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Test ID SPEP Electrophoresis, Protein, Serum


Ordering Guidance


Protein electrophoresis alone is not considered an adequate screen for monoclonal gammopathies. When screening a patient or establishing a first-time diagnosis for a monoclonal gammopathy, consider ordering DMOGA / Monoclonal Gammopathy, Diagnostic, Serum instead, which includes free light chain analysis and isotyping by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS).

 

If free light chain testing has already been performed locally, PEISO / Protein Electrophoresis and Isotype, Serum may be ordered instead of DMOGA / Monoclonal Gammopathy, Diagnostic, Serum for a first-time diagnosis.

 

For monitoring patients with a diagnosis of monoclonal gammopathy, order TMOGA / Monoclonal Gammopathy, Monitoring, Serum.



Necessary Information


Indicate if multiple myeloma is suspected.



Specimen Required


Patient Preparation: Fasting (12 hour) preferred but not required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Useful For

Screening patients with suspected monoclonal gammopathies

 

Diagnosis of monoclonal gammopathies, when used in conjunction with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and free light chain analysis

Profile Information

Test ID Reporting Name Available Separately Always Performed
TPE Total Protein Yes, (Order TP) Yes
SPE Protein Electrophoresis No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IFXED Immunofixation Delta and Epsilon, S Yes No
MPTS M-protein Isotype MALDI-TOF MS, S Yes, (Order MALD) No

Testing Algorithm

This test includes total protein and serum protein electrophoresis.

 

If a discrete electrophoresis band is identified, the laboratory will evaluate the serum protein electrophoresis and, if necessary, perform M-protein isotype at an additional charge.

 

If a light chain is identified without a corresponding heavy chain during initial testing, immunofixation with IgD and IgE antisera will be performed at an additional charge.

 

The following algorithms are available:

-Amyloidosis: Laboratory Approach to Diagnosis

-Multiple Myeloma: Laboratory Screening

Method Name

TPE: Colorimetric, Biuret

SPE: Agarose Gel Electrophoresis

Reporting Name

Electrophoresis, Protein, S

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  7 days

Reference Values

≥1 year: 6.3-7.9 g/dL

Reference values have not been established for patients that are younger than 12 months of age.

 

PROTEIN ELECTROPHORESIS

Albumin: 3.4-4.7 g/dL

Alpha-1-globulin: 0.1-0.3 g/dL

Alpha-2-globulin: 0.6-1.0 g/dL

Beta-globulin: 0.7-1.2 g/dL

Gamma-globulin: 0.6-1.6 g/dL

An interpretive comment is provided with the report.

Reference values have not been established for patients that are younger than 16 years of age.

Day(s) Performed

Monday through Friday

Report Available

2 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

84155

84165

0077U (if appropriate)

86334 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SPEP Electrophoresis, Protein, S 24351-9

 

Result ID Test Result Name Result LOINC Value
TPE Total Protein 2885-2
602837 Albumin 2862-1
602838 Alpha-1 Globulin 2865-4
602839 Alpha-2 Globulin 2868-8
602840 Beta-Globulin 2871-2
602841 Gamma-Globulin 2874-6
602842 A/G Ratio 44429-9
602843 M spike 51435-6
602844 M spike 35559-4
602836 Impression 49296-7

Special Instructions

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Renal Diagnostics Test Request (T830)