Home
HelpTest Code BJ-24HR Immunofixation, Urine 24 Hour
Useful For
This test is useful in determining if Bence-Jones (free light chain) protein is present in the urine. Bence-Jones proteins are monoclonal kappa or lambda immunoglobulin light chains, which are not attached to a heavy chain portion of the immunoglobulin molecule. They may be seen in urine of plasma cell myeloma patients, where a monoclonal heavy chain and light chain, or just a free light chain is being produced. Bence-Jones protein may occur as a result of protein overload, where high concentrations of serum monoclonal protein appear in the urine. Free light chains may filter through the glomerulus of the kidney due to their small molecular size, and accumulate in the tubules. Renal impairment may result from the toxicity of the light chains.
Polyclonal light chains may be detected, but are not Bence-Jones proteins. The polyclonal light chains are generated by increased catabolism of polyclonal light chains in the serum. They may be found in large quantities in autoimmune diseases such as Lupus Erythothematosis and Rheumatoid Arthritis.
Synonyms/Keywords
Quantitative Light Chains, Urine Protein Electrophoresis, Kappa/Lambda Urine Light Chains, Bence-Jones Protein
Specimen Requirements
| Fasting Required | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|---|
| No | Urine, 24 hour | 24 hour Urine Jug, no preservative | Sage cup + 10 mL aliquot in Sarstedt urine aliquot tube | 10 mL aliquot from a well-mixed 24 hr collection - collected without a preservative | 10 mL aliquot | 6 mL aliquot |
Collection/Processing Instructions
Indicate the collection times. The total volume collected must be measured, recorded, and included with the test request.
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine, 24 hour | Refrigerate | 3 days |
Rejection Criteria
Specimens collected with a preservative
Test Components
Urine Protein and Bence-Jones Protein Electrophoresis
Test Information
Urine electrophoresis is performed to quantitate the kappa or lambda monoclonal light chain component if the sample is:
1) Positive for monoclonal light chains and
2) The specimen is a 24 HR collection, and
3) the urinary total protein is > 30 mg/dL
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| Marshfield | No Bence-Jones protein detected. |
Marshfield Labs Performing Department
Marshfield Labs Special Chemistry
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Friday | 6-8 hours, but if Bence-Jones protein needs to be quantitated, an addition 24 hours is required. | Agarose gel electrophoresis and immunofixation/Sebia Hydrasys System |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 84166-26 |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 84166-26 |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | Immunofixation, Urine 24Hr |