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Test Code LAB119 Protein Electrophoresis, Reflex, Serum

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Capillary Electrophoresis

Testing Algorithm:

If a paraprotein is suspected and an immunotyping has not been performed within the last year or if the protein electrophoresis pattern is different from previous, LAB4943 Immunotyping, Serum will be performed, at an additional charge.
If gamma globulin result is <0.5 g/dL, and immunotyping has not been performed with the last year, LAB4943 Immunotyping, Serum will be performed, at an additional charge.

If immunotyping is negative for monoclonal protein, #9559 Immunoglobulin Free Light Chains, Serum will be performed, at an additional charge. 

Literature References:

1.Package insert: CAPI 3 PROTEIN (E) 6, Secia Electrophoresis, 2018.

2. Bradwell AR. Serum free light chain analysis. The Binding Site. 2006:4.
3. Ritzmann, SE and Daniels JC. Serum protein abnormalities: diagnostic and clinical aspects. Boston: Little, Brown, and Co.; 1975.

Specimen Requirements

Specimen Type: Serum

Container/Tube: Plain red top

Specimen Volume: Full tube

 

Day(s) Test Set Up

PROTEIN ELECTROPHORESIS

Monday through Friday

Cut-off time: 0800

Turnaround Time:
STAT: not available
Routine: 2 working days

 

IMMUNOGLOBULIN FREE LIGHT CHAINS

Monday through Friday

Cut-off time: 0800

Turnaround Time:
STAT: not available
Routine: 2 working days

Test Classification and CPT Coding

84165-Protein electrophoretic fractionation and quantitation

83883 x 2-Immunoglobulin free light chains (if appropriate)

86334- Immunotyping (if appropriate)

Reference Values

Albumin: 3.2-5.0 g/dL
Alpha 1: 0.2-0.4 g/dL
Alpha 2: 0.5-1.0 g/dL
Beta 1: 0.3-0.6 g/dL

Beta 2: 0.2-0.6 g/dL
Gamma: 0.5-1.7 g/dL
Restricted Peaks: 0.0-0.0

Interpretation: No monoclonal peaks detected.
For discussion of interpretation and significance of results, call the Laboratory Medicine resident at digital pager 314-747-1320.

 

IMMUNOGLOBULIN FREE LIGHT CHAINS

KAPPA-FREE LIGHT CHAIN

0.33-1.94 mg/dL

 

LAMBDA-FREE LIGHT CHAIN

0.57-2.63 mg/dL

 

KAPPA/LAMBDA FLC RATIO

0.26-1.65

These ranges were obtained by measuring the light chain concentrations of 282 normal adult sera. Assays were performed at the Mayo Clinic, Rochester, MN, USA

Literature References:

1. Bradwell AR. Serum free light chain analysis. The Binding Site. 2006:4.

2. Katzmann JA, Clark RJ, Abraham RS, et al. Serum reference intervals and diagnostic ranges for free kappa and free lambda immunoglobulin light chains: relative sensitivity for detection of monoclonal light chains. Clin Chem 2002;48:1437-44.

Specimen Transport Temperature

Ambient

Additional Information

For BJH Laboratory Use Only

 

Alternative tube types:

Serum separator (Red/Gray top) 

Serum separator (Gold top)

 

Analyte Stability:

See analyte stability chart.

Laboratory Processing Instructions:

Test performed in BJH Core lab.  Processed by automated line and delivered to Immunology for anaylsis. Sample stored refrigerated for 5 days.