Serum protein electrophoresis is useful for the diagnosis and monitoring of monoclonal gammopathies. It is performed in conjunction with total protein, albumin, total immunoglobulins and serum free light chain analysis.
Protein electrophoresis alone is not considered an adequate screen for monoclonal gammopathies.
Electrophoretic Protein Pattern
M Band quantitation
Please Note: PLASMA samples are no longer accepted for Protein Electrophoresis. The presence of fibrinogen can be confused for a monoclonal band.
Ambient (8 - 24 degrees Celsius)
An interpretive comment is provided with the report.
If a monoclonal band is detected, immunofixation will be performed to identify the abnormal immunoglobulins involved. The monoclonal band will be quantitated by densitometric scanning of the gel using the perpendicular drop gating method.
A qualitatively normal but elevated gamma fraction (polyclonal increase in immunoglobulins) is consistent with infection, liver disease, or autoimmune disease.
Decreased immunoglobulins (hypogammaglobulinaemia) is consistent with immune deficiency and can also be associated with primary amyloidosis or nephrotic syndrome.
An absent or reduced alpha-1 fraction is consistent with alpha-1 antitrypsin deficiency and further testing will be suggested if clinically indicated.
A raised alpha-1 and or alpha-2 fraction are indication of a recent or current inflammatory process.
A low alpha-2 fraction can be indicative of haemolysis or liver disease. Haptoglobin testing is added if this is noted.
|Monoclonal Band Size||Uncertainty of Measurement|
|< 10 g/L||20 %|
|10 – 20 g/L||8 %|
|> 20 g/L||4 %|
|Beta migrating M Bands||20 %|
ELECTROPHORESIS - Serum proteins are separated in an electric field according to their size, shape, and electric charge. The separation is performed on agarose gels. The proteins are visualised by staining with acid blue and the intensity of staining is quantitated by densitometry. Multiplying by the serum total protein converts the percentage of protein in each fraction into a serum concentration.
IMMUNOFIXATION - Only if required- Detection and identification of abnormal immunoglobulins. Immunofixation is not usually performed if the electrophoresis pattern is normal, unless accompanied by an abnormal serum free light chain or immunoglobulin result.
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