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Monoclonal Gammopathy Evaluation, Serum

Serum Monoclonal Gammopathy Evaluation

Test Codes

EPIC: LAB5871, Beaker: SMGE, Antrim #32036

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 Testing 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.

Serum Protein fractions (g/dL):

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 Month	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	0.22-0.41	0.55-1.09	0.53-1.01	0.60-1.45

Monoclonal protein: Negative

Test Methodology

Capillary Protein 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.

Reflex Testing

Run SPE and FRLC. If new abnormality, reflex to immunofixation electrophoresis.

Clinical Utility

It is suggested that this test be ordered for patients suspected of having a monoclonal gammopathy. If a monoclonal protein is detected, it will be identified and quantified automatically.

CPT Codes

83520 x 2, 84165 with reflex to 86334

Contacts

Last Updated

1/11/2024