Download - Bence Jones Protein—Urine(1).ppt
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
1/16
Bence Jones Protein—UrineBence Jones Protein—Urine
ب ن
ب ن
س ن اب ل
ن اب ل
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
2/16
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
3/16
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
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
4/16
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
5/16
• $n infants, thoroughly wash the area$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.
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
6/16
• 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.
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
7/16
• 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
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
8/16
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.
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
9/16
• 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..
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
10/16
•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
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
11/16
PreparationPre paration
• %btain a clean specimen container without%btain a clean specimen container without
preservativespreservatives
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
12/16
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..
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
13/16
Postprocedre !arePost procedre !are
• 4end the specimen to the laboratory and4end the specimen to the laboratory and
refrigeraterefrigerate..
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
14/16
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).
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
15/16
:.:. ;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.
-
8/9/2019 Bence Jones Protein—Urine(1).ppt
16/16