Demonstrated on this slide are schematic drawings of normal and abnormal serum protein electrophoretic (SPE) patterns. Serum electrophoresis is accomplished by adding serum to agarose gel or cellulose acetate gel and applying an electric current. The proteins separate due to differences in charge and size. The top pattern shows the five components of normal serum: albumin, alpha 1, alpha 2, beta, and gamma globulins. The gamma region is where the majority of the Igs migrate. However, some Igs migrate anywhere from the alpha 1 to the gamma region as shown on this slide. The presence of an abnormal spike as shown in the lower pattern is not proof of monoclonal Ig. An immunoelectrophoresis (IEP) is necessary to show that the spike contains one heavy chain and one light chain species, ie, is monoclonal. Although rare, spikes can be seen on SPE that are caused not by Ig but by immune complexes, fibrinogen, hemoglobin-haptoglobulin complexes, or elevated levels of transferrin. The SPE pattern is the best method of quantitating the amount of paraprotein present. The amount of paraprotein is correlated with the number of cells in the body producing that Ig.
Course Section: 10. Plasma Cell Dyscrasias
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