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HelpTest ID PEL Electrophoresis, Protein, Serum
Useful For
Monitoring patients with monoclonal gammopathies
Diagnosis of monoclonal gammopathies, when used in conjunction with immunofixation
Protein electrophoresis alone is not considered an adequate screen for monoclonal gammopathies
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| TPE | Total Protein | Yes, (order TP) | Yes |
| ELP | Protein Electrophoresis | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IMFX | Immunofixation | No | No |
Testing Algorithm
If a discrete electrophoresis band is identified, the laboratory will evaluate the serum protein electrophoresis and, if necessary, perform immunofixation at an additional charge.
Method Name
TPE: Biuret
ELP: Agarose Gel Electrophoresis
IMFX: Immunofixation and/or Immunodiffusion
Reporting Name
Electrophoresis, Protein, SSpecimen Type
SerumContainer/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 1 mL
Collection Instructions: Fasting preferred but not required
Additional Information: Indicate if multiple myeloma is suspected.
Forms: If not ordering electronically, complete, print, and send a General Request Form (T239) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf).
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
Clinical Information
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 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.
Reference Values
PROTEIN, TOTAL
≥1 year: 6.3-7.9 g/dL
Reference values have not been established for patients that are <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.
Cautions
A normal serum protein electrophoresis (PEL) does not rule out disease. MPSS / Monoclonal Protein Study, Serum, which includes immunofixation, and FLCP / Immunoglobulin Free Light Chains, Serum should be done to screen if the clinical suspicion is high.
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 Saturday; Continuously until 2 p.m.
Report Available
1 dayPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84155-Protein, total
84165-Protein, electrophoresis
86334-Immunofixation (if appropriate)