Performance of the Sebia CAPILLARYS 2 for Detection and Immunotyping of Serum Monoclonal Paraproteins

Department of Pathology, University of Alabama, Birmingham, AL 35233, USA.
American Journal of Clinical Pathology (Impact Factor: 2.51). 09/2007; 128(2):293-9. DOI: 10.1309/1L3CG8GK6F8VYNYH
Source: PubMed


We evaluated the performance of the CAPILLARYS 2 (Sebia, Norcross, GA) capillary electrophoresis system for detection and identification of monoclonal proteins in serum samples. We analyzed 104 serum specimens by Sebia Hydragel serum protein electrophoresis (agarose gel electrophoresis [AGE]/immunofixation electrophoresis [IFE]) and CAPILLARYS 2 capillary zone electrophoresis (CZE)/immunosubtraction. AGE and CZE had sensitivities of 90% and 81%, respectively, based on IFE as the "gold standard," and all bands detected were confirmed by IFE (100% specificity). AGE and CZE had an overall agreement of 91% on serum protein electrophoresis. In the population tested, IgG was detected in 29% of samples by IFE and 30% using immunosubtraction. Similarly IgA was detected in 9% of cases by IFE and 8% by immunosubtraction. IgM and light chains were detected in 6% and 3% of cases, respectively, by IFE, whereas CZE/immunosubtraction did not detect any IgM or light chains. In our hands, AGE and CZE had the same specificity for detection of monoclonal proteins; however, CZE/immunosubtraction seems to be less sensitive than IFE for the detection of IgM and, possibly, serum light chains.

94 Reads
  • Source
    • "There are multiple published studies comparing AGE and CZE for the detection of monoclonal proteins demonstrating following sensitivity rates: 91% (95% CI 86.2– 95.6%) vs. 92% (95% CI 85.9–97.1%) by McCudden et al., 99% vs. 97% by Bossuyt et al, 87% and 90% by Bakker et al. and 90% (95% CI 81–98%) vs. 81% (95% CI 70–92%) by Yang et al. but the characterized specimens in these studies did not contain a HCD (9–12). Yang et al. report that in their study both methods “missed” samples with monoclonal IgA which often migrates in the beta region similar to our described gamma HC protein (12). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Heavy chain diseases (HCD) are neoplastic proliferations of B cells which secrete truncated immunoglobulin heavy chains without associated light chains. Being rare and probably underdiagnosed diseases the aim of this report is to show an additional case of gamma heavy chain disease in a 48 year old female patient with rheumatoid arthritis focusing on the laboratory presentation. Laboratory work-up included agarose gel electrophoresis (AGE), capillary zone electrophoresis (CZE), immunofixation and nephelometrically determined immunoglobulin and immunoglobulin subclasses of the patient's serum. Urine samples were also subjected to immunofixation and to a SDS-PAGE with consecutive immunoblot. Nephelometrically measured elevated IgG concentrations were noted in combination with a decreased gamma globulin region and an increased beta globulin region on AGE. A definite monoclonal spike was not identified on AGE but at least suspected on CZE; finally serum and urine immunofixation demonstrated a monoclonal gamma heavy chain devoid of any corresponding light chains confirming the diagnosis of HCD. Analysis of the gamma heavy chain (HC) with means of SDS-PAGE revealed proteins of 40 kD and 80 kD most likely presenting a truncated HC in its monomeric and dimeric form and possibly leading to the failure of IgG-subclass typing with the applied IgG subclass antisera. This case report illustrates a new case of gamma HCD demonstrating variable laboratory manifestations and therefore the need for heightened awareness concerning this disease when confronted with abnormal and discrepant protein profiles in routinely applied laboratory tests.
    Biochemia Medica 10/2012; 22(3):373-9. DOI:10.11613/BM.2012.039 · 2.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A turbo coded hybrid automatic repeat request (TC-HARQ) scheme is proposed based on packet combining technique and segment selective repeat. First, we demonstrate through simulation that, data combining gives substantial performance improvement over log-likelihood ratio (LLR) combining with the cost of more buffers. Second, we propose a novel retransmission strategy for TC-HARQ: segment selective repeat (SSR), which intends to select the worst corrupted part of the packet for retransmission. We show that SSR increases system throughput and has a potential to perform better with more sophisticated use of LLR.
    Wireless Communications and Networking Conference, 2004. WCNC. 2004 IEEE; 04/2004
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: With the improvement of capillary electrophoresis, much progress has been made in terms of sensitivity and automation, but the interpretation of the patterns, actually, depends totally on expert personnel. The aim of this work was to evaluate Neurosoft-Sebia, an expert system developed to discriminate between regular and anomalous serum protein electrophoresis patterns performed on Capillarys2. Neurosoft-Sebia, based on six auto-associative neural networks, was trained to create the initial knowledge base. In the tuning phase, 3000 electrophoretic patterns were performed in three different laboratories, and the discordances between human experts and Neurosoft-Sebia classifications were added to the initial knowledge base. Finally, the performances of Neurosoft-Sebia were evaluated using a benchmark dataset. The initial knowledge base was created with 2685 fractions. In the tuning phase, 241 discordances were found: 56 as regular by Neurosoft-Sebia and anomalous by human experts, and 185 as anomalous by Neurosoft-Sebia and regular by human experts. Sensitivity values were evidenced as the ability of Neurosoft-Sebia in selecting anomalous fractions, with an increase from 66.67% using the initial knowledge base to 97.40% using the enriched knowledge base. This work demonstrated how the ability of Neurosoft-Sebia in selecting anomalous pattern was comparable to that of human experts, saving time and providing rapid and standardized interpretations.
    Clinical Chemistry and Laboratory Medicine 02/2008; 46(10):1458-63. DOI:10.1515/CCLM.2008.284 · 2.71 Impact Factor
Show more


94 Reads
Available from