Serum Protein Electrophoresis (Blood)

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Serum Protein Electrophoresis (Blood)

Testing Laboratory

Auckland Te Toka Tumai | Auckland Hospital

Department

Chemical Pathology

Delphic Registration Code (Alpha Code)

EPG

Test Code (Numeric Code)

7301

Laboratory Handling

Phlebotomy

Serum

Transport

Ambient

Registration

For serum samples received for EPP, if any of the following tests are also requested, they must be registered under a separate barcode: Alkaline Phosphatase Isoenzymes, CSF Protein Analysis, Lipoprotein electrophoresis, Cryoglobulin and Cryofibrinogen

Laboratory

LabPlus Immunochemistry

Test Adds Requirement

Samples are stored at -20°C for 1 month

Sample Stability

4-8°C for up to 10 days. For longer storage should be frozen within 8 hours of collection. Once frozen, serum is stable for up to 2 months at -20°C

Associated Tests

Immunofixation (Blood)

Synonyms

EPP, Immunofixation, SPEP, Protein electrophoresis

Turnaround Time

5 days

Up to 5 extra days if immunofixation is required

Specimen Type

Serum

Specimen Requirements

Tube/Container Type:

Preferred

SST II (Gold Cap)

Acceptable

Plain (Red Top)

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Plain (Red Top)

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

0.5

Pre-testing Requirements

Requests for serum protein electrophoresis in a patient who already has a result reported in the last 25 days, will be automatically declined.

In the rare circumstance that more frequent testing is clinically indicated (e.g., light chain nephropathy), please contact the laboratory within 7 days to reinstate.

Diagnostic Use

The following tests will be performed for Myeloma Screen:

Immunoglobulin G, A and M
Serum protein electrophoresis
Serum free light chains and kappa/lambda ratio

Identifying Monoclonal ammopathies

Capillary zone electrophoresis (CZE) is performed to identify abnormal/ monoclonal bands. Features like, e.g., significant reduction in albumin, low alpha 1 (raises the possibility of alpha 1- antitrypsin deficiency), and patterns suggestive of acute phase reaction, iron deficiency, nephrotic syndrome, immune suppression or interference from, e.g., haemolysis or contrast will also be commented on if present.
If an abnormal band is detected or suspected on CZE, immunofixation will be performed to identify the isotype of the band, while band quantification will be performed by CZE.
Immunofixation will only be performed when a new, abnormal protein band is detected, when a patient’s protein electrophoretic pattern changes significantly, when immunofixation is specifically requested or at the pathologist’s discretion.
Immunofixation is not routinely performed if the CZE pattern looks normal. However, in peripheral neuropathy for investigation (where chronic inflammatory demyelinating neuropathy is suspected), immunofixation can be useful as it has a higher sensitivity than CZE; in these cases, “NEUROPATHY – immunofixation required” should be written clearly on the request form under Clinical Details. Otherwise, immunofixation will not be added to the request.
First-tier immunofixation routinely identifies IgG, IgA, IgM, kappa and lambda isotypes. For newly identified, unmatched kappa or lambda light chain bands, immunofixation against the rare IgD and IgE heavy chains will be tested.
Multiple bands of the same isotype can arise from in vitro polymerisation of the IgA or IgM monoclonal protein. Treatment with a depolymerising reagent (beta-mercaptoethanol) before immunofixation can help to identify polymerisation.

Band quantitation

Band quantitation aids in monitoring patients with a quantifiable monoclonal band. The uncertainty of measurement for band quantitation is 15%.
Quantitation of bands in the non-gamma region: perpendicular drop method (or selected perpendicular drop method if the reader can confidently define the shoulders of the band). This gating method includes both the monoclonal band and the co-migrating normal serum proteins. This caveat (over-estimating the band quantity) is routinely stated in all such reports.
Quantitation of bands in the gamma region: tangent skimming method.

An interpretative comment is included in the report to assist with clinical interpretation of the EPP findings.

Reference Intervals

Qualitative interpretation.

Test Method

Capillary electrophoresis on the Sebia Capillarys 3 Octa

Limitations / Interference

Viscous samples / Moderate or grossly haemolysed samples / Lipaemic samples / Fibrin clots

Uncertainty of Measurement

For the gamma region: The uncertainty of measurement of paraproteins (if present) is 8% at a concentration of 20g/L and 20% at a concentration of 8 g/L. For the non-gamma region: The uncertainty of the quantitation (if present) is 5% at the concentration of 20g/L.

Last updated: 13/05/2026

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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z #

Overview

Testing Laboratory

Department

Delphic Registration Code (Alpha Code)

Test Code (Numeric Code)

Laboratory Handling

Phlebotomy

Transport

Registration

Laboratory

Test Adds Requirement

Sample Stability

Associated Tests

Synonyms

Turnaround Time

Specimen

Specimen Type

Specimen Requirements

Tube/Container Type:

Preferred

Acceptable

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

Preferred Sample Volume (ml)

Minimum Sample Volume (ml)

Pre-testing Requirements

Referral

Aliquot Instructions

Sample Type

Minimum Volume (ml)

Transport to Lab

Clinical Information/Test Method

Diagnostic Use

Reference Intervals

Test Method

Limitations / Interference

Uncertainty of Measurement

Additional Information

Resources

Contact Information

Contact Information

Enquiry Form

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