Ordering Recommendation

Aids in the diagnosis and monitoring of monoclonal gammopathies. Panel includes serum free light chain testing, eliminating the need for urine monoclonal studies as part of initial screening. Use to detect, quantify, and characterize serum monoclonal protein.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Serum separator tube (SST).

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 2.5 mL serum to an ARUP standard transport tube. (Min: 2.0 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma. Room temperature specimens.

Remarks
Stability

After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month

Methodology

Qualitative Immunofixation Electrophoresis (IFE)/Quantitative Capillary Electrophoresis/Quantitative Immunoturbidimetry/Colorimetry

Performed

Sun-Sat

Reported

1-5 days

Reference Interval

Test Number
Components
Reference Interval
  Albumin 3.75-5.01 g/dL
  Alpha 1 Globulin 0.19-0.46 g/dL
  Alpha 2 Globulin 0.48-1.05 g/dL
  Beta Globulin 0.48-1.10 g/dL
  Gamma 0.62-1.51 g/dL
  Immunoglobulin A
Age Reference Interval (mg/dL)
0-2 years 2-126
3-4 years 14-212
5-9 years 52-226
10-14 years 42-345
15-18 years 60-349
19 years and older 68-408

  Immunoglobulin G
Age Reference Interval (mg/dL)
0-2 years 242-1108
3-4 years 485-1160
5-9 years 514-1672
10-14 years 581-1652
15-18 years 479-1433
19 years and older 768-1632

  Immunoglobulin M
Age Reference Interval (mg/dL)
0-2 years 21-215
3-4 years 26-155
5-9 years 26-188
10-14 years 47-252
15-18 years 26-232
19 years and older 35-263

  Total Protein, Serum Refer to report. Reference intervals may vary based on instrumentation.
  Kappa Qnt Free Light Chains 3.30 - 19.40 mg/L
  Lambda Qnt Free Light Chains 5.71-26.30 mg/L
  Kappa/Lambda Free Light Chain Ratio 0.26-1.65
  Monoclonal Protein <=0.00 g/dL

Interpretive Data

Undetected antigen excess is a rare event but cannot be excluded. Free light chain results should always be interpreted in conjunction with other clinical and laboratory findings.

Compliance Category

FDA

Note

A copy of the graph will follow the final report. This assay is highly sensitive to increasing concentrations of monoclonal free kappa or free lambda light chains in the serum of patients with evolving or relapsing myelomas.

Hotline History

N/A

CPT Codes

82784 x3; 84155; 84165; 86334; 83521 x2

Components

Component Test Code* Component Chart Name LOINC
0050020 Albumin 2862-1
0050035 Alpha 1 Globulin 2865-4
0050060 Alpha 2 Globulin 2868-8
0050110 Beta Globulin 2871-2
0050270 Gamma 2874-6
0050271 Immunofixation 25700-6
0050340 Immunoglobulin A 2458-8
0050350 Immunoglobulin G 2465-3
0050355 Immunoglobulin M 2472-9
0050545 Total Protein, Serum 2885-2
0055168 Kappa Qnt Free Light Chains 36916-5
0055169 Lambda Qnt Free Light Chains 33944-0
0055179 Kappa/Lambda Free Light Chain Ratio 80517-6
2005168 SPEP/IFE Interpretation 49275-1
2011827 Monoclonal Protein 33358-3
2012457 EER Monoclonal Protein and FLC, Serum 11502-2
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • IFE
  • IgA, IgG, and IgM
  • Immunofixation, serum
  • Kappa Qnt Free Light Chains
  • Kappa/Lambda Free Light Chain Ratio
  • Kappa/Lambda Free Light Chains
  • Lambda Qnt Free Light Chains
  • MGUS study
  • Monoclonal Protein Study
  • Mutiple Myeloma Study
  • SPEP
Monoclonal Protein Study, Expanded Panel, Serum