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Slide 9
Shown on this slide are the SPE patterns of four patients. The albumin band is at the far right. The top SPE is a normal pattern. The next two SPEs show an abnormal spike in the gamma region (number 3 demonstrates two abnormal restricted bands). SPE number 4 shows diffuse hypergammaglobulinemia, a pattern seen in many chronic infections.

Agarose SPE will show a restricted peak in 90% of patients with myeloma. Patients whose test patterns show a spike should have an IEP done to determine if the spike represents a monoclonal Ig. Some monoclonal Igs (light chain, heavy chain, IgD) do not produce a sharp spike. For this reason an IEP should be done even after a negative SPE if clinical suspicions are strong.

Course Section: 10. Plasma Cell Dyscrasias
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