Bence Jones Protein—Urine(1).ppt

8/9/2019 Bence Jones Protein—Urine(1).ppt

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Bence Jones Protein—UrineBence Jones Protein—Urine

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DefinitionDefinition

• A quantitative BenceA quantitative Bence--Jones protein testJones protein test

measures the specific level of abnormalmeasures the specific level of abnormal

proteinsproteins ((BenceBence--Jones proteinsJones proteins)) in yourin your

urineurine

• Alternative Names Alternative Names

• Immunoglobulin light chains - urine;Immunoglobulin light chains - urine;Urine Bence-Jones proteinUrine Bence-Jones protein


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• $n infants, thoroughly wash the area$n infants, thoroughly wash the area

around the urethraaround the urethra.. %pen a urine collection%pen a urine collection

bagbag ((a plastic bag with an adhesive papera plastic bag with an adhesive paperon one endon one end)), and place it on your infant, and place it on your infant..

&or boys, the entire penis can be placed in&or boys, the entire penis can be placed in

the bag and the adhesive attached to thethe bag and the adhesive attached to the

s'ins'in.. &or girls, the bag is placed over the&or girls, the bag is placed over the

labialabia.. lace a diaper over the infantlace a diaper over the infant ((bagbagand alland all).).

• hec' your baby fre*uently and removehec' your baby fre*uently and remove

the bag after the infant has urinated into it.the bag after the infant has urinated into it.

&or active infants, this procedure may ta'e&or active infants, this procedure may ta'ea couple of attempts -- lively infants cana couple of attempts -- lively infants can

displace the bag. he urine is drained intodisplace the bag. he urine is drained into

a container for transport bac' to the healtha container for transport bac' to the health

care provider.care provider.


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• How the Test Will Feel How the Test Will Feel

•he test involves only normal urination,and there is no discomfort.

• Why the Test is Performed Wh

y the Test is Performed

• +ence-ones proteins are relatively small+ence-ones proteins are relatively smalland are filtered out by the 'idneys. hisand are filtered out by the 'idneys. histest is done to help diagnose medicaltest is done to help diagnose medicalconditions that lead to protein in the urineconditions that lead to protein in the urine

((proteinuria).proteinuria).• our doctor may also order this test whenour doctor may also order this test when

your urine protein level is high or if youyour urine protein level is high or if youhave other signs ofhave other signs of multiple myelomamultiple myeloma.


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• Normal esultsNormal esults

• A normal result means no +ence-ones

proteins are found in your urine.• !hat Abnormal esults "ean!hat Abnormal esults "ean

• +ence-ones proteins are rarely found in

urine. $f they are, it is usually associated

with multiple myeloma.• An abnormal result may also be due to

Waldenstroms macroglobulinemia, chronicWaldenstroms macroglobulinemia, chronic

lymphocytic leu'emia, or amyloidosislymphocytic leu'emia, or amyloidosis.

• #onsi$erations#onsi$erations• /rine immunofi0ation/rine immunofi0ation is the best test for

detecting +ence-ones proteins


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test test

• NormalNormal

• 1egative1egative

• %ositive%ositive

• Amyloidosis (primary), benign monoclonal Amyloidosis (primary), benign monoclonalgammopathy, cryoglobulinemia, &anconigammopathy, cryoglobulinemia, &anconi

syndrome (adult), hyperparathyroidism,syndrome (adult), hyperparathyroidism,

multiple myeloma (high levels indicatemultiple myeloma (high levels indicate

poor prognosis), osteomalacia, andpoor prognosis), osteomalacia, and

Waldenstr2ms macroglobulinemiaWaldenstr2ms macroglobulinemia.


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• A low A low--molecular molecular --weight, lightweight, light--chainchain

immunoglobulin synthesi3ed by malignantimmunoglobulin synthesi3ed by malignantplasma cells in the bone marrow andplasma cells in the bone marrow and

initially bro'en down and reabsorbed byinitially bro'en down and reabsorbed by

the 'idneysthe 'idneys..

• $n multiple myeloma, such a large$n multiple myeloma, such a large

amount of these proteins are producedamount of these proteins are produced

that they e0ceed the 'idneys capacity tothat they e0ceed the 'idneys capacity to

metaboli3e themmetaboli3e them..


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•his causes them to spill into the urinehis causes them to spill into the urine..rolonged production of +ence onesrolonged production of +ence ones

protein eventually causes degeneration ofprotein eventually causes degeneration of

the renal tubular cells, and the proteinthe renal tubular cells, and the protein

accumulates in the tubules, causingaccumulates in the tubules, causing

inclusions that may lead to renal failureinclusions that may lead to renal failure..

• 4ubse*uently, increasing amounts of the4ubse*uently, increasing amounts of the

protein spill into the urine and can beprotein spill into the urine and can be

detected by thermal coagulation and aciddetected by thermal coagulation and acidtests and confirmed bytests and confirmed by

immunoelectrophoresisimmunoelectrophoresis


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PreparationPre paration

• %btain a clean specimen container without%btain a clean specimen container without

preservativespreservatives


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ProcedreProcedre

• %btain a "5-m6 first morning%btain a "5-m6 first morning--voided,voided,

random urine specimen in a cleanrandom urine specimen in a clean

container container .. A fresh specimen may be ta'en A fresh specimen may be ta'en

from a urinary drainage bagfrom a urinary drainage bag..


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Postprocedre !arePost procedre !are

• 4end the specimen to the laboratory and4end the specimen to the laboratory and

refrigeraterefrigerate..


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Factors That Affect "esltsFactors That Affect "eslts

!.!. &ailure to refrigerate the specimen may&ailure to refrigerate the specimen mayresult in false-negative results.result in false-negative results.

".". &alse-positive results may be caused by&alse-positive results may be caused bychronic renal insufficiency, connectivechronic renal insufficiency, connectivetissue diseases (such as rheumatoidtissue diseases (such as rheumatoidarthritis, systemic lupus erythematosusarthritis, systemic lupus erythematosus

74689, scleroderma, polymyositis, or74689, scleroderma, polymyositis, orWegeners granulomatosis), and otherWegeners granulomatosis), and othermalignancies (lymphoma, leu'emia, andmalignancies (lymphoma, leu'emia, andmetastatic cancer of the lung or of themetastatic cancer of the lung or of thegastrointestinal or genitourinary tracts).gastrointestinal or genitourinary tracts).


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:.:. ;rugs that may cause false-positive;rugs that may cause false-positive

results include aminosalicylic acid,results include aminosalicylic acid,cephaloridine, chlorproma3ine, penicillincephaloridine, chlorproma3ine, penicillin

(high doses), proma3ine hydrochloride,(high doses), proma3ine hydrochloride,

sulfiso0a3ole, and tolbutamide.sulfiso0a3ole, and tolbutamide.


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Bence Jones Protein—Urine(1).ppt

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