Reflexing Suspicious ß-Region Findings on Capillary Serum Protein Electrophoresis to Immunofixation or Immunosubtraction for Detecting Monoclonal Proteins.
Am J Clin Pathol
; 157(2): 171-179, 2022 Feb 03.
Article
em En
| MEDLINE
| ID: mdl-34519791
ABSTRACT
OBJECTIVES:
Monoclonal immunoglobulins (M-proteins) that migrate in the ß region on serum protein electrophoresis (SPEP) are often cloaked by this region's normal constituents. The present study interrogates the utility of using both quantitative and qualitative alterations in ß-region bands for detection of ß-migrating M-proteins.METHODS:
Consecutive SPEP cases analyzed by capillary electrophoresis were searched to identify the initial workup on 1,841 patients with increased total ß regions, suspicious ß-region findings resulting in reflex immunofixation (IFE), or immunosubtraction (ISUB). To augment quantitative information, separate ß1 and ß2 measurements were established and retrospectively used to evaluate their sensitivity for M-protein detection.RESULTS:
We identified M-proteins in 205 (11.1%) cases, including immunoglobulin A (IgA) (54%), IgG (24%), IgM (13%), and free light chain (9%) isotypes. Of the 15 cases flagged by separate ß1 and ß2 measurements that were not identified by total ß-region measurement, 1 progressed to myeloma. Of the 56 ß-migrating M-proteins identified by qualitative features but without increase in any of the ß-region measurements, 1 progressed to myeloma.CONCLUSIONS:
A combination of separate measurements for ß1 and ß2 regions together with detection of ß-region distortions increase sensitivity for identifying ß-migrating M-proteins via reflex IFE or ISUB.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Paraproteinemias
/
Mieloma Múltiplo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
Limite:
Humans
Idioma:
En
Revista:
Am J Clin Pathol
Ano de publicação:
2022
Tipo de documento:
Article