Serum Protein Electrophoresis (SPE); Immunofixation (IFE)

What is the purpose of SPE test?

When an abnormal protein (band or peak) is detected, further tests are conducted to identify the specific type of protein, a process known as immunotyping. Immunofixation electrophoresis or immunosubtraction electrophoresis can be employed to identify abnormal bands observed in protein electrophoresis, typically within the gamma region. These tests help determine whether there is an abnormal production of a particular type of antibody (immunoglobulin), such as IgG, IgA, or IgM.

In most cases of multiple myeloma, there is an excessive production of a single type of intact (whole) immunoglobulin. However, in a minority of cases, elevated levels of only one segment of immunoglobulin, referred to as a "free light chain," are produced. These surplus-free light chains are released into the bloodstream and, due to their relatively small size, are filtered by the kidneys and excreted in the urine. Another term for these excess free light chains in the urine is Bence Jones proteins.

How is the test used?

Serum electrophoresis is employed for various purposes, including:

1. Aiding in the diagnosis and monitoring of conditions like lymphoma, chronic lymphocytic leukemia, or monoclonal gammopathies, such as multiple myeloma.
2. Investigating unusual results from other laboratory tests, such as abnormal total protein levels, albumin levels, elevated calcium levels, or low counts of white or red blood cells.
3. Evaluating individuals for inflammatory conditions, autoimmune diseases, infections, kidney disorders, or liver disorders.

On the other hand, urine protein electrophoresis is utilized:

1. To investigate and diagnose multiple myeloma.
2. To determine the underlying cause of unusually high protein levels in the urine (proteinuria), which can arise from various forms and causes of protein excretion.

When should I do the SPE test?

Protein electrophoresis is a frequently requested test when you exhibit symptoms indicative of certain medical conditions. Here are some examples:

1. Serum and urine protein electrophoresis may be recommended if you display signs and symptoms associated with multiple myeloma, such as:
2. Fragile bones, lead to soft spots, fractures, bone lesions, and bone pain.
3. Carpal tunnel syndrome.
4. Bone destruction often results in elevated blood calcium levels, causing symptoms like appetite loss, nausea, thirst, fatigue, constipation, and confusion.
5. Anemia.
6. Frequent infections.
7. Excessive bleeding and easy bruising.
8. Kidney disease, where significant protein levels in the urine, including Bence Jones proteins, can harm the kidneys, potentially causing permanent damage.
9. Hyperviscosity syndrome can lead to thickened blood, resulting in headaches, vision issues, seizures, or even a coma.
10. Urine protein electrophoresis may be ordered if you have unusually high protein levels in your urine.
11. Immunofixation electrophoresis or immunosubtraction electrophoresis might be recommended when an abnormal band, suggestive of monoclonal immunoglobulin, is detected during either serum or urine electrophoresis.
12. CSF protein electrophoresis may be performed:
13. When you experience symptoms that suggest multiple sclerosis, including sensory symptoms like numbness, tingling, pain, burning, itching, facial pain, and visual disturbances.
14. For motor symptoms such as speech difficulties, weakness, tremors, walking difficulties, lack of coordination, constipation, and urinary control problems.
15. In the presence of psychological symptoms such as mood swings, depression, and cognitive issues related to thinking, learning, and memory.
16. When dealing with fatigue or other neurological symptoms, identify proteins indicative of inflammation or infection.

Once a disease or condition has been diagnosed, electrophoresis may be conducted at regular intervals to monitor the disease's progression or recurrence and assess the effectiveness of treatment.

What does the test result show?

Protein electrophoresis tests provide healthcare professionals with an approximate measurement of the various protein fractions in your sample and help identify the presence of any unusual proteins or atypical protein patterns.

These results are assessed in conjunction with your clinical symptoms and medical background. Typically, the laboratory report includes an explanation and interpretation of the findings.