Immunoglobulin G (IgG) Heavy and Light Chain (HLC) Pairs, κ and λ With Ratio

CPT: 83521(x2)
Print Share


  • Hevylite IgG
  • HLC IgG
  • IgG κ:λ HLC Ratio

Related Documents

For more information, please view the literature below.

Published Plasma Cell Dyscrasias Selection Table

Specimen Requirements




0.75 mL

Minimum Volume

0.5 mL


Red-top tube or gel-barrier tube


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

Storage Instructions


Stability Requirements



Room temperature

14 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Microbially-contaminated specimen; specimen containing particulate matter; lipemic or hemolyzed specimen

Test Details


For the quantitative measurement of human IgG heavy chain and light chain intact immunoglobulin in serum. The IgG HLC ratio can be used when monitoring previously diagnosed IgG multiple myeloma in conjunction with other laboratory tests and clinical evaluations.

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 IgG proteins that are difficult to quantitate using serum protein electrophoresis alone.

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


Decisions on patient evaluation and management must not be given on the basis of IgG κ, IgG λ, or IgG 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 IgG κ and IgG λ by this assay has not been evaluated.

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

For initial detection of monoclonal proteins, see:

Immunofixation (IFE), Serum and Protein Electrophoresis, Serum [001495]

Immunofixation (IFE), Serum, Protein Electrophoresis (PE), Serum, and Quantitative Free κ and λ Light Chains (FLC) Plus Ratio, Serum [120256]

Immunofixation (IFE) and Protein Electrophoresis, 24-Hour Urine [003467]



Reference Interval

• IgG κ (g/L): 4.03−9.78

• IgG λ (g/L): 1.97−5.71

• IgG κ:IgG λ ratio: 0.98−2.75

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

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

Additional Information

Elevated serum concentrations of monoclonal protein are indicative of an underlying abnormality, such as monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, and other lymphoproliferative disorders. International guidelines recommend serum protein electrophoresis or nephelometric immunoglobulin quantification as tools to monitor patients' disease1 (alongside other tests including flow cytometry and serum free light chain analysis).2 Total IgG nephelometric assays will include nontumor immunoglobulin, and measurement of either IgG κ or IgG λ may give a more accurate representation of tumor production.

Furthermore, measurement of both IgG κ and IgG λ, calculation of the IgG κ:IgG λ ratio, and comparison with values found in normal subjects can give a more sensitive indication of clonality.3-5 Additionally, changes in the IgG κ:IgG λ ratio and its normalization when compared to a normal ratio range should assist in monitoring patients' disease. Use of the IgG κ:IgG λ ratio will also compensate for any changes in plasma volume and correct for half life variations due to receptor saturation.


1. Dimopoulos M, Kyle R, Fermand JP, et al. Consensus recommendations for standard investigative workup: Report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011 May 5; 117(18):4701-4705. 21292778
2. Rajkumar SV, Harousseau JL, Durie B, et al. Concensus recommendations for the uniform reporting of clinical trials: Report of the International Myeloma Workshop Consensus Panel 1. Blood. 2011 May 5; 117(18):4691-4695. 21292775
3. Bradwell AR, Harding SJ, Fourrier NJ, et al. Assessment of monoclonal gammopathies by nephelometric measurement of individual immunoglobulin kappa/lambda ratios. Clin. Chem. 2009 Sep; 55(9):1646-1655. 19617289
4. Ludwig H, Milosavljevic D, Zojer N, et al. Immunoglobulin heavy/light chain ratios improve paraprotein detection and monitoring, identify residual disease and correlate with survival in multiple myeloma patients. Leukemia. 2013 Jan; 27(1):213-219. 22955329
5. Bradwell A, Harding S, Fourrier N, et al. Prognostic utility of intact immunoglobulin Ig'κ/Ig'λ ratios in multiple myeloma patients. Leukemia. 2013 Jan; 27(1):202-207. 22699454


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123550 IgG Heavy Light Chains(HLC), S 123534 IgG Kappa, S g/L 74862-4
123550 IgG Heavy Light Chains(HLC), S 123535 IgG Lambda, S g/L 74863-2
123550 IgG Heavy Light Chains(HLC), S 123536 IgG K/L HLC Ratio Ratio 74868-1

For Providers

Please login to order a test

Order a Test

© 2021 Laboratory Corporation of America® Holdings and Lexi-Comp Inc. All Rights Reserved.

CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at Additional information regarding LOINC® codes can be found at, including the LOINC Manual, which can be downloaded at