Question

Bence Jones proteinuria may be seen in:

• A. Alpha heavy chain disease
• B. Gamma heavy chain disease
• C. Mu heavy chain disease
• D. Epsilon heavy chain disease

Hint:

Look for the heavy chain disease that also secretes free light chains.

Answer 1

The Correct Option is C

Step 1: Recall what Bence Jones protein is. It is free monoclonal light chains (kappa or lambda) excreted in the urine. So Bence Jones proteinuria needs excess free LIGHT chains, even in a heavy chain disease.
Step 2: Look at the heavy chain diseases listed. In alpha and gamma heavy chain disease, the abnormal clone secretes incomplete heavy chains and free light chains are typically NOT produced, so Bence Jones proteinuria is not a feature.
Step 3: Focus on mu heavy chain disease. Mu heavy chain disease is the rarest and behaves differently. It is often associated with chronic lymphocytic leukaemia, and a characteristic finding is that the cells also secrete free kappa light chains. These appear in the urine as Bence Jones protein.
Step 4: Epsilon heavy chain disease (option D) is essentially not an established entity and is not associated with Bence Jones proteinuria.
Step 5: Therefore, among the heavy chain diseases offered, mu heavy chain disease is the one in which Bence Jones proteinuria may be seen.
Answer: C. Mu heavy chain disease.