The importance of capillary protein electrophoresis in the early diagnosis and follow-up of monoclonal gammopathies

INTRODUCTION: Serum protein electrophoresis is a low-cost and low-sensitivity technique used for screening monoclonal gammopathies with capillary protein electrophoresis. Immunofixation electrophoresis, on the other hand, is a highly sensitive technique used in the diagnosis, treatment, and follow-up of monoclonal gammopathies in patients with peak or abnormal patterns in serum protein electrophoresis scans; however, it is also more expensive. In monoclonal gammopathies, excessive production of immunoglobulins, known as monoclonal bands, is observed as sharp bands in immunofixation electrophoresis. In this study, we aimed to highlight the contribution of serum protein electrophoresis and immunofixation electrophoresis in detecting monoclonal bands in laboratory reports and their role in the early diagnosis and follow-up of patients.
METHODS: In this study, 781 serum protein electrophoresis and 144 immunofixation electrophoresis analysis reports were retrospectively evaluated. Of the 52 patients with deterioration in their SPE, 10 patients with SUD detected in their IFE were included in the study. The serum samples of the patients were analyzed using the Minicap Flex Piercing and Hydrasys 2 Scan Focusing analysis devices (Sebia, France).
RESULTS: Among serum protein electrophoresis patterns, pathology (peak or distortion) was detected in 196 cases. Of these, peak was detected in 144 cases in SPE, while distortion was observed in 52 cases. For the evaluation of the disturbed electrophoretic patterns, immunofixation electrophoresis was recommended in the reports. Following clinical evaluation by the treating physician, immunofixation electrophoresis was performed for 26 patients. Monoclonal band was observed in 10 (38.5%) of these patients who underwent IFE study.
DISCUSSION AND CONCLUSION: In our retrospective study, it was found that the frequency of monoclonal bands was high in patients with abnormal serum protein electrophoresis patterns where immunofixation electrophoresis was recommended. This underscores the importance of serum protein electrophoresis as a screening tool in the early diagnosis and follow-up of monoclonal gammopathies.