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Microglobulin
metals such as cadmium and mercury,11
English upper urinary tract infections,8 kidney
transplantation,4 and nephrotoxicity
resulting from cyclosporin,7
Intended Use: For in vitro diagnostic use aminoglycoside9 or cis-platinum therapy.10
with the IMMULITE® and IMMULITE 1000
Elevated serum concentrations in the
Analyzers — for the quantitative
presence of a normal glomerular filtration
measurement of 2-microglobulin (2M) in
rate suggest increased 2M production or
serum and urine, as an aid in clinical
release. Increased levels may be seen in
diagnosis of active rheumatoid arthritis
lymphoproliferative diseases such as
and kidney disease.
multiple myeloma, -cell chronic
Catalog Number: LKBM1 (100 tests) lymphocytic leukemia,6 Hodgkin's disease,
Test Code: BMG Color: Orange non-Hodgkin's lymphoma;5 systemic lupus
erythematosus; rheumatoid arthritis;
Sjogren's syndrome; Crohn's disease;5
Summary and Explanation and certain viral infections, including
2-Microglobulin (2M) was first isolated in cytomegalovirus, non-A and non-B
1968 from the urine of patients with hepatitis and infectious mononucleosis.3
Wilson's disease and cadmium poisoning. Elevated serum levels have also been
It has since been identified as the light observed in some hemodialysis patients
chain of the HLA-A, -B, and -C major and in renal transplant rejection.1
histocompatibility complex antigens,
100 amino acids in length and Measurement of 2M is considered a
noncovalently associated with the heavy sensitive means for diagnosing proximal
chain. In structure and amino acid tubular dysfunction. It is reportedly the
sequence, it resembles the CH3 region of most reliable test for distinguishing upper
from lower urinary tract infections, and a
IgG, though it is antigenically distinct. 2M
useful method for assessing the results of
occurs on the surface of nucleated cells —
therapy and diagnosing recurrences of
abundantly on lymphocytes and
acute pyelonephritis using serial
monocytes — and on many tumor cell
determinations.2
lines. Its function is unknown, but it may
control the expression and biosynthesis of
antigens on the cell surface. Principle of the Procedure
Because of its low molecular weight IMMULITE/IMMULITE 1000 Beta-2
(11,800 daltons), 95 percent of all free 2M Microglobulin is a solid-phase, two-site
is rapidly eliminated by glomerular filtration. chemiluminescent immunometric assay.
Proximal tubular cells then take up Incubation Cycles: 1 × 30 minutes
99.9 percent of this filtered amount by
endocytosis, after which degradation to Specimen Collection
amino acids occurs. Normal urinary
excretion of 2M is less than Serum
370 micrograms per 24 hours; higher rates The use of an ultracentrifuge is
are interpreted as evidence of tubular recommended to clear lipemic samples.
dysfunction. Increased urinary excretion of
2M has been observed in a wide variety of Hemolyzed samples may indicate
conditions including Wilson's disease, mistreatment of a specimen before receipt
Fanconi's syndrome, untreated congenital by the laboratory; hence the results should
galactosemia, nephrocalcinosis, cystinosis, be interpreted with caution.
chronic potassium depletion, interstitial
nephritis, connective-tissue diseases such
as rheumatoid arthritis and Sjogren's
syndrome,2 occupational exposure to heavy
Means:
1,624 ng/mL (IMMULITE) Technical Assistance
1,304 ng/mL (Coat-A-Count IRMA) In the United States, contact
Method Comparison – Urine: The assay Siemens Healthcare Diagnostics
was compared to Coat-A-Count Beta-2 Technical Services department.
Microglobulin IRMA in two studies that Tel: 877.229.3711. Outside the United
included 94 and 40 urine samples. States, contact your National Distributor.
(Concentration range: approximately 13 to www.siemens.com/diagnostics
400 ng/mL. See Method Comparison –
Urine graph.) By linear regression:
The Quality System of Siemens Healthcare
(IMMULITE) = 1.28 (CAC IRMA) – 7.3 ng/mL Diagnostics Products Ltd. is certified to
r = 0.983 ISO 13485.
Means:
92 ng/mL (IMMULITE)
78 ng/mL (Coat-A-Count IRMA)
Tables and Graphs
References
1) Backman L, Ringden O, Bjorkhem I, Lindback Intraassay Precision (ng/mL)
B. Increased serum 2-microglobulin during
rejection, cyclosporin-induced nephrotoxity, and Mean1 SD2 CV3
cytomegalovirus infection in renal transplant 1 29 1.0 3.4%
recipients. Transplantation 1986;42:368–71.
2) Cooper E, Forbes M, Hammbling M. Serum 2 81 4.2 5.2%
2-microglobulin and C-reactive protein 3 192 15.1 7.9%
concentrations in viral infections. J Clin Path
1984;37:1140–3. 3) Fields B, Sollinger H, Glass
N, Carlson I, Belzer F. Beta-2-microglobulin
versus creatinine as the sole indicator of Interassay Precision (ng/mL)
rejection in renal transplants. Transplant Proc
1984;16:1591–3. 4) Forman D. Serum 2- Mean1 SD2 CV3
microglobulin as an indicator of neoplasia. J Clin
Immunoassay 1983;6:228–33. 5) Gejyo F, 1 28 2.3 8.2%
Homma N, Suzuki J, Arakawa M. Serum levels 2 74 7.5 10.1%
of 2-microglobulin as a new form of amyloid
protein in patients undergoing long-term 3 198 13.9 7.0%
hemodialysis. N Engl J Med 1986;314:585–6.
6) Peterson L. 2-Microglobulin. CCN
1988;14:6. 7) Schardijn G, Statius van Eps L.
