Ordering Recommendation

Aid in the diagnosis of monoclonal gammopathies, including multiple myeloma, when clinical pretest probability is low. Use to detect and quantify serum monoclonal protein. Immunofixation is performed if patterns from SPEP are monoclonal or suspicious.  

Mnemonic
SPEP REFLEX
Methodology

Quantitative Capillary Electrophoresis/Qualitative Immunofixation Electrophoresis/Quantitative Nephelometry/Quantitative Spectrophotometry

Performed

Sun-Sat

Reported

1-5 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Serum Separator Tube (SST).

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 1.5 mL serum to an ARUP Standard Transport Tube. (Min: 1.5 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma.

Remarks
Stability

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

Reference Interval
Test Number
Components
Reference Interval

0050640 Protein Electrophoresis, Serum Effective August 19, 2019
Test Number
Components
Reference Interval
  Total Protein, Serum Refer to report
  Albumin Refer to report
  Alpha 1 Globulin Refer to report
  Alpha 2 Globulin Refer to report
  Beta Globulin Refer to report
  Gamma Refer to report

0050350 Immunoglobulin G
0- 30 days: 611-1542 mg/dL              
1 month: 241-870 mg/dL                          
2 months: 198-577 mg/dL            
3 months: 169-558 mg/dL                    
4 months: 188-536 mg/dL                          
5 months: 165-781 mg/dL                          
6 months: 206-676 mg/dL                           
7-8 months: 208-868 mg/dL                        
9-11 months: 282-1026 mg/dL
1 year: 331-1164 mg/dL
2 years: 407-1009 mg/dL
3 years: 423-1090 mg/dL
4 years: 444-1187 mg/dL
5-7 years: 608-1229 mg/dL
8-9 years: 584-1509 mg/dL
10 years and older: 768-1632 mg/dL

0050340 Immunoglobulin A Effective February 16, 2016
0-30 days: 1-7 mg/dL
1 month: 1-53 mg/dL
2 months: 3-47 mg/dL
3 months: 5-46 mg/dL
4 months: 4-72 mg/dL
5 months: 8-83 mg/dL
6 months: 8-67 mg/dL
7-8 months: 11-89 mg/dL
9-11 months: 16-83 mg/dL
1 year: 14-105 mg/dL
2 years: 14-122 mg/dL
3 years: 22-157 mg/dL
4 years: 25-152 mg/dL
5-7 years: 33-200 mg/dL
8-9 years: 45-234 mg/dL
10 years and older: 68-408 mg/dL

0050355 Immunoglobulin M Effective February 16, 2016
0-30 days: 0-24 mg/dL                     
1 month: 19-83 mg/dL                                
2 months: 16-100 mg/dL                          
3 months: 23-85 mg/dL                               
4 months: 26-96 mg/dL                             
5 months: 31-103 mg/dL                            
6 months: 33-97 mg/dL                               
7-8 months: 32-120 mg/dL                         
9-11 months: 39-142 mg/dL
1 year: 41-164 mg/dL
2 years: 46-160 mg/dL
3 years: 45-190 mg/dL
4 years: 41-186 mg/dL
5-7 years: 46-197 mg/dL
8-9 years: 49-230 mg/dL
10 years and older: 35-263 mg/dL

Interpretive Data

Immunofixation electrophoresis is a more sensitive technique than serum protein electrophoresis for the identification of small M-proteins found in patients with amyloidosis, early or treated myeloma and macroglobulinemia, MGUS, solitary plasmacytoma, and extramedullary plasmacytoma. 

Compliance Category

FDA

Note

If patterns from serum protein electrophoresis are monoclonal or suspicious, then Immunofixation Electrophoresis will be added. Additional charges apply.

IFE is a more sensitive method for determining and defining monoclonal proteins. No additional testing will be added for proteins that are normal, polyclonal, or that lack monoclonal patterns.

Hotline History
N/A
CPT Codes

84155; 84165; if reflexed, add 82784 x3; 86334

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
0050346 Immunofixation Reflex 13348-8
0050545 Total Protein, Serum 2885-2
2005168 SPEP/IFE Interpretation 49275-1
2012455 EER Serum Protein Electrophoresis Reflex 11526-1
* 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
  • Electrophoresis, Protein, Serum with Reflex to Immunofixation Electrophoresis
  • IFE Reflex
  • MGUS study
  • Monoclonal protein detection
  • Monoclonal Protein Study
  • Multiple Myeloma Study
  • Protein Electrophoresis with Interpretation, Serum and Reflex to IFE and QNTIG's
  • Protein Electrophoresis, Serum with Reflex to IFE, Serum
  • Protein Electrophoresis, with Interpretation Serum, With Reflex to IFE, Serum
  • SPEP
Protein Electrophoresis with Reflex to Immunofixation, Serum