CLIENT CODE : C000027050 Cert. No.

M-0025

CLIENT'S NAME AND ADDRESS : SRL LIMITED

HEALTH CENTRE PRIME SQUARE BUILDING,PLOT NO 1,GAIWADI INDUSTRIAL
D-8, BASEMENT, HAUZ KHAS, ESTATE,S.V. ROAD,GOREGAON (W)
MUMBAI, 400062
DELHI 110016 MAHARASHTRA, INDIA
DELHI INDIA Tel : 1-800-222-000,1-800-102-8282, Fax : 022 - 67801212
9212443644 09212443644 CIN - U74899PB1995PLC045956
Email : connect@srl.in

PATIENT NAME : USHA LATA SAXENA PATIENT ID : USHAF605417620

ACCESSION NO : 0009QE063302 AGE : 56 Years SEX : Female DATE OF BIRTH :

DRAWN : 29/05/2017 00:00 RECEIVED : 29/05/2017 16:15 REPORTED : 31/05/2017 19:38

REFERRING DOCTOR : DR. AIIMS CLIENT PATIENT ID :

Test Report Status Preliminary Results Biological Reference Interval Units

COMPREHENSIVE MYELOMA PROTEIN PANEL

(5040)
PROTEIN ELECTROPHORESIS, SERUM
TOTAL PROTEIN 7.7 6.4 - 8.2 g/dL
ALBUMIN 2.53 Low 3.2 - 4.6 g/dL
ALPHA 1 0.31 0.15 - 0.33 g/dL
ALPHA 2 0.71 Low 0.72 - 1.06 g/dL
BETA 0.65 Low 0.74 - 1.06 g/dL
GAMMA 3.51 High 0.91 - 1.71 g/dL
MYELOMA BAND *SEE COMMENT* NOT DETECTED

Serum Protein Histogram, From Fully Automated Sebia Electrophoresis System

IMMUNOFIXATION EP, SERUM
MYELOMA BAND M-BAND NOT NOT DETECTED
DETECTED. SEE
COMMENT.
IGG BAND POSITIVE NOT DETECTED
IGM BAND NOT DETECTED NOT DETECTED

Page 1 Of 4
CLIENT CODE : C000027050 Cert. No. M-0025

CLIENT'S NAME AND ADDRESS : SRL LIMITED

HEALTH CENTRE PRIME SQUARE BUILDING,PLOT NO 1,GAIWADI INDUSTRIAL
D-8, BASEMENT, HAUZ KHAS, ESTATE,S.V. ROAD,GOREGAON (W)
MUMBAI, 400062
DELHI 110016 MAHARASHTRA, INDIA
DELHI INDIA Tel : 1-800-222-000,1-800-102-8282, Fax : 022 - 67801212
9212443644 09212443644 CIN - U74899PB1995PLC045956
Email : connect@srl.in

PATIENT NAME : USHA LATA SAXENA PATIENT ID : USHAF605417620

ACCESSION NO : 0009QE063302 AGE : 56 Years SEX : Female DATE OF BIRTH :

DRAWN : 29/05/2017 00:00 RECEIVED : 29/05/2017 16:15 REPORTED : 31/05/2017 19:38

REFERRING DOCTOR : DR. AIIMS CLIENT PATIENT ID :

Test Report Status Preliminary Results Biological Reference Interval Units

IGA BAND NOT DETECTED NOT DETECTED

KAPPA BAND POSITIVE NOT DETECTED
LAMBDA BAND POSITIVE NOT DETECTED
Comments

NOTE: DIFFUSE BAND IS SEEN IN THE GAMMA GLOBULIN REGION.

IMMUNOGLOBULIN, SERUM
TOTAL IGA 10.90 High 0.52 - 4.68 g/L
METHOD : NEPHELOMETRY, PARTICLE- ENHANCED IMMUNONEPHELOMETRY

TOTAL IGG 27.30 High 6.5 - 16.4 g/L

METHOD : NEPHELOMETRY, PARTICLE- ENHANCED IMMUNONEPHELOMETRY

TOTAL IGM 2.62 0.39 - 3.38 g/L

METHOD : NEPHELOMETRY, PARTICLE- ENHANCED IMMUNONEPHELOMETRY

SERUM LIGHT CHAINS (KAPPA & LAMBDA) RESULT PENDING

B2-MICROGLOBULIN, SERUM
B2-MICROGLOBULIN 17420.0 High 609.0 - 2366.0 ng/mL
METHOD : CHEMILUMINESCENCE, SOLID PHASE TWO SITE CHEMILUMINESCENT IMMUNOMETRIC ASSAY

Intepretation(s)
PROTEIN ELECTROPHORESIS, SERUM-
SERUM PROTEIN SERUM IMMUNOFIXATION RESULT
ELECTROPHORESIS ELECTROPHORESIS
1. M band detected or One heavy chain (IgM/IgG/IgA) Suggestive of Monoclonal Gammopathy
Discrete band detected with one light chain (K/L).