2-Microglobulin: its significance in the
1 — 11 — — 1 8 in 8 97 — —
A 57 51 112% 4 in 8 51 49 104%
2 — 13 — — 2 8 in 8 194 — —
A 60 53 113% 4 in 8 93 97 96%
3 — 20 — — 3 8 in 8 219 — —
1 2 3 3
Dilution Observed Expected %O/E 2400
1 8 in 8 175 — — 2000
4 in 8 88 88 100% 1600
2 in 8 44 44 100%
1200
1 in 8 20 22 91%
800
2 8 in 8 188 — —
4 in 8 96 94 102% 400
400 800 1200 1600 2000 2400
2 in 8 47 47 100% CAC Beta-2 Microglobulin IRMA, ng/mL
1 in 8 22 24 92%
(IMMULITE) = 1.36 (CAC IRMA) + 146 ng/mL
3 8 in 8 213 — —
r = 0.905
4 in 8 112 107 105%
Method Comparison: Urine
2 in 8 49 53 92%
500
1 in 8 24 27 89%
IMMULITE Beta-2 Microglobulin
400
300
200
100
0
0 100 200 300 400
Serum Urin
Der Einsatz einer Ultrazentrifuge wird zur Erforderliche Menge: 5 µl Urin. (Der
Klärung von lipämischen Proben Probenträger muss mindestens 100 µl
empfohlen. Überschussvolumen enthalten.)
Bei hämolysierten Proben besteht die Besondere Hinweise: Harnblase zuerst
Möglichkeit einer unsachgemäßen entleeren, dann ein großes Glas Wasser
Handhabung vor Eintreffen im Labor, trinken. Anschließend innerhalb 1 Stunde
daher sind die Ergebnisse mit Vorsicht zu die Urinprobe sammeln. Alternativ kann,
interpretieren. entsprechend der gängigen Praxis
Mittelstrahlurin verwendet werden.
Die Zentrifugation der Serumproben vor
dem völligen Abschluss der Gerinnung Eine Vorverdünnung des Urins ist nicht
kann zu Fibringerinnseln führen. Um erforderlich, solange die enthaltene
fehlerhaften Analysenergebnissen infolge B2M-Konzentration 500 ng/ml nicht
von Gerinnseln vorzubeugen, ist übersteigt.
sicherzustellen, dass die Gerinnung vor pH Einstellung: Da Beta-2. Mikroglobulin
der Zentrifugation der Proben vollständig
pH labil ist, ist der pH-Wert der Urinproben
abgeschlossen ist. Insbesondere Proben
mit 1,0 M NaOH auf einen Wert zwischen
von Patienten unter Antikoagulantien- pH 6 und 8 einzustellen.
therapie können eine verlängerte
Gerinnungszeit aufweisen. Lagerung (nach pH-Einstellung):
2 Tage bei 2–8°C oder 2 Monate
Blutentnahmeröhrchen von verschiedenen
tiefgekühlt bei –20°C. Proben sollten nach
Herstellern können differierende Werte dem Auftauen für 10 Minuten zentrifugiert
verursachen. Dies hängt von den
werden, um eventuelle Präzipitate zu
verwendeten Materialien und Additiven
eliminieren.
(Gel oder physische Trennbarrieren,
Suero Orina
Se recomienda el uso de una Volumen de Muestra: 5 µl de orina.
ultracentrífuga para aclarar las muestras (La copa de muestra debería contener al
lipémicas. menos 100 µl más que el volumen total de
Las muestras hemolizadas podrían indicar muestra requerido.)
una mala manipulación de la muestra Instrucciones especiales: Antes de la
antes de ser recibida por el laboratorio; en recogida, vaciar la vejiga urinaria, beber
este caso, los resultados deben entonces un gran vaso de agua y recoger
interpretarse con precaución. la orina en 1 hora.
La centrifugacion de las muestras de No se necesita predilución a menos que
suero antes de que se forme el coagulo se esperen valores superiores a
puede ocasionar la presencia de fibrina. 500 ng/ml.
Para evitar resultados erroneos debidos a
la presencia de fibrina, asegurarse que se Ajuste del pH: Una vez recogidas, ajustar
ha formado el coagulo completamente el pH de todas las muestras de orina entre
antes de centrifugar las muestras. 6 y 8 con 1,0 M NaOH.
Algunas muestras, particularmente Conservación (una vez ajustado el pH):
aquellas de pacientes sometidos a terapia 2–8°C durante 2 días, o durante 2 meses
anticoagulante, pueden requerir mayor si se congelan a –20°C. Si se han
tiempo de coagulacion. congelado las muestras deben ser
Los tubos de recogida de muestra de descongeladas y centrifugadas durante
distintos fabricantes pueden producir 10 minutos para eliminar cualquier
valores diferentes, dependiendo del precipitado.
material del tubo y de los aditivos,
incluyendo barreras de gel o barreras
físicas, activadores de la coagulación y/o
anticoagulantes. El Beta-2 Microglobulina
IMMULITE/IMMULITE 1000 no ha sido
analizado con todos los distintos tipos de
tubos. Para obtener detalles sobre los
tipos tubos que se han analizado,
Médias:
2018-03-15
1 405 ng/mL (Soro) PILKBM – 18
1 356 ng/mL (Heparina)
1 412 ng/mL (SST)
cc#EU23262, cc#EU23262A, cc#EU23343
Comparação de métodos – Soro:
O ensaio foi comparado ao Beta-2
Microglobulina IRMA Coat-A-Count em
dois estudos, os quais incluíram 54 e 50
amostras de soro pré-diluidas (1 em 41)
(Faixa de Concentração:
aproximadamente 500 à 2 800 ng/ml.
Consulte o gráfico “Comparação de
Métodos: Soro”) Por regressão linear:
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