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2-Mercaptoethanol treatment improves measurement of an IgMkappa M-protein by capillary electrophoresis.

A recent consensus conference on monoclonal gammopathies recommended the use of high-resolution electrophoresis, which achieves crisp separation of the major β-1 (transferrin) and β-2 (C3) bands (1)(2). Capillary electrophoresis (CE) provides this degree of resolution and has an additional advantage of automating both the analysis and the presentation of serum protein electrophoresis results (3)(4)(5). We report a rare discrepancy in the CE measurement of an IgM M-protein in the serum.

The patient, a 59-year-old man, was first referred in August 1999 for evaluation of alcohol dependence, thrombocytopenia, and splenomegaly. Hemoglobin was 140 g/L, the white blood cell count was 4.7 × 109/L, and the platelet count was 54 × 109/L. A bone marrow aspirate was almost entirely plasmacytoid lymphocytes consistent with Waldenstrom macroglobulinemia. In addition to the lymphoproliferative process, the patient suffered from alcoholic hepatitis. On the day the sample …