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HelpTest ID PEISO Protein Electrophoresis and Isotype, Serum
Ordering Guidance
To monitor a patient with an established diagnosis of a monoclonal gammopathy, order TMOGA / Monoclonal Gammopathy, Monitoring, Serum.
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.
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.
Secondary ID
609781Useful For
Diagnosing monoclonal gammopathies, when used in conjunction with locally performed serum free light chain studies
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TMAB | Therapeutic Antibody Administered? | No | Yes |
| TPE | Total Protein | Yes, (Order TP) | Yes |
| SPE | Protein Electrophoresis | No | Yes |
| MPTS | M-protein Isotype MALDI-TOF MS, S | Yes, (Order MALD) | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IFXED | Immunofixation Delta and Epsilon, S | Yes | No |
Testing Algorithm
This test includes total protein, serum protein electrophoresis, and heavy and light chain typing (kappa and lambda).
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:
Special Instructions
Method Name
TMAB: Patient Information
TPE: Colorimetric, Biuret
SPE: Agarose Gel Electrophoresis
MPTS: Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)
Reporting Name
Prot Electrophoresis and Isotype, SSpecimen Type
SerumSpecimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 7 days |
Clinical Information
This profile includes total protein, protein electrophoresis, and M-protein isotyping. The serum proteins can be grouped into 5 fractions by protein electrophoresis:
-Albumin, which represents almost two-thirds of the total serum protein
-Alpha-1, composed primarily of alpha-1-antitrypsin (A1AT), an alpha-1-acid glycoprotein
-Alpha-2, composed primarily of alpha-2-macroglobulin and haptoglobin
-Beta, composed primarily of transferrin and complement C3
-Gamma, composed primarily of immunoglobulins
The concentration of these fractions and the electrophoretic pattern may be characteristic of diseases such as monoclonal gammopathies, A1AT deficiency disease, nephrotic syndrome, and inflammatory processes associated with infection, liver disease, and autoimmune diseases.
The following algorithms are available:
Reference Values
TOTAL PROTEIN
≥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.
M-PROTEIN ISOTYPE MALDI-TOF MS, S
No monoclonal protein detected
M-PROTEIN ISOTYPE MALDI-TOF MS FLAG
Negative
Cautions
Very large IgG M-spikes (>4 g/dL) may saturate the protein stain. In these situations, quantitative IgG assays (IGG / Immunoglobulin G [IgG], Serum) should be performed to accurately determine M-spike concentrations to monitor disease progression or response to therapy.
Fibrinogen will migrate as a distinct band in the beta-gamma fraction. Serum specimens from new patients with a beta-gamma band are to be treated with thrombin to ensure complete conversion of fibrinogen.
Hemolysis may augment the beta fraction.
Penicillin may split the albumin band.
Radiographic agents may produce an uninterpretable pattern.
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysPerforming 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. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
84155
84165
0077U
86334 (if appropriate)