Sign in →

Test Code TLCU Immunoglobulin Total Light Chains, Urine

Reporting Name

Immunoglobulin Total Light Chains,U

Useful For

Monitoring patients whose urine demonstrates large M-spikes

 

Confirming the quantitation of specimens that show M-spikes by electrophoresis

 

Detecting urine monoclonal proteins and identification of specimens that need urine protein electrophoresis

Profile Information

Test ID Reporting Name Available Separately Always Performed
KTLCU Kappa Total Light Chain, U No Yes
LTLCU Lambda Total Light Chain, U No Yes
KLTRU Kappa/Lambda TLC Ratio, U No Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


If serum is being submitted on the same patient for FLCS / Immunoglobulin Free Light Chains, Serum; that test should be ordered under a different order number.



Specimen Required


Submit only 1 of the following specimens:

Supplies:  Sarstedt Aliquot Tube, 5 mL (T914)

 

Specimen Type: Random urine

Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 5-mL tube

Specimen Volume: 1 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Refrigerate after collection and send refrigerate.

 

Specimen Type: 24-Hour urine

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 1 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. No additive needed for preservation.

3. Urine may be kept ambient during the collection period but should be refrigerated within 4 hours of collection completion.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 7 days
  Frozen  20 days
  Ambient  72 hours

Reference Values

KAPPA TOTAL LIGHT CHAIN

<0.9 mg/dL

 

LAMBDA TOTAL LIGHT CHAIN

<0.7 mg/dL

 

KAPPA/LAMBDA RATIO

0.7-6.2

Day(s) Performed

Monday through Friday

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83883 x 2

Clinical Information

Immunoglobulin light chains are usually cleared from blood through the renal glomeruli and reabsorbed in the proximal tubules so that urine light-chain concentrations are very low or undetectable. The production of large amounts of monoclonal light chains, however, can overwhelm this reabsorption mechanism. The detection of monoclonal light chains in the urine (Bence Jones proteinuria) has been used as a diagnostic marker for multiple myeloma since the report by Dr. H. Bence Jones in 1847.

 

Current laboratory procedures employ protein electrophoresis and isotype testing for the identification and characterization of urine monoclonal light chains, which may be present in large enough amounts to also be quantified as an M-spike on protein electrophoresis. The electrophoretic M-spike is the recommended method of monitoring monoclonal gammopathies, such as multiple myeloma. Monitoring the urine M-spike is especially useful in patients with light-chain multiple myeloma in whom the serum M-spike is very small or absent, but the urine M-spike is large.

 

Just as quantitative serum immunoglobulins by immunonephelometry are a complement to M-spike quantitation by serum electrophoresis, this quantitative urine light-chain assay may be used to complement urine M-spike quantitation by electrophoresis.

Report Available

Same day/1 to 3 days

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Method Name

KTLCU, LTLCU: Nephelometry