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Amyloidosis/Neuropathy Monoclonal Gammopathy Evaluation

Test Codes

EPIC: LAB8573, Beaker: NMGE

Department

Special Chemistry

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 2.0 mL)

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Transfer serum to a plastic aliquot tube and refrigerate (2-8°C or 36-46°F) within 8 hours of collection. (Minimum Serum: 0.5 mL)

Preparation for Courier Transport

Transport: Serum aliquot tube, refrigerated (2-8°C or 36-46°F). (Minimum Serum: 0.5 mL)

Rejection Criteria

Plasma specimens.

Severely hemolyzed, lipemic or icteric specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Transfer serum to a plastic aliquot tube. Room temperature is acceptable for a maximum of 8 hours. (Minimum Serum: 0.5 mL)

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes, and Microtainers®
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Chemistry Laboratory

Performed

Monday – Friday.
Results available within 3 business days.

Reference Range

See the Chemistry Department’s reference ranges for Total Protein.

See Free Light Chains’ reference ranges for Free Kappa and Free Lambda.

Age	Albumin	Alpha-1 Globulins	Alpha-2 Globulins	Beta Globulins	Gamma Globulins
0-6 Days	2.19-3.26	0.18-0.51	0.26-0.62	0.35-0.56	0.81-1.67
7-15 Days	3.41-4.80	0.18-0.51	0.26-0.62	0.35-0.56	0.81-1.67
16 Days-12 Months	3.41-4.80	0.18-0.51	0.43-0.94	0.43-0.84	0.58-1.55
13 Months-5 Years	3.41-4.80	0.18-0.68	0.43-1.25	0.43-1.03	0.58-2.03
6-16 Years	3.50-5.09	0.18-0.68	0.43-1.25	0.43-1.03	0.58-2.03
17 Years and older	3.42-4.86	0.22-041	0.55-1.09	0.53-1.01	0.60-1.45

Monoclonal protein: Negative

Test Methodology

Capillary Protein Electrophoresis and Immunofixation Electrophoresis.

Interpretation

Capillary Electrophoresis is performed with quantitation of any monoclonal protein detected. A complete immunofixation is also performed. Immunoglobulin quantitations are performed on initial diagnosis of a monoclonal protein, and on follow-up when quantitation by scan is not possible. Immunoglobulin quantitation is also performed with initial diagnosis of hypogammaglobulinemia. If only a small amount of monoclonal protein is present in the beta globulin region, quantitation may not be possible and following the affected immunoglobulin level is the best way to monitor a patient. If the patient has a free kappa or lambda monoclonal protein, use of the free light chain assay to monitor the monoclonal protein quantitation, is recommended.

Clinical Utility

Screening/monitoring of patients with monoclonal proteins, which can be associated with various plasma cell (MGUS, myeloma, light chain amyloidosis) and other hematolymphoid neoplasms.

CPT Codes

83520 x 2, 84165 and 86334.

Contacts

Last Updated

3/9/2023