Protein Electrophoresis questions
 

Here are my blood test results for "Interpretation" part.
Under the PE Value it says: "SPE1"
Then it says: "The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent."

What does this mean? Is there some sort of pattern that showed up? Or, no pattern at all showed up? Also, did any other protein show up?

The other values are in range. Thank you.

Your test appears to be negative...which is obviously good news.

I am by no means an expert in this, but I believe there are only two light chains of the monoclonal proteins they look for: Kappa and Lambda. You apparently have neither present.

You should have no worries.

Are there other proteins or patterns that they look for? Other than monoclonal. Also, what does the "SPE1" mean?

Like I said, the values were normal. However, the Alpha 1 value is 0.2. The range is 0.1 - 0.4. This makes it on the lower end of normal. Does that have any significance?

Spe1--
 

--stands for "serum protein electrophoresis one" which is simply a testing protocol that looks through your profile of serum proteins for rogue antibodies (monoclonal or M-proteins, which can be associated with blood cancers and, though cross-reactivities, cause neuropathy).

If you have neuropathy, though, the more specific test for this is the immunofixaton electrophoresis (IFE) with globulin enumeration. A serum protein electrophoresis will tell you how much alpha, beta, and gamma globulins there are and if any are in too great a supply, but small elevations in monoclonals may be obscured in the overall gamma globulin figures. An immunofication of serum and urine will break apart the specific types of gamma globulin (IgA, IgM and IgG), enumerate them, and see if any of the protein chains are monoclonal.

Take a look at:

http://en.wikipedia.org/wiki/Immunofixation

http://www.wardelab.com/21-2.html

glenntaj: Is this what you meant by "immunofixaton electrophoresis (IFE) with globulin enumeration?":

I got the report from the lab. The report says "Serum Protein Electrophoresis, RFX to Immunofixation." It includes the results, a graph, and some sort of "stain" picture. It mentions Fraction and Percentage also.

Under the graph part, the fraction for Beta says 14.0%. I don't know the range for it. But I found one online. It says 8.5-13.7. This would make it high. Would that have any significance?

Thank you.

It would be good if--
 

--you could list what it says in more detail.

Normally, a serum protein electrophoresis divides the blood proteins into the part that is albumin and then subdivides the part that is globulin into alpha, beta, and gamma globulins. An immunofixation electrophoresis goes further in that it enumerates and types the gamma globulins (antibodies) into A, G and M fractions (these are the proteins involved in the immune response) and looks for any rogue or monoclonal antibody types.

It's certainly possible they did both in your testing profile. The immunofixation is preferred, though, as small monoclonal increases can be obscured in the gamma portion of a serum electrophoresis.

That beta globulin number is not that far out of range, although the range does vary from lab to lab. High beta globulins can come from a number of inflammatory causes, estrogen and other drug therapies, even from high cholesterol levels, so they're not very specific. Generally high levels of gamma globulins have more clinical significance, as they are found in long term inflammatory/autoimmune disease, many infectious disorders, and in certain blood disorders.

The report mentions Albumin, Alpha 1, Alpha 2, Beta, and Gamma Fraction. There is a % for each Fraction. The "g/dl value" is also listed. The Beta Fraction % seems a little high. The Alpha 1 Fraction % is on the low end of normal.

It says the M-Spike is "Not Observed." It also says what the A/G ratio and Total Protein are.

What's the significance of the A/G ratio when both Albumin and Total Globulin are in the normal range but the ratio is high?

That is, 5.0 Albumin (high normal), 2.3 Glubulin (low normal) and the AG ratio of 2.2, which exceeds the reference range (0.7-2.0).

I'm not sure. But this link may help.
http://labtestsonline.org/understand...es/tp/tab/test

Since a high albumin--
 

--doesn't really have all that much clinical significance, the ration of Albumin to globulin in this case is not likely to be indicative of anything.

It does still sound like you to need to have the more advanced immunofixation electrophoresis to enumerate and examine the components of your gamma globulins. From what you've reported that has not been done, as you would have figures for IgA, IgG and IgM concentrations as well as more specific analysis to see if any monoclonal proteins were detected.

My report doesn't mention IgA, IgG, or IgM. How would the report mention the immunofixation electrophoresis? Is there an example online I could see?

Also, do you have any information on Urine Protein Electrophoresis? I also had that test done.

The urine protein electrophoresis--
 

--would indicate if there were any Bence-Jones proteins (which are the urinary breakdown of monoclonals) and/or any light chain protein of the lambda or kappa class. If there are none of these, that is a good thing.

An immunofixation electrophoresis would be definitely demarcated in a lab report--it might be abbreviated IFE--and it would generally come with figures for amounts of IgA , IgM, and IgG along with reference ranges.

Here's one of my favorite listings of lab tests with reference ranges--look on page 61/62:

http://www.hosp.uky.edu/ClinLab/report.pdf

1. My Serum Protein Electrophoresis says it has "RFX to Immunofixation." But, I don't see anything about IgA , IgM, and IgG. Could it be they didn't find anything to comment on?

2. How would the Urine Protein Electrophoresis show Bence-Jones proteins? Different proteins showed up on mine. For example, Beta Globulin is 1.1 mg/dl. Albumin is 0.9 mg/dl. I don't see any ranges, except for the Total Protein.

Your serum protein electrophoresis--
 

--did not also result in an immunofixation and gamma globulin enumeration being also done, apparently. If these was done, results would have been included.

Same with the Bence Jones proteins--apparently in your urinalysis they did a protein breakdown by type of protein--basically, albumin and globulins--but not a FURTHER breakdown by type of gamma globulin. Again, if that had been done, there would have been a notation such as "no Bence Jones proteins detected" or "no light chains detected".

Thank you for answering me. I hope you don't mind me asking questions.

1. My blood test mentions immunofixation. But there is no mention of the IgG, IgA, etc. That seems strange. The results mentioned are: Total Protein; the types of protein in g/dl (Albumin, Alpha 1 Globulin, etc); A/G ratio; and the protein fractions with %. There is also an interpretation.

2. My urine tests mention: Total Protein; Protein 24 hr calculated; the types of protein in mg/dl (Albumin, Alpha 1 Globulin, etc); and the protein fractions with %. It seems the Beta Globulin is higher than the other proteins. The fraction is 30% and 1.1 mg/dl. Would that indicate anything?

I can't seem to get a hold of the doctor who ordered the tests. I go to a clinic. They are only there 2 times a week. I have an appointment, but it's not until June.

Yes, it does seem strange--
 

--unless you don't have the complete results.

By definition, an immunofixation electrophoresis is concerned with enumerating and typing the IMMUNE proteins--which are the gamma globulins, or antibodies, of the Ig class, so it should have information about amount and type of IgA, IgG, IgM at least.

Is there nobody at the clinic you can ask the question of besides the original physician you saw?

For the blood electrophoresis, I called LabCorp (where the test was sent). The person I spoke to said the immunofixation part was not done. She said it was because an M Spike was not observed. I guess that's why the IgA, IgG, IgM are not on my results.

I also asked the lab about the urine electrophoresis. She didn't give me any range for anything like the globulins and fractions. She said there isn't any. I found some info on the LabCorp site. But, It doesn't have any range either. Here is the site: http://tinyurl.com/bdrbz5z

There is no one else at the clinic I can ask. I left 2 messages. The nurse I spoke with was kind of rude. I could ask my primary care doctor or another one.