24 Resolution of Discrepant Results in Serum Protein Electrophoresis and Immunofixation Electrophoresis
Abstract Introduction Serum protein electrophoresis (SPEP) from a 77-year-old male patient and a 33-year-old female patient showed an abnormal SPEP pattern with a M-spike in the beta region. The 77-year-old male patient had a 1 g/dL (17.6%) densitometer result in the beta fraction (normal range for...
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Published in | American journal of clinical pathology Vol. 149; no. suppl_1; p. S10 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
US
Oxford University Press
11.01.2018
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Subjects | |
Online Access | Get full text |
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Summary: | Abstract
Introduction
Serum protein electrophoresis (SPEP) from a 77-year-old male patient and a 33-year-old female patient showed an abnormal SPEP pattern with a M-spike in the beta region. The 77-year-old male patient had a 1 g/dL (17.6%) densitometer result in the beta fraction (normal range for beta fraction 0.6–1.3 g/dL) and the 33-year-old female patient had a 1.1 g/dL (14%) densitometer result in the beta fraction. These abnormal patterns were followed by an immunofixation electrophoresis (IFE), which did not reveal a distinctive monoclonal band in either patient.
Methods
Although neither patient’s samples appeared to show visible hemolysis, the samples were treated and incubated 1:1 with commercial thrombin reagent. Samples clotted after incubation with the thrombin, and a clot was removed from the sample. SPEP was repeated, and the initial M-spike in the beta region was not seen in the new SPEP.
Conclusions
A variety of other proteins besides monoclonal proteins may contaminate a serum protein electrophoresis sample. Hemolysis causes decreased alpha-2 band (haptoglobin), and appearance of a hemoglobin band between the alpha-2 and beta-1 regions. Treatment of the sample with thrombin prior to electrophoresis resulted in a normal SPEP pattern and resolution of the discrepancies, and eliminated the need for further unnecessary testing. |
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ISSN: | 0002-9173 1943-7722 |
DOI: | 10.1093/ajcp/aqx115.023 |