2. Thin discrete/Very One heavy chain (IgM/IgG/IgA) Suspicious/poorly defined band. The level or spike
thin discrete band band with one light chain (K/L) is too low to quantify or to call it a definite M band.
Such suspected cases of unknown significance
(MGUS, Smouldering myeloma) requires follow ups in
3-6 months. This pattern may also be a case of
myeloma on therapy.
3. M band/Discrete/ Either K/L chain only, no heavy 1. Light chain disease, suggest urine immunofixation.
Thin discrete band chain band 2. IgD or IgE disease
3. Multiple bands in kappa/lambda region indicates
Polymerized form.
4. Discrete/Thin Only heavy chain with no Heavy chain disease should be ruled out. Suggested
discrete band apparent light chain Immunoselection.

5. Very thin Only heavy chain with no Cryoglobulin

discrete band apparent light chain

6. 2 M bands/ 2 2 bands with same or different 1. Biclonal gammopathy

discrete bands heavy chains and 2 bands with
same or different light chains.
7. A diffuse band in One or more heavy chains
gamma globulin with both light chains
region (K and L) bands
2. Paraprotein (monomer/polymer of
immunoglobulins)
Usually indicates a polyclonal gammopathy e.g. TB,
Hepatitis, SLE, AIDS, and some autoimmune
disorders.

8. Thin/ Very thin One heavy chain The free light chain is to ascess renal function. A
discrete bands with one light chain urine immunofixation electrophoresis is
and a different free light recommended to know if there are free light
chain band chains in the urine or even worse if there are
heavy chains. Light chains are an indication that
. the tubules are malfunctioning.
IMMUNOFIXATION EP, SERUM-
SERUM PROTEIN SERUM IMMUNOFIXATION RESULT
ELECTROPHORESIS ELECTROPHORESIS
1. M band detected or One heavy chain (IgM/IgG/IgA) Suggestive of Monoclonal Gammopathy

Page 2 Of 4
CLIENT CODE : C000027050 Cert. No. M-0025

CLIENT'S NAME AND ADDRESS : SRL LIMITED

HEALTH CENTRE PRIME SQUARE BUILDING,PLOT NO 1,GAIWADI INDUSTRIAL
D-8, BASEMENT, HAUZ KHAS, ESTATE,S.V. ROAD,GOREGAON (W)
MUMBAI, 400062
DELHI 110016 MAHARASHTRA, INDIA
DELHI INDIA Tel : 1-800-222-000,1-800-102-8282, Fax : 022 - 67801212
9212443644 09212443644 CIN - U74899PB1995PLC045956
Email : connect@srl.in

PATIENT NAME : USHA LATA SAXENA PATIENT ID : USHAF605417620

ACCESSION NO : 0009QE063302 AGE : 56 Years SEX : Female DATE OF BIRTH :

DRAWN : 29/05/2017 00:00 RECEIVED : 29/05/2017 16:15 REPORTED : 31/05/2017 19:38

REFERRING DOCTOR : DR. AIIMS CLIENT PATIENT ID :

Test Report Status Preliminary Results Biological Reference Interval Units

Discrete band detected with one light chain (K/L).

2. Thin discrete/Very One heavy chain (IgM/IgG/IgA) Suspicious/poorly defined band. The level or spike
thin discrete band band with one light chain (K/L) is too low to quantify or to call it a definite M band.
Such suspected cases of unknown significance
(MGUS, Smouldering myeloma) requires follow ups in
3-6 months. This pattern may also be a case of
myeloma on therapy.
3. M band/Discrete/ Either K/L chain only, no heavy 1. Light chain disease, suggest urine immunofixation.
Thin discrete band chain band 2. IgD or IgE disease
3. Multiple bands in kappa/lambda region indicates
Polymerized form.
4. Discrete/Thin Only heavy chain with no Heavy chain disease should be ruled out. Suggested
discrete band apparent light chain Immunoselection.

5. Very thin Only heavy chain with no Cryoglobulin

discrete band apparent light chain

6. 2 M bands/ 2 2 bands with same or different 1. Biclonal gammopathy

discrete bands heavy chains and 2 bands with
same or different light chains.
7. A diffuse band in One or more heavy chains
gamma globulin with both light chains
region (K and L) bands
2. Paraprotein (monomer/polymer of
immunoglobulins)
Usually indicates a polyclonal gammopathy e.g. TB,
Hepatitis, SLE, AIDS, and some autoimmune
disorders.

