I have been looking at results from these since December 2021 when the wife had her Myeloma diagnosis. There was a large monoclonal peak in the gamma globulin area, a characteristic “finger print”. I have seen dozens of these electrophoresis traces. Her therapy quickly reduced the monoclonal peak below the detection thresholds. The technique is key to the diagnosis of Myeloma and smouldering Myeloma.
My blood is having one of these tests done today. I have found that Canadian healthcare web sites have a nice balance of detail and not treating you as a numpty.
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South Tees Hospital Pathology
“Serum electrophoresis is essential in the investigation of suspected paraproteinaemia and immune deficiency. Characteristic patterns are also seen in the presence of an acute phase response, nephrotic syndrome, alpha 1 antitrypsin deficiency, inflammatory and infective disorders. SPE is performed on all specimens submitted for immunoglobulin quantitation to check whether the immunoglobulins are polyclonal or monoclonal proteins. Polyclonal increases are due to and increased activity of numerous different lymphocytes and are associated with a wide range of infectious and inflammatory diseases including liver disease. The main value in serum electrophoresis is detection of monoclonal immunoglobulins associated with lymphoid malignancy, myeloma or related haematological disorders. Since quantitative immunoglobulin measurements cannot differentiate between monoclonal and polyclonal immunoglobulins, paraprotein determination (monoclonal protein) must be carried out by quantitation of bands obtained on electrophoresis.”
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From https://myhealth.alberta.ca
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“The serum protein electrophoresis (SPEP) test measures specific proteins in the blood to help identify some diseases. Proteins are substances made up of smaller building blocks called amino acids. Proteins carry a positive or a negative electrical charge, and they move in fluid when placed in an electrical field. Serum protein electrophoