Protein Electrophoresis

Label Mnemonic:	SPE
Epic code:	LAB953
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Chemistry
6240 RCP
356-3527

Specimen(s):

Serum

Collection Medium:

Red top tube 5 mL (Clot Activator)

Minimum:

2 mL whole blood or one microtube for pediatric patients includes total protein.

Testing Schedule:

Daily - Monday-Friday

Turn Around Time:

48 Hours

Reference Range:

Albumin      3.7 - 5.2 g/dl
Alpha1       0.3 - 0.6 g/dl
Alpha2       0.3 - 0.8 g/dl
Beta         0.5 - 1.1 g/dl
Gamma        0.6 - 1.5 g/dl

Comments:

Serum protein electrophoresis methodology switched from traditional gel electrophoresis to capillary electrophoresis on September 24, 2012.

Capillary electrophoresis can resolve separate beta-1 and beta-2 fractions, although a reference range is only available for the total beta fraction.

Reference ranges changed on 10/17/2023. The reference intervals published by Katzmann et al. were verified as appropriate for the UIHC population.

Katzmann JA, et al. Prospective study of serum protein capillary zone electrophoresis and immunotyping of monoclonal proteins by immunosubtraction. Am J Clin Pathol. 1998 Oct;110(4):503-9. doi: 10.1093/ajcp/110.4.503. PMID: 9763037.

The table below shows the proteins that predominantly make up the fractions of electrophoresis:


Fraction     Protein                     Major or minor protein
                                         visible by electrophoresis

Albumin      Albumin                               Major

Alpha-1      Alpha-1 antitrypsin                   Major
             Alpha-1 lipoprotein                   Minor
             Alpha-1 acid glycoprotein             Minor

Alpha-2      Alpha-2 macroglobulin                 Major
             Haptoglobin                           Major
             Ceruloplasmin                         Minor
             Fibronectin                           Minor

Beta-1       Transferrin                           Major

Beta-2       C3                                    Major
             C4                                    Minor
             Beta-lipoprotein                      Minor

Beta-2 /     Fibrinogen                            Major
Beta-gamma   IgA                                   Major*
             IgM                                   Major*

Gamma        Most immunoglobulins                  Major
             C-reactive protein                    Minor

*IgA and IgM are normally not very visible in individuals without a 
plasma cell dyscrasia by electrophoresis, but are detectable when 
present as M-proteins.  Polyclonal IgA can be seen in cirrhosis.

Radiocontrast dyes used in imaging can produce small peaks by capillary 
electrophoresis.  Iohexol and iopamidol show up in the alpha-2 region.  
It is recommended to delay electrophoresis, if possible, for several 
days after radiocontrast dye administration.

Gelatin-based plasma substitutes can produce polyclonal-like increases 
in beta-gamma and gamma regions.

Piperacillin-tazobactam can produce a small peak in the beta-1 
region.

Methodology:

Capillary Electrophoresis