The most common of the monoclonal gammopathies is m____le my___a, which is
characterized by neo____c prol___tion of plasma cells or abnormal plasma cells
(m___a cells), primarily occurring in the bone m___w. Serum protein
electrophoresis (SPE) shows the presence of a m_________al
hypergammaglobulinemia while the immunoelectrophoresis (IEP) demonstrates an
increase in one of the i_________s.
Waldenstrom's macrog_______mia is characterized by an increase in the
immunoglobulin Ig_ and one of the l___t chains. The associated symptoms are
due to an increase in serum vi____ity. Hyperviscosity and sludging of blood may
lead to v____l disturbances, n_______cal symptoms, impaired k__y function, and
congestive h___t failure.
Heavy chain disease is characterized by the presence of monoclonal but
incomplete h____y chains without l____t chains in serum or urine. The heavy
chain involved may be gamma, alpha, or mu with a___a being the most common.
The key to diagnosis is the demonstration of the presence of the heavy chain
without any discernable l____t chain.
Enzyme immunoassays have emerged as qu_____ive techniques for detection of
extremely s____l quantities of antigens, haptens, and a_____s. They all employ
various e___s linked to either an antigen or antibody to form an e____e-labeled
tag which can easily be detected by measurement of the e___e activity.
The most widely used immunoassays are enzyme-linked i_________ent assay
(ELISA) and the enzyme i______ay (EIA). The principles of ELISA and EIA tests
are similar to those of r_______say (RIA) technique except e_____e activity is
measured instead of r____oactivity.
To measure antibody, antigen is fixed to a s___d phase, incubated with test
serum, and then incubated with anti-h____n globulin tagged with an enzyme
(conjugate). Substrate is then added and the enzyme activity adherent to the solid
phase is then related to the amount of a____y bound.
To measure antigen, a___y is bound to the solid phase, a test solution containing
the a____n is added, and then a second e_____e-labeled antibody (conjugate)
with specificity for the antigen being assayed is added and allowed to in____e.
Substrate is then added and measurement of e____e activity is related to the