Paraprotein typing - serum

Last updated: Thursday, 29, April, 2004
Item Process
Specimen

10 mL blood in plain tube.

Method

IEP, IFE, IEF with immunofixation, immunosubtraction.

Reference Interval

Qualitative test.

Application

Characterisation of the light and heavy chains of monoclonal (M) bands (paraproteins) detected on EPG.
Detection of small bands which may not be apparent on protein staining.

Interpretation

The presence of an IgG, IgA or, less commonly, IgD paraprotein indicates multiple myeloma or 'monoclonal gammopathy of uncertain significance'.

Monoclonal light chains (Bence Jones protein) of significant amounts indicate myeloma.

Paraproteins and/or monoclonal light chains may occasionally be found in primary amyloidosis.

An IgM paraprotein is characteristic of Waldenström macroglobulinaemia but lower concentrations may be seen in lymphoproliferative disorders.

For quantitation of paraproteins, see Protein electrophoresis - serum.

Reference

Whicher J et al. Ann Clin Biochem 1987; 24: 119-132.