These measurements indicate the degree to which the myeloma cells in the marrow are affecting normal blood cell development. Monoclonal gammopathy of undetermined significance (MGUS). We look forward to connecting with you. Immunofixation electrophoretic techniques applied to identification of proteins in serum and cerebrospinal fluid. An immunofixation blood test, also known as protein electrophoresis, measures certain proteins in the blood. Proteins play many important roles, including providing energy for the body, rebuilding muscles, and supporting the immune system. Other names: serum protein electrophoresis, (SPEP), protein electrophoresis, SPE, immunofixation electrophoresis, IFE, serum immunofixation. Albumin, the largest peak, lies closest to the positive electrode. Mayo Clinic does not endorse companies or products. Its not always obvious what high or low protein levels in the blood serum may mean. In many myeloma patients, the coordinated process of making and attaching light chains and heavy chains fails in the malignant plasma cells. Monoclonal gammopathies are conditions in which abnormal proteins are found in the blood. Levels of albumin are increased in patients with a relative reduction in serum water (e.g., dehydration). 1 It's called a monoclonal . Since the expression levels of these genes and how mutations in them, if present, influence the behavior of the myeloma cells, these techniques may be helpful in better predicting treatment outcomes and developing new and improved targeted therapies. [7], The identification of oligoclonal bands in CSF is helpful in the diagnosis of multiple sclerosis. Much of the clinical interest is focused on the gamma region of the serum protein spectrum because immunoglobulins migrate to this region. Characterized by a sharp peak in the beta-gamma region, monoclonal gammopathies involve increased production of immunoglobulins, or antibodies (IgA, IgG, IgM, etc.). Immunofixation to identify the M component as an IgM immunoglobulin with a quantitative IgM level greater than 3 g/dL. Beaumont-Epinette MP, Moreau C, Besnard S, Latute F, Collet N, Sebillot M, et al. How Is a Serum Immunofixation Test Done? Do You Need It? - WebMD Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. These tests are done in conjunction with immunofixation for example, serum immunofixation electrophoresis (SIFE), which identifies immunoglobulins in blood samples. Also, the level of protein being excreted in the urine and the amount of light chains can be measured. As denoted in the normal curve above, antibodies are primarily found in the fraction. Autoinflammatory vs. Autoimmune: What is the Difference? 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Affected patients have no lytic bone lesions, no anemia, no hypercalcemia, and no renal disease. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjA4Njk3Ni1vdmVydmlldw==. Unattached, free light chains enter the blood and are excreted rapidly in the urine. 2018 Dec 3. It can also detect changes in the ratio of kappa and lambda light chain production, which indicates an excess of abnormal plasma cells. [1] Serum or urine immunofixation negative for a monoclonal protein or a polyclonal pattern is considered to be normal. These proteins can also be referred to as an M-spike, monoclonal immunoglobulin, or paraprotein. Image courtesy of Rush University. [9], In addition, immunofixation can be used to monitor therapy in plasma cell dyscrasias (ie, multiple myeloma and Waldenstrom macroglobulinemia). Some people experience mild pain when the needle is inserted. Some immunoglobulins can be abnormal and may be due to cancer. Instead, they only make light chains. Bone marrow biopsy may be useful to show aggregates of plasma cells in focal or diffuse patterns. Portland (ME): Maine Health; c2019. Reference Range Immunofixation consists of an electrophoresis phase and a fixation phase. Affected patients have only one tumor, with no other bone lesions and no urine or serum abnormalities. How is a serum sample collected for an immunofixation test? How is a urine sample collected for an immunofixation test? The stained gel is then sent to a pathologist for diagnosis. 5 fractions are shown in this image: albumin, alpha-1 ( 1 ), alpha-2 ( 2 ), beta () and gamma (). 9 (5):1895-1900. You don't need any special preparations for an immunofixation blood test. The following table shows what most labs would consider normal results for SPEP testing. If the curve is relatively normal (e.g. A small number of patients with myeloma have either oligosecretory disease, inwhich the detectable level of monoclonal protein is low, or nonsecretory disease,in which no monoclonal protein can be detected. [QxMD MEDLINE Link]. M-protein is an antibodyor part of an antibodythat can show up in tests of your blood and/or urine, and its presence can mean different things. A normal result includes a darker immunoglobulin G (IgG) lane, a lighter immunoglobulin A (IgA), an absent immunoglobulin M (IgM), and a denser kappa compared to lambda lane, with ratio of 2:1. Urine Immunofixation: Symptoms, Treatment, and More - WebMD [15], However,a study by Lahuerta et al indicated that, with the exception of persons with light-chainonly disease, urine immunofixation is not needed in combination with serum immunofixation to define complete response in multiple myeloma. In most cases in which a monoclonal protein is present, it shows as a narrow band at the IgG lane in combination with a monoclonal band at the kappa or lambda lane. Serum protein electrophoresis is used to identify patients with multiple myeloma and other serum protein disorders. Cavuoti D, Baskin L, Jialal I. Immunofixationconsists of an electrophoresis phase and a fixation phase. Polyclonal Gammopathy: Definition & Causes - Cleveland Clinic
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