Immunoglobulin A (IgA) Heavy and Light Chain (HLC) Pairs, ? and ? With Ratio

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CPT Code:


Test Type: 0.75 mL Serum
Stability Time:



Room temperature

14 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Reference Range:

• IgA κ (g/L): 0.48−2.82

• IgA λ (g/L): 0.36−1.98

• IgA κ:IgA λ ratio: 0.80−2.04

An elevated IgA heavy and light chain (HLC) pair ratio suggests a clonal proliferation of an IgA κ clone of plasma cells.

A low IgA HLC pair ratio suggests a clonal proliferation of an IgA λ clone of plasma cells.


For the quantitative measurement of human IgA heavy chain and light chain intact immunoglobulin in serum. The result can be used when monitoring previously diagnosed IgA multiple myeloma patients and is used in conjunction with other clinical and laboratory findings.

Heavy and light chain pair quantitation may be useful for:

1. Distinguishing between broadly migrating monoclonal proteins and restricted polyclonal immunoglobulin patterns on serum protein electrophoresis.

2. Quantitating monoclonal IgA proteins that are difficult to quantitate using serum protein electrophoresis alone.

3. Providing a more specific quantitation of the monoclonal protein than total IgA measurements alone.

Decisions on patient evaluation and management must not be given on the basis of IgA κ, IgA λ, or IgA κ:IgG λ ratio measurements alone. Clinical history and other laboratory findings must be taken into account.

Heavy and light chain (HLC) quantitation should be used as a complementary method to serum protein electrophoresis.

The effect of therapeutic drugs on the measurement of IgA κ and IgA λ by this assay has not been evaluated.

Small increases in the concentrations of monoclonal IgA proteins may not result in an altered HLC pair ratio.

Collection Details:

Patient Preparation:

Patient should be fasting for eight hours to avoid lipemic sample interference.

Collection Instructions:

Red-top tube or gel-barrier tube.

Separate serum immediately after coagulation (30 minutes) to prevent hemolysis.

Maintain specimen at room temperature.