ARUP's Laboratory Test Directory

Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, Quantitation & Characterization, IgA, IgG, & IgM, Serum : 2002109

Mnemonic: SPEP REFLEX

Ordering Recommendation: Aids in the diagnosis and management of plasma cell dyscrasia when clinical pre-test probability is low. Use to detect and quantify monoclonal serum protein.
Methodology: Quantitative Capillary Electrophoresis/Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry
Performed: Mon-Fri
Reported: 1-5 days
Specimen Required: Collect: Serum separator tube.

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)

Storage/Transport Temperature: Refrigerated.

Unacceptable Conditions: Plasma.

Stability (collection to initiation of testing): After separation from cells: Ambient: 8 hours; Refrigerated: 1 week; Frozen: 1 month
Reference Interval:
 
Test Number Components Reference Interval
0050640Protein Electrophoresis, Serum  
 
Test Number Components Reference Interval
 Total Protein-Electrophoresis, Serum Refer to report
 Albumin Refer to report
 Alpha-1 Globulins Refer to report
 Alpha-2 Globulins Refer to report
 Beta Globulins Refer to report
 Gamma  Refer to report
0050350Immunoglobulin G  
 
0- 30 days: 611-1542 mg/dL             
1 month: 241-870 mg/dL                         
2 months: 198-577 mg/dL           
3 months: 169-558 mg/dL                   
4 months: 188-536 mg/dL                         
5 months: 165-781 mg/dL                         
6 months: 206-676 mg/dL                           
7-8 months: 208-868 mg/dL                        		9-11 months: 282-1026 mg/dL
1 year: 331-1164 mg/dL
2 years: 407-1009 mg/dL
3 years: 423-1090 mg/dL
4 years: 444-1187 mg/dL
5-7 years: 608-1229 mg/dL
8-9 years: 584-1509 mg/dL
10 years and older: 768-1632 mg/dL
0050340Immunoglobulin A  
 
0-30 days: 1-7 mg/dL
1 month: 1-53 mg/dL
2 months: 3-47 mg/dL
3 months: 5-46 mg/dL
4 months: 4-72 mg/dL
5 months: 8-83 mg/dL
6 months: 8-67 mg/dL
7-8 months: 11-89 mg/dL 		9-11 months: 16-83 mg/dL
1 year: 14-105 mg/dL
2 years: 14-122 mg/dL
3 years: 22-157 mg/dL
4 years: 25-152 mg/dL
5-7 years: 33-200 mg/dL
8-9 years: 45-234 mg/dL
10 years and older: 68-378 mg/dL
0050355Immunoglobulin M  
 
0-30 days: 0-24 mg/dL                     
1 month: 19-83 mg/dL                               
2 months: 16-100 mg/dL                         
3 months: 23-85 mg/dL                               
4 months: 26-96 mg/dL                             
5 months: 31-103 mg/dL                           
6 months: 33-97 mg/dL                               
7-8 months: 32-120 mg/dL                          		9-11 months: 39-142 mg/dL
1 year: 41-164 mg/dL
2 years: 46-160 mg/dL
3 years: 45-190 mg/dL
4 years: 41-186 mg/dL
5-7 years: 46-197 mg/dL
8-9 years: 49-230 mg/dL
10 years and older: 60-263 mg/dL

Interpretive Data: Immunofixation electrophoresis is a more sensitive technique than serum protein electrophoresis for the identification of small M-proteins found in patients with amyloidosis, early or treated myeloma and macroglobulinemia, MGUS, solitary plasmacytoma, and extramedullary plasmacytoma. 
Note: If patterns from serum protein electrophoresis are monoclonal or suspicious, then Immunofixation Electrophoresis will be added. Additional charges apply.

IFE is a more sensitive method for determining and defining monoclonal proteins. No additional testing will be added for proteins that are normal, polyclonal, or that lack monoclonal patterns.
CPT Code(s): 84160; 84165; if reflexed, add 82784 x3 and 86334
Cross References: Electrophoresis, Protein, Serum with Reflex to Immunofixation Electrophoresis, Serum (Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, Quantitation & Characterization, IgA, IgG, & IgM, Serum) , Protein Electrophoresis with Interpretation, Serum and Reflex to IFE and QNTIG's (Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, Quantitation & Characterization, IgA, IgG, & IgM, Serum) , Protein Electrophoresis, Serum with Reflex to IFE, Serum and Free Kappa and Lambda Light Chains, Serum (Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, Quantitation & Characterization, IgA, IgG, & IgM, Serum) , Protein Electrophoresis, with Interpretation Serum, With Reflex to IFE, Serum and Free Kappa Lambda Light Chains, Serum (Protein Electrophoresis with Reflex to Immunofixation Electrophoresis Monoclonal Protein Detection, Quantitation & Characterization, IgA, IgG, & IgM, Serum)