title: Inability to Measure M-Protein With Capillary Zone Electrophoresis (CAPPILLARYS 2) in Tracings With NonDiscernable Peaks.
abstract: BACKGROUND
  We performed a retrospective study to illustrate the challenges with quantifying monoclonal (M)-protein in the cases of serum protein capillary zone electrophoresis (SPCZE) where no discernable peak is apparent.
  
  
  METHODS
  We retrospectively reviewed 160 serum immunofixation electrophoresis (SIFE) that were performed at Memorial Hermann Hospital-Texas Medical Center between October 2013 and November 2013 and we identified the positive SIFE results. The corresponding SPCZE of the positive SIFE were retrieved and evaluated for the ability to quantify M-proteins in them. We define the ability to quantify M-protein as the ability for the operator of the SPCZE to identify a discernable peak and to be able to manually gate the area under the peak.
  
  
  RESULTS
  Twenty-two cases of SIFE detected a monoclonal immunoglobulin. Of the corresponding 22 SPCZE, we could not quantify the M-protein in 6 (27.3%) of the cases.
  
  
  CONCLUSIONS
  We have shown several cases where we were not able to quantify the M-protein with SPCZE. This poses a challenge in the diagnosis and management of these patients.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas.
authors.forename: Richard S P
authors.initials: RS
authors.lastname: Huang
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas.
authors.forename: Amitava
authors.initials: A
authors.lastname: Dasgupta
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas.
authors.forename: Andy N D
authors.initials: AN
authors.lastname: Nguyen
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas.
authors.forename: Amer
authors.initials: A
authors.lastname: Wahed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000097:blood* / Q000302:isolation & purification; D004587:Electrophoresis, Agar Gel; D019075:Electrophoresis, Capillary / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009194:Myeloma Proteins / Q000032:analysis* / Q000302:isolation & purification; D010265:Paraproteinemias / Q000097:blood; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins
keywords: agarose gel electrophoresis; capillary zone electrophoresis; immunofixation electrophoresis; monoclonal gammopathy; monoclonal protein