepine use. In conclusion, carbamazepine may be a potential drug in the development of multiple myeloma. For this reason, periodical evaluation of serum levels of immunoglobulin is necessary in patients receiving carbamazepine. Figure 1 Abnormal serum protein electrophoresis pattern in a patient with multiple myeloma. Note the large spike in the early gamma region. Conflict of Interest Statement The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/ or affiliations relevant to the subject matter or materials included.

Relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell non-Hodgkin lymphoma

Event Abstract Back to Event Relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell non-Hodgkin lymphoma Mourad Aribi1*, Meriem Rabia Zahzeh1, Zineb Hadjidj1, Chahinez Triqui1 and Naima Mesli1, 2 1 Laboratory of Applied Molecular Biology and Immunology. University of Tlemcen, Algeria 2 Haematology Department, Tlemcen Medical Centre University, Algeria Background: Non-Hodgkin lymphoma (NHL) is the seventh most common cancer in the world. They are malignancies that develop from lymphoid cells. Selenium can modulate the expression of multiple cellular signaling pathways leading to decreased inflammatory gene expression. Objectives: To determine the relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell NHL. Materials and Methods: Newly-diagnosed patients with B-cell NHL and healthy age- and sex-matched controls were recruited at the Hematology Department of Tlemcen Medical Centre University (Algeria Northwest) for a retrospective case-control study. Results: Dietary selenium intake was significantly decreased in patients than in controls, and was significantly correlated with high C-reactive protein (CRP) levels and serum protein electrophoresis patterns. Additionally, oxidant/antioxidant balance was altered in patients. Conclusion: The reduction of selenium intake induces the synthesis of CRP during the acute phase response in B-cell NHL. Additionally, oxidative stress biomarkers and multi-serum proteomic models may be used for diagnosis and prognosis of the disease. Acknowledgements The authors are grateful to patients and subjects for their participation. Keywords: Inflammatory markers, non-Hodgkin lymphoma, Selenium, crp, Serum protein electrophoresis patterns Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Immune-mediated disease pathogenesis Citation: Aribi M, Zahzeh M, Hadjidj Z, Triqui C and Mesli N (2013). Relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell non-Hodgkin lymphoma. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.01106 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 19 Jul 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Mourad Aribi, Laboratory of Applied Molecular Biology and Immunology. University of Tlemcen, Tlemcen, Algeria, mourad.aribi@univ-tlemcen.dz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Mourad Aribi Meriem Rabia Zahzeh Zineb Hadjidj Chahinez Triqui Naima Mesli Google Mourad Aribi Meriem Rabia Zahzeh Zineb Hadjidj Chahinez Triqui Naima Mesli Google Scholar Mourad Aribi Meriem Rabia Zahzeh Zineb Hadjidj Chahinez Triqui Naima Mesli PubMed Mourad Aribi Meriem Rabia Zahzeh Zineb Hadjidj Chahinez Triqui Naima Mesli Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.