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PROTEIN ELECTROPHORESIS

About the test
What is this test done for?
Serum protein electrophoresis (SPEP) is an easy and inexpensive blood test used to determine the levels of protein subtypes in the blood sample.
Why is it Done?
SPEP is generally done in any patient with an elevated total protein count on liver function test.
When should it be performed?
It is especially ordered in patients with elevated globulin level relative to albumin (in liver profile analysis). It is also done if there are any signs and symptoms such as unexplained anemia, back pain, bone pain, fatigue, or pathologic fracture, kidney insufficiency with bland urine sediment, or recurrent infections (suggesting an underlying plasma cell disorder such as multiple myeloma), Waldenstrom’s macroglobulinemia, or primary amyloidosis.
How is it done
A blood sample will be collected from a vein in your arm. Fasting is not needed prior to sample collection.
Results
The reference range for SPEP is as follows:
  • Albumin: 3.3-5.7 g/dL
  • Alpha 1: 0.1-0.4 g/dL
  • Alpha 2: 0.3-0.9 g/dL
  • Beta: 0.7-1.5 g/dL
  • Gamma: 0.5-1.4 g/dL
Various disease states or conditions change the pattern of proteins in electrophoresis.
  • Albumin
    • Increased in conditions such as Severe dehydration
    • Decreased in conditions such as Malnutrition; liver disease such as cirrhosis, autoimmune or viral hepatitis; nephrotic syndrome; severe burns
  • Alpha 1
    • Increased in conditions such as Inflammatory states, pregnancy
    • Decreased in conditions such as Alpha-1 antitrypsin deficiency
  • Alpha 2
    • Increased in conditions such as inflammatory states, nephrotic syndrome, oral contraceptive use, steroid use, or in hyperthyroidism
    • Decreased in conditions such as Hemolysis; liver disease such as cirrhosis, autoimmune or viral hepatitis
  • Beta
    • Increased in conditions such as Hyperlipidemia, iron-deficiency anaemia
    • Decreased in conditions such as Hypo-B-lipoproteinemia, malnutrition
  • Gamma
    • Increased in conditions such as Polyclonal and monoclonal gammopathies
    • Decreased in conditions such as Agammaglobulinemia, hypogammaglobulinemia
Other Tests

There may be a need for other high-sensitivity tests in following conditions:

  • The presence of an M-protein may be missed if its level is too small to be detected using SPEP. A more specific test will be required.
  • In cases where there is a high suspicion for a clonal plasma cell disorder, more sensitive tests such as a serum immunofixation or free light chain assay should be performed.
  • In addition, when deficiency of either alpha-1 antitrypsin or immunoglobulin is seen, specific quantitation is indicated. SPEP can be insensitive in these cases.
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