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Protein Electrophoresis (Serum)

Specimen Required

3-5cc Clotted Blood or Serum

Fasting Required

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Purpose of the Test

To help diagnose and monitor tumours of the antibody producing cells (B lymphocytes) and to diagnose and monitor deficiencies of the immune system

When this test is required

Protein electrophoresis may be requested when a doctor is investigating symptoms that suggest multiple myeloma, such as bone pain, anaemia, tiredness, unexplained fractures, and recurrent infections. It may also be used as a follow-up to other laboratory tests, such as an abnormal total protein and/or albumin level, elevated urine protein levels, elevated calcium levels, and low white or red blood cell counts. Immunofixation electrophoresis is usually ordered when the protein electrophoresis test shows the presence of an abnormal protein band that may be an immunoglobulin.Electrophoresis tests are most frequently requested when a doctor suspects a disease or condition that causes a monoclonal protein to be produced. Once a disease or condition has been diagnosed, electrophoresis may be used at regular intervals to monitor the course of the disease and the effectiveness of treatment. As disease progresses, the amount of protein goes up; with treatment, it goes down. Monoclonal protein production may be due to a malignant disease, such as multiple myeloma, but it may also be due to a monoclonal gammopathy of undetermined significance (MGUS). Most patients with MGUS have no symptoms, but they must continue to be monitored regularly as some may develop multiple myeloma after a number of years.Serum protein electrophoresis may also be used when symptoms suggest an inflammatory condition, an autoimmune disease, an acute or chronic infection, a kidney or liver disorder, or a protein-losing condition, even if the total protein and/or albumin concentrations are apparently normal. Urine protein electrophoresis may be used when there is protein detected in the urine or when the doctor suspects a monoclonal protein may be present.

What the Test Detects

Protein electrophoresis is a method for separating the proteins found in blood (serum) or urine. During the test, an electric current is used to move the proteins across a thin layer of agarose gel. The distances that individual proteins travel depend on their size, shape, and electrical charge. These separated proteins may be detected by the use of a dye that binds to (stains) all of the proteins and reveals a characteristic…Protein electrophoresis is a method for separating the proteins found in blood (serum) or urine. During the test, an electric current is used to move the proteins across a thin layer of agarose gel. The distances that individual proteins travel depend on their size, shape, and electrical charge. These separated proteins may be detected by the use of a dye that binds to (stains) all of the proteins and reveals a characteristic pattern of bands. Each band indicates the presence of a particular protein or group of proteins, while the size of the band is a rough indication of the quantity. This pattern of bands is converted into a visual graph, showing vertical spikes or peaks where there is a lot of protein and smaller peaks or valleys where there is less. A newer method called capillary zone electrophoresis (CZE) separates proteins by passing them through a long, thin column, producing a graph that is very similar to the one made by running the protein through an agarose gel.Specific proteins of interest can be identified by separating the proteins by gel electrophoresis and then adding an antibody. The antibody can recognise individual proteins and sticks to them making a big complex that gets caught in the gel. All the other proteins in the system are washed away and the gel stained so the proteins in question can be identified. This procedure is called immunofixation electrophoresis (IFE).Serum proteins are separated into six major groupings by protein electrophoresis. These fractions are called albumin, alpha 1, alpha 2, beta 1, beta 2 and gamma. Albumin, which is produced in the liver, forms its own group and accounts for about 60% of the protein in the blood. ‘Globulins’ is a collective term used to refer to proteins other than albumin. With the exception of the immunoglobulins and some complement proteins, most of the globulins are produced in the liver. These groups are described more fully in the table below, Protein Groups.The bands seen on protein electrophoresis form characteristic patterns. Alterations to these patterns are associated with a variety of different diseases and conditions. For example in multiple myeloma (a cancer of certain types of white blood cells called plasma cells), the uncontrolled growth and division of a malignant plasma cell leads to the production of large amounts of a single type of immunoglobulin (antibody). In contrast to other proteins in serum, which are typically of a single type, antibodies (immunoglobulins) must differ from each other to be able to recognise bacteria, viruses and other ‘foreign’ substances. Each time the body is exposed to a virus, for example, one plasma cell replicates and makes a group (or clone) of plasma cells to produce antibody to eliminate it. Since our total immunoglobulin represents antibody made by many clones, we refer to it as a polyclonal pattern. When there is a cancer of plasma cells, only one type of antibody is produced, termed a monoclonal pattern. This abnormal protein can be seen as a characteristic band on the electrophoresis gel. How is the sample collected for testing? A blood sample is obtained by inserting a needle into a vein in the arm. Sometimes a random or 24-hour urine sample is required. Is any test preparation needed to ensure the quality of the sample? No test preparation is needed. See MoreSee Less

Preparation for the Test

None

Sample Requirements

A blood sample taken from a vein in your arm; sometimes a random or 24-hour urine sample

Additional Notes

Immunisations within the previous six months can increase immunoglobulins as can drugs such as phenytoin (Dilantin), procainamide, oral contraceptives, methadone, and therapeutic gamma globulin.Aspirin, bicarbonates, chlorpromazine (Thorazine), corticosteroids, and neomycin can affect protein electrophoresis results.