8. Thin/ Very thin One heavy chain The free light chain is to ascess renal function. A
discrete bands with one light chain urine immunofixation electrophoresis is
and a different free light recommended to know if there are free light
chain band chains in the urine or even worse if there are
heavy chains. Light chains are an indication that
. the tubules are malfunctioning.
IMMUNOGLOBULIN, SERUM-Useful For detecting or monitoring of monoclonal gammopathies and immune deficiencies
Clinical Information
The gamma globulin band as seen in conventional serum protein electrophoresis consists of 5 immunoglobulins. In normal serum, about 80% is immunoglobulin G (IgG),
15% is immunoglobulin A (IgA), 5% is immunoglobulin M (IgM), 0.2% is immunoglobulin D (IgD), and a trace is immunoglobulin E (IgE).

Elevations of IgG, IgA, and IgM may be due to polyclonal immunoglobulin production.

Monoclonal gammopathies of all types may lead to a spike in the gamma globulin zone seen on serum protein electrophoresis. Monoclonal elevations of IgG, IgA, IgD, and IgE
characterize multiple myeloma. Monoclonal elevations of IgM occur in macroglobulinemia.

Decreased immunoglobulin levels are found in patients with congenital deficiencies

Serum IgG levels are decreased in several immunodeficiencies. In congenital hypogammaglobulinemia IgG is less than 200 MG/DL by 6 months of age.
Acquired hypogammaglobulinemia may occur at any age and has IgG levels less than 500 MG/DL. IgG levels may also be decreased in combined cell-mediated and antibody
immunodeficiencies. Lymphocyte phenotype and function studies may be helpful in evaluation of immunodeficiencies. Suspected paraproteinemias should be screened for
with immuno electrophoresis. Selective deficiency of one or more IgG subclasses is associated with a variety of recurrent infections or asthma.

Total IgM evaluates humoral immunity establishes the diagnosis and monitors therapy in Macroglobulinemia of Waldenstrom & Plasma Cell Myeloma. IgM levels are used to
evaluate likehood of in utero infections or acuteness of infections.

IgA deficiency is the most common of the primary immunodeficiency diseases. It can be induced by drug such as penicillamine, phenytoin, sulfasalzine & captoril. IgA
deficiency is also seen in autoimmune diseases.
Polymeric IgA is found in conditions resulting in parenchymal liver damage, IgA Nephropathy, utreated Coeliac Disease, Chronic bronchial suppurative disorders, herpes
Simplex, Encephalites, Herpes zoster, Mumps & Meningitis.
B2-MICROGLOBULIN, SERUM-
Beta-2 Microglobulin (2M) has been identified as the light chain of the HLA-A, -B, and -C major histocompatibility complex antigens, 100 amino acids in length and
noncovalently associated with the heavy chain.

2M occurs on the surface of nucleated cells- abundantly on lymphocytes and monocytes- and on many tumor cell lines. Its function is unknown, but it may control the
expression and on the cell surface.

Elevated serum concentrations in the presence of a normal glomerular filtration rate suggest increased 2M production or release. Increased levels may be seen in
lymphoproliferative diseases such as multiple myeloma, - cell chronic lymphocytic leukemia, Hodgkin's diseases, non- hodgkin's lymphoma, systemic lupus erythematosus,
rheumatoid arthritis, Sjogren's syndrome, Crohn's disease, and certain viral infections, including cytomegalovirus, non-A and non-B hepatitis and infectious mononucleosis.
Elevated serum levels have also been observed in some hemodialysis patients and in renal transplant rejection.

Measurement of 2M is considered a sensitive means for diagnosing proximal tubular dysfunction, It is reportedly the most reliable test for distinguishing upper from lower
urinary tract infections, and a useful method for assessing the results of therapy and diagnosing recurrences of acute pyelonephritis using serial determinations.
**End Of Report**
Please visit www.srlworld.com for related Test Information for this accession

Page 3 Of 4

Dr. Kshama P, MD
CLIENT CODE : C000027050 Cert. No. M-0025

CLIENT'S NAME AND ADDRESS : SRL LIMITED

HEALTH CENTRE PRIME SQUARE BUILDING,PLOT NO 1,GAIWADI INDUSTRIAL
D-8, BASEMENT, HAUZ KHAS, ESTATE,S.V. ROAD,GOREGAON (W)
MUMBAI, 400062
DELHI 110016 MAHARASHTRA, INDIA
DELHI INDIA Tel : 1-800-222-000,1-800-102-8282, Fax : 022 - 67801212
9212443644 09212443644 CIN - U74899PB1995PLC045956
Email : connect@srl.in

PATIENT NAME : USHA LATA SAXENA PATIENT ID : USHAF605417620

ACCESSION NO : 0009QE063302 AGE : 56 Years SEX : Female DATE OF BIRTH :

DRAWN : 29/05/2017 00:00 RECEIVED : 29/05/2017 16:15 REPORTED : 31/05/2017 19:38

REFERRING DOCTOR : DR. AIIMS CLIENT PATIENT ID :

Test Report Status Preliminary Results Biological Reference Interval Units

Page 4 Of 4