The following table shows what most labs would consider normal results for SPEP testing. Thus, it is most often present in the blood but not in the urine. Reference Range Immunofixation consists of an electrophoresis phase and a fixation phase. 2015 May. The released hemoglobin can also bind to haptoglobin, a protein in the 2 fraction, forming a hemoglobin-haptoglobin complex that blurs the 2 and separation and may resemble a malignant peak. The precise cause of MGUS isn't known. The beta fraction has two peaks labeled beta1 and beta2. Further separation of protein subtypes is achieved by staining with an immunologically active agent, which results in immunofluorescence and immunofixation. Sasson SC, McGill K, Wienholt L, Carr A, Brown DA, Kelleher AD, et al. Immunofixation is clearly indicated upon clinical or laboratory evidence of a plasma cell dyscrasia for the diagnosis of multiple myeloma, Waldenstrom macroglobulinemia, or amyloid light-chain (AL) amyloidosis. Monoclonal gammopathies are associated with a clonal process that is malignant or potentially malignant. Please check with your financial advisor if you have more questions. Protein electrophoresis serum : Overview; [updated 2021 Aug 9; cited 2021 Aug 9]; [about 2 screens]. Am J Clin Pathol. NGS can identify mutations present in the genes of the myeloma cells. The Licensed Content is the property of and copyrighted by DSM. What does "polyclonal light chains detected but no monoclonal immunoglobilin or free light chain (bencejones) is MD presence of free light chain in urine is diagnostic of multiple myeloma.Multiple myeloma is a type of cancer that is caused by malignant plasma cells that proliferate in the bone marrow and produce abnormally high amounts. If there are not CRAB signs and/or symptoms, 60% plasma cells in the bone marrow indicates a diagnosis. It should be noted that immunoglobulins often can be found throughout the electrophoretic spectrum. A monoclonal spike (M spike or paraprotein) on serum protein electrophoresis (SPEP) is a frequent finding in the general population and typically is pathognomonic of an asymptomatic, premalignant condition called monoclonal gammopathy of undetermined significance (MGUS). After the needle is inserted, a small amount of blood will be collected into a test tube or vial. Serum protein electrophoresis is a laboratory examination that commonly is used to identify patients with multiple myeloma and other disorders of serum protein. [Full Text]. Unattached, free light chains enter the blood and are excreted rapidly in the urine. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in the serum . [10, 17], A 24-hour concentrated urine sample is appropriate for urine immunofixation. There is very little risk to having a blood test. Immunofixation can either reveal a normal pattern or identify a monoclonal protein or a polyclonal immunoglobulin pattern. People with monoclonal gammopathy generally don't experience signs or symptoms. The presence of a suspected monoclonal can lead to further testing by immunofixation electrophoresis (IFE). Blood Chemistry Tests. 11 (2):24. In healthy individuals, antibodies produced by plasma cells in the bone marrow help this process. Immunofixation tests can also be done in urine. What is the clinical application of an immunofixation test? Inflammatory diseases include. The remainder had hypogammaglobulinemia or a normal-appearing pattern. Blood. Immunoglobulins are secreted by plasma cells, a type of white blood cell in the bone marrow, in response to infection and disease. Medscape Education, 20022007195-overviewDiseases & Conditions, encoded search term (Immunofixation) and Immunofixation, Fast Five Quiz: Key Aspects of Multiple Myeloma, Fast Five Quiz: Multiple Myeloma Management, Fast Five Quiz: Relapsed/Refractory Multiple Myeloma, From War-Torn Beirut to Myeloma Research in NY, Bispecific Antibody Provides Durable Remission in Myeloma, Pathology of Mantle Cell Lymphoma: Biopsies, Diagnostic Markers, and Options for Clinicians Treating This Disease, CAR T-Cell Therapy for Relapsed/Refractory Multiple Myeloma. Fanning SR, Hussein MA. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g.
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