Serum Protein Electrophoresis

Serum protein electrophoresis (SPEP) is an easy, inexpensive method of separating proteins based on their net charge, size, and shape. The 2 major types of protein present in the serum are albumin and the globulin proteins. Albumin is the major protein component of serum and represents the largest peak that lies closest to the positive electrode. [1] Globulins comprise a much smaller fraction of the total serum protein but represent the primary focus of interpretation of serum protein electrophoresis. Five globulin categories are represented: alpha-1, alpha-2, beta-1, beta-2, and gamma, with the gamma fraction being closest to the negative electrode.

Serum protein electrophoresis is generally considered in any patient with an elevated total protein, especially those with elevated globulin level relative to albumin, or any signs and symptoms suggestive of an underlying plasma cell disorder such as multiple myeloma, Waldenstrom’s macroglobulinemia, or primary amyloidosis. [3] These include any of the following:

• Unexplained anemia, back pain, bone pain, fatigue
• Unexplained pathologic fracture or lytic lesions
• Unexplained peripheral neuropathy
• Hypercalcemia secondary to possible malignancy
• Hypergammaglobulinemia
• Rouleaux formation noted on peripheral blood smear
• Renal insufficiency with bland urine sediment
• Unexplained proteinuria
• Bence Jones proteinuria
• Recurrent infections

Read more:
Serum Protein Electrophoresis: Reference Range, Interpretation, Collection and Panels

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Source: Medscape