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PROTEIN ELECTROPHORESIS (PEP), SERUM OR URINE

Item Value
Available Stat? No
Test code Serum - SPEP
Urine - UPEL
Performed by? Chemistry
Sendout? no
Price range Serum - $$$
Urine - $$$
In House Availability M, W, F
Interpretation 1. Serum: in protein electrophoresis (PEP), serum proteins with net negative charges migrate at different rates toward the anode on buffered agarose gel (pH =8.6). Organic dye (amido black) binds to the separated proteins, and permits quantitation by densitometer scanning.

2. Urine: Urine specimens are routinely concentrated to improve sensitivity. Trace amounts of albumin in the urine, and occasionally trace amounts of both kappa and lambda light chains, occur in a 2:1 ratio. Variation in this ratio suggests a monoclonal gammopathy or "light chainuria." Free light chains are found in other lymphoid diseases, and also in renal failure, as well as SLE.
Container type gold top gel tube for serum
sterile cup for urine
Amount to Collect 3 mL - blood
20 mL - urine
Collection Instructions Fresh specimens. Urine, no preservative; refrigerate during collection. Urine must be refrigerated to prevent degradation of Bence Jones proteins by bacteria. Radio-opaque dyes interfere.
Special instructions When urine PEP is ordered, a serum specimen must be submitted at the same time. Indicate history on the requisition. Immunofixation electrophoresis is performed only when protein electrophoresis is abnormal or by special request.
Normal range Interpretation accompanies report.
Synonyms PEP;
Stability Serum, Urine stable for 1 week at 2-8°C
Interferences No hemolysis.
Additional information INDICATIONS: Include detection of qualitative serum protein deficiencies, acute and chronic inflammatory reactions and monoclonal gammopathies (including multiple myeloma, Waldenstrom's disease, Bence Jones proteinuria) and screening for decreases in alpha-1-antitrypsin and increases in alpha-1-fetoprotein. Evaluation of urine and serum electrophoretic patterns for decreases of specific fractions due to nephrosis, burns and enteropathy.

Note: If you desire to investigate monoclonal gammopathies, a spot urine may be sent together with serum. Send clinical history or consult the Laboratory Medicine Resident in Clinical Chemistry (x65527, or pager 415-443-2311).
References 1. Cawley, L.P.: Electrophoresis and Immunoelectrophoresis. Little Brown & Co, Boston, 1969.

2. Cronstedt, J.: Idiopathic light chain dyscrasia. Acta Med Scand 196;445, 1974.

3. McLaughlin, H.: J Clin Pathol, 25:555, 1972.

4. Tietz, N.W. Textbook of Clinical Chemistry and Molecular Diagnosis, ed. 4. St. Louis, MO: Elsevier Saunders, 584-586; 2006.

5. Sebia Hydragel product insert (9398-11/00). Sebia Inc., Norcross, GA, 2000, p 7-11.
CPT coding 84165
Last Updated 10/23/2012 4:50:32 PM
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