--is a serum protein electrophoresis, and as I've written about here a few times, that is NOT the test of choice for determining if there are monoclonal proteins, as it is insufficiently specific to detect all monoclonal chains (it generally only measures overall levels of alpha, beta, and gamma globulins). The immunfixation electrophoresis, which breaks out the classes of gamm globulins (Ig) and enumerates them is the way to go.

So, if you're looking to be choosy about tests coming up, I'd go after that one, and bring the Poncelet protocols, the Treihaft paper, and/or the Latov/Quest labs serology paper from the Useful Websites section that I posted for backup:

http://neurotalk.psychcentral.com/thread177.html

And I do think they should have done the pcr for a whole series of infectious agents--you can mention the Human herpes virus family, cyto, parvo, and E. Coli, West Nile, Lyme, and ciguertera just for starters (this may be something an infectious disease specialist would be better to consult with).

By the way, Epstein Barr Virus, or Human Herpes Virus 4, is ubiquitous in most people--it's estimated that 95% of us have been exposed to it by age 30. Sometimes people know they've caught it by getting mononucleosis, but not always--in young kids, for example, an EBV infection (people joke that it stands for Everybody's Virus) may just look like a cold or flu. As a result, almost everyone will show some IgG activity to certain antigens once they've been infected, and will show it for life, as EBV is immortalized in the cells of the pharynx (most human herpes viruses stick around in dormant stage after initial attack) and may re-activate under conditions of immune compromise. There is a specific antibody pattern that tends to indicate this. (It's really complicated--I can send it to you if you really want, but be warned--a lot of doctors are not up on this, in the same way they don't know that most of the speculation that EBV was involved in Chronic Fatigue Syndrome has been discounted; too many people with chronic fatigue didn't have EBV reactivation and vice versa. In fact, researchers are looking now more closely at Human Herpes Viruses 6 and 8 to see how closely THEY are correlated with chronic fatigue.)

Wow glen Thankyou so much for the info.

I did have both Spep by my gp and immunofixation one by my Neuro. And only thing elevated is igg. Rest is normal.

But he didn't do the 24 urine. Only random so I don't know if that makes a difference