Protein Electrophoresis, Reflex to Immunofixation, IgG, IgA and IgM, Serum


Abbrev Code:ELPR   
Order Code:LAB3449Order Name:ELP Reflex to IFE
Synonyms:Electrophoresis, Serum; SPEP
Methodology:ELP: capillary electrophoresis; IELP: Agarose Immunofixation, Globulins: rate nephelometry, Biochromatic rate
CPT Codes: 84165 x1, 86334 x1, 82784 x1, 82784 x1, 82784 x1, 84155 x1
Test Includes:Protein electrophoresis. May reflex to serum immunofixation, IgG, IgA, IgM
Turnaround Time:Performed Mon-Fri; results are reported the same day.


Collection Instructions

Specimen:Blood
Optimal Volume:5 mL
Minimum\Peds Volume:1.8 mL
Container:Red or gold (gel)
Alternate Containers: Red (no gel)


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 1.4 mL, 0.7 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Stability:Samples suspected of having macroglobulins or cryoglobulins should be collected and held at 37°C. Samples suspected of containing cold agglutinins should not be refrigerated prior to serum separation from clot.
Test Performed at or Referral Lab Protein and Chemistry  (UMMC-East Bank)


Interpretive

Reference Range:

 

Age

g/dL

Albumin

0-15 d

15 d – 1 y

1 y and older

3.0-3.9

2.2-4.8

3.7-5.1

 

Globulins

Alpha 1

Less than 1 y

1 y and older

0.1-0.3

0.2-0.4

Alpha 2

0-15 d

15 d and older

0.3-0.6

0.5-0.9

Beta

0-15 d

15 d and older

0.4-0.6

0.6-1.0

Gamma

0-15 d

15 d -1 y

1 y and older

0.7-1.4

0.5-1.3

0.7-1.6

Monoclonal

All ages

Not present

 

 

Use:This combination of tests should be requested when the physician seeing the patient would like an immunofixation automatically performed on the same serum specimen to characterize a suspected monoclonal immunoglobulin(s) that has been seen on regular serum electrophoresis (ELP). As an example, for anyone in whom there may be a clinical suspicion of multiple myeloma, we suggest a serum protein electrophoresis with automatic reflex to immunofixation be ordered. In general, the pathologist will elect to add the IELP whenever the estimated concentration of the monoclonal immunoglobulin band exceeds 0.1 g/dL.


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