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Reflexing Suspicious β-Region Findings on Capillary Serum Protein Electrophoresis to Immunofixation or Immunosubtraction for Detecting Monoclonal Proteins.

Authors :
Kitson, Amanda L
Taylor, Alexander S
Giacherio, Donald A
Keren, David F
Source :
American Journal of Clinical Pathology. Feb2022, Vol. 157 Issue 2, p171-179. 9p.
Publication Year :
2022

Abstract

<bold>Objectives: </bold>Monoclonal immunoglobulins (M-proteins) that migrate in the β 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 β-region bands for detection of β-migrating M-proteins.<bold>Methods: </bold>Consecutive SPEP cases analyzed by capillary electrophoresis were searched to identify the initial workup on 1,841 patients with increased total β regions, suspicious β-region findings resulting in reflex immunofixation (IFE), or immunosubtraction (ISUB). To augment quantitative information, separate β1 and β2 measurements were established and retrospectively used to evaluate their sensitivity for M-protein detection.<bold>Results: </bold>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 β1 and β2 measurements that were not identified by total β-region measurement, 1 progressed to myeloma. Of the 56 β-migrating M-proteins identified by qualitative features but without increase in any of the β-region measurements, 1 progressed to myeloma.<bold>Conclusions: </bold>A combination of separate measurements for β1 and β2 regions together with detection of β-region distortions increase sensitivity for identifying β-migrating M-proteins via reflex IFE or ISUB. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00029173
Volume :
157
Issue :
2
Database :
Academic Search Index
Journal :
American Journal of Clinical Pathology
Publication Type :
Academic Journal
Accession number :
155145646
Full Text :
https://doi.org/10.1093/ajcp/aqab108