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The University of Chicago Medicine Laboratories

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Mayo Clinic Laboratories

Test Code SPEPIFE Protein Electrophoresis and Immunofixation

Specimen and Container/Tube

Specimen Type: Serum

Preferred Specimen: Serum/Gold Top

Other Acceptable specimens: Serum/Red Top

Volume

Preferred Volume: 0.5 mL

Minimum Volume: 0.2 mL

Specimen Stability

Storage Temperature

Stability

Refrigerated

3 days

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

 

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Samples should be centrifuged within 2 hours of collection.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Aliquot sample into plastic transport tube containing a minimum of 0.2 mL of specimen.
  • Samples must be sent room temperature at 15-25oC.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that are clotted or grossly hemolyzed.
  • Specimens that were transported unspun/whole blood and draw time is greater than 6 hours.

Reference Values

 

Test

Age

Sex

Reference Range

Total Protein

All

All

6.0-8.3 g/dL

Albumin

All

All

3.5-5.0 g/dL

Alpha Globulin 1

All

All

    0.10-0.40 g/dL

Alpha Globulin 2

All

All

    0.50-1.10 g/dL

Beta Globulin 1

All

All

0.50-0.70 g/dL

Beta Globulin 2

All

All

    0.10-0.50 g/dL

Gamma Globulin

All

All

    0.50-1.50 g/dL

 

Critical Values

Not applicable

Clinical Indications

  • Total protein measurements are used in the diagnosis and treatment of a variety of diseases involving the liver, kidney or bone marrow, as well as other metabolic or nutritional disorders.
  • Immunofixation Electrophoresis is a valuable method in the evaluation of disorders of the immune system. When abnormalities occur on protein electrophoresis (e.g., paraproteinemia), which are suspectedly due to changes in immunoglobins, confirmatory testing such as immunofixation electrophoresis should be performed to: 
    • Differentiate between monoclonal and polyclonal increases in immunoglobulins in serum.
    • Identify the immunoglobulin(s) involved by class and type.
    • Detect and identify intact monoclonal immunoglobulins or monoclonal free light chains (Bence Jones Proteins) in urine. 

Test Components

Total Protein, Albumin, Alpha Globulin 1, Alpha Globulin 2, Beta Globulin 1, Beta Globulin 2, Gamma Globulin, Immunoglobulin G, Immunoglobulin A, Immunoglobulin M, Kappa, Lambda

 

Methodology

Endpoint Colorimetric Assay Spectrophotometric (Roche Diagnostics)

Sebia Hydragel (HYDRASYS LC and PHORESIS) Electrophoresis System

Sebia Capillarys 3 Tera 

 

CPT Codes

84155 - Total Protein, 84165 -  Assay of protein, electrophoretic fractionation and quantitation , 86334 - Immunofixation electrophoresis 

LOINC Codes

2885-2 Total Protein, 49275-1 SPEP-IFE Interpretation

Additional Information

  • Results should always be assessed in conjunction with patient's medical history, clinical examination and other findings.
  • The total protein concentration is 0.4 to 0.8 g/dL lower when the sample is collected from a patient situated in the recumbent position rather than upright.
  • Immunofixation is indicated when resuls of immunoelectrophoresis are equivocal. Immunofixation is useful in detecting a biclonal gammopathy and is useful for recognizing a small monoclonal protein in the presence of a polyclonal increase in immunoglobulins. 
  • Clinically significant monoclonal proteins are rarely present in patients less than 30 years of age. 

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: Not available as STAT test

Routine Turnaround Time: 48 hours

Testing Schedule: Monday - Friday

Synonyms/Keyword Search

SPEP

Last Review Date

07/31/2024

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