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CC BY-NC-ND 4.0 · J Lab Physicians 2022; 14(04): 505-510
DOI: 10.1055/s-0042-1744242
Case Report

Unraveling the Possibilities of Monoclonal Protein Migration, Identification, and Characterization in SPEP on Capillary Zone Electrophoresis

Shailata Prisi
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
,
Vatsala Khurana
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
,
Rajni Saijpaul
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
,
Rashmi Verma
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
,
Lal Chandra
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
,
Bidhan Chandra Koner
1   Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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Abstract

Serum protein electrophoresis (SPEP) is a method by which proteins present in serum are separated into different fractions based on their molecular weight and electric charge. Presence of M spike, composed of monoclonal protein, on electrophoretogram is a characteristic finding that can be seen in monoclonal gammopathies like multiple myeloma. M spike is most commonly seen in the gamma region however, the M-spike can be observed in fraction other than the Y fraction as well i.e. in the beta region and rarely alpha region. Here we have enumerated few cases where M protein has been seen in fractions other than the gamma region. Thus one needs to be cautious about the variable appearance of M-spike during interpretation of SPEP as some physiological proteins if elevated can also give rise to similar spike sometimes referred as pseudo monoclonal pattern.

Keywords

capillary zone electrophoresis - multiple myeloma - M-spike - monoclonal protein - variable migration

Authors' Contribution

All the authors contributed to the concepts, design, definition of intellectual content, and statistical analysis. S.P., R.S., and R.V. contributed to the literature research, manuscript preparation, and data analysis. S.P., V.K., and R.S. contributed to data acquisition. S.P., V.K., R.S., and R.V. contributed to manuscript editing. R.S., L.C., and B.C.K. contributed to manuscript review. All authors are the guarantors of this paper.




Publication History

Article published online:
25 April 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Dash NR, Mohanty B. Multiple myeloma: a case of atypical presentation on protein electrophoresis. Indian J Clin Biochem 2012; 27 (01) 100-102
    CrossrefPubMedGoogle Scholar
  • 2 Keren DF, Schroeder L. Challenges of measuring monoclonal proteins in serum. Clin Chem Lab Med 2016; 54 (06) 947-961
    CrossrefPubMedGoogle Scholar
  • 3 Tripathy S. The role of serum protein electrophoresis in the detection of multiple myeloma: an experience of a corporate hospital. J Clin Diagn Res 2012; 6 (09) 1458-1461
    PubMedGoogle Scholar
  • 4 Smith JD, Raines G, Schneider HG. Should routine laboratories stop doing screening serum protein electrophoresis and replace it with screening immune-fixation electrophoresis? No quick fixes: counterpoint. Clin Chem Lab Med 2016; 54 (06) 967-971 (CCLM)
    CrossrefPubMedGoogle Scholar
  • 5 Regeniter A, Siede WH. Peaks and tails: evaluation of irregularities in capillary serum protein electrophoresis. Clin Biochem 2018; 51: 48-55
    CrossrefPubMedGoogle Scholar
  • 6 Gastélum-Cano JM, Fragoso-Flores J, Noffal-Nuño VM, Deffis-Court M. An unusual pattern in serum protein electrophoresis to take in mind: a case report. Pract Lab Med 2021; 24: e00200
    CrossrefPubMedGoogle Scholar
  • 7 Plasma proteins. In: Marshall WJ. ed. Illustrated Textbook of Clinical Chemistry. 2nd ed.. London: Gower Medical Publications; 1992: 210-221
    Google Scholar