A retrospective study of the relative utility of electrophoresis, immunoelectrophoresis, immunofixation, and nephelometry in the investigation of serum proteins.
OBJECTIVE
To assess the relative value of visual inspection of protein electrophoresis patterns, immunoelectrophoresis, immunofixation, and specific protein quantitation in the investigation of serum proteins.


METHODS
A retrospective study of protein results on 372 sera analyzed by electrophoresis and immunoelectrophoresis. A subsection of specimens (276) also had immunoglobulin quantitation by immunonephelometry and 30 were studied by immunofixation.


RESULTS
Total gamma globulin levels were correctly assessed visually in 84.4% of cases. Discrete bands seen visually were mainly monoclonal in 74 of 80 (92.5%). Six monoclonal proteins were not detected visually. Twenty-five monoclonal proteins required immunofixation for typing, and 60 were typed by immunoelectrophoresis. The visual assessment of the level of normal immunoglobulins in the presence of a monoclonal gammopathy was correct in 58% of cases.


CONCLUSIONS
The majority of monoclonal gammopathies could be evaluated by a combination of protein electrophoresis and immunoelectrophoresis. Except for quantitating monoclonal immunoglobins, protein electrophoresis was unreliable as a quantitative procedure and nephelometry was preferred.
Salkie
M L
ML
Department of Laboratory Medicine and Pathology, University of Alberta Hospitals, Edmonton, Canada.
D000911:Antibodies, Monoclonal / Q000276:immunology; D001797:Blood Protein Electrophoresis; D001798:Blood Proteins / Q000032:analysis*; D004591:Electrophoresis, Polyacrylamide Gel; D006801:Humans; D007122:Immunoelectrophoresis; D007143:Immunoglobulin Heavy Chains / Q000032:analysis; D007147:Immunoglobulin Light Chains / Q000032:analysis; D007136:Immunoglobulins / Q000032:analysis; D007158:Immunologic Techniques; D009391:Nephelometry and Turbidimetry; D012189:Retrospective Studies
D000911:Antibodies, Monoclonal; D001798:Blood Proteins; D007143:Immunoglobulin Heavy Chains; D007147:Immunoglobulin Light Chains; D007136:Immunoglobulins