Immunofixation Only, Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Monoclonal gammopathies indicate a clonal expansion of plasma cells or mature B lymphocytes. The monoclonal gammopathies include diseases such as multiple myeloma, Waldenstrom’s macroglobulinemia, lymphoproliferative disease, primary systemic amyloidosis, light-chain deposition disease, as well as the premalignant disorders of smoldering myeloma and monoclonal gammopathy of undetermined significance (MGUS). Monoclonal gammopathy patients may have a relatively small monoclonal protein abnormality or a large quantifiable peak (M-spike) on serum or urine protein electrophoresis. Abnormalities detected on serum protein electrophoresis (SPEP) should be immunotyped to confirm and characterize the monoclonal protein. Immunotyping of monoclonal proteins is usually done by immunofixation electrophoresis (IFE) and identifies the monoclonal immunoglobulin heavy-chain (gamma, alpha, mu, delta, or epsilon) and/or light-chain type (kappa or lambda). It is generally recommended that both SPEP and IFE be used as a screening panel. Because IFE is more sensitive than SPEP, IFE is not only recommended as part of the initial screening process but also for confirmation of complete response to therapy.
Identification of monoclonal immunoglobulin heavy and light chainsDocumentation of complete response to therapy
Immunofixation impression comments are made based on visual interpretation of gels.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Immunofixation is not a quantitative assay. If a monoclonal protein is identified, a serum protein electrophoresis assay is required for quantifying the abnormality.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
No monoclonal protein detected
Clinical References Provides recommendations for further in-depth reading of a clinical nature
Kyle RA, Katzmann JA, Lust, JA, Dispenzieri A: Clinical indications and applications of electrophoresis and immunofixation. In Manual of Clinical Laboratory Immunology. Sixth edition. Edited by NR Rose, RG Hamilton, B Detrick. Washington DC. ASM Press, 2002, pp 66-70