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Protein Electrophoresis questions

by Caeryn23 on Sat Mar 09, 2013 10:29 am

I had these done because of neuropathy and pain.

1. 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. Is that common for them not to not run the test? Also, the Beta Globulin Fraction is 14.0%, which seems high. Would that indicate anythying?

2. For the urine electrophoresis: The Beta Globulin fraction is 30% and 1.1 mg/dl. It is higher than the Albumin. Would that indicate anything? Also, Alpha 1 Globulin, Alpha 2 Globulin, and Gamma Globulin showed up. What are the ranges for those? The are no ranges listed except for Total Protein and 24 hr calculated protein.

I left 2 messages for my doctor, but they never called me back.

Thank you

Caeryn23

Re: Protein Electrophoresis questions

by terryl1 on Sat Mar 09, 2013 4:48 pm

Hi Caeryn, about 20% of people with myeloma are light chain only. I am one of these patients. Our disease is harder to track as we don't have the traditional M-spike. Our SPEP's are normal. However, immunofixation, if done, would show the presence of abnormal immunoglobulins. So would the free light chain assay.

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49

Re: Protein Electrophoresis questions

by Caeryn23 on Sat Mar 09, 2013 5:12 pm

The SPEP and the UPEP did not test for free light chains or immunofixation. I didn't have an M-Spike on either test. Like I said, Albumin, Alpha 1 Globulin, Alpha 2 Globulin, Beta Globulin, and Gamma Globulin showed up on both tests. What does that mean that those proteins showed up?

Caeryn23

Re: Protein Electrophoresis questions

by terryl1 on Sun Mar 10, 2013 6:58 am

The UPEP is very sensitive and if it did not detect any myeloma related paraproteins (Bence Jones), that is a great sign that you, coupled with a negative SPEP, don't have myeloma, including the light chain variety. Keep trying your doctor to explain the rest.

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49

Re: Protein Electrophoresis questions

by Anonymous on Sun Mar 10, 2013 12:29 pm

What is the Bence Jones Protein? On the UPEP, they tested for Total Protein, Albumin, Alpha 1 Globulin, Alpha 2 Globulin, Beta Globulin, and Gamma Globulin. Those proteins showed up.

Should I ask to be tested for the immunofixation or free light chains?

Anonymous

Re: Protein Electrophoresis questions

by Caeryn23 on Sun Mar 10, 2013 12:39 pm

I forgot my username.

Here are my results for the Urine Electrophoresis:
Total Protein 3.5 mg/dl (0 - 15)
Protein 24 hr calculated 33.3 mg/dl (30 - 150)
M-Spike not observed
Albumin 25.3% and .9 mg/dl
Alpha 1 Globulin 4.5% and .2 mg/dl
Alpha 2 Globulin 18.1% and .6 mg/dl
Beta Globulin 30% and 1.1 mg/dl
Gamma Globulin 22.2% and .8 mg.dl

That's all the report has on it. There is also a graph.

Caeryn23

Re: Protein Electrophoresis questions

by terryl1 on Mon Mar 11, 2013 8:02 am

It's normal. They did not detect any myeloma-related pp's.

terryl1
Name: Terry
Who do you know with myeloma?: self
When were you/they diagnosed?: August 10, 2011
Age at diagnosis: 49

Re: Protein Electrophoresis questions

by Caeryn23 on Mon Mar 11, 2013 11:22 am

Thank you. I was just confused. I was just wondering what it meant that those other proteins showed up.

I don't think they tested for Bence Jones Proteins, immunofixation, or free light chains.

Caeryn23

Re: Protein Electrophoresis questions

by Dr. Edward Libby on Mon Mar 11, 2013 1:53 pm

Hello Caeryn 23,
IHC stands for immunohistochemistry. The IHC is needed only if the serum protein electrophoresis (SPEP) showed an m-spike. Your testing did not demonstrate an m-spike by electrophoresis so IHC was unnecessary. The critical finding (which you do not have) is an m-spike in either the blood or urine. As others have noted a minority of patients have a unique type of m-spike called "light chains". Light chains an only be detected with a serum( blood) free light chain test or with a 24 hour urine collection which is then tested for Bence Jones proteins (free light chains).
Therefore your screening testing is normal so far. The only thing missing would be testing for light chains. This could be done by simply ordering a serum free light chain assay.
Best of luck with all of this complicated stuff !
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: Protein Electrophoresis questions

by Caeryn23 on Tue Mar 12, 2013 12:29 pm

Thank you again for responding. The Neurology clinic is hard to get a hold of. I will try to ask my primary care doctor about it.

Caeryn23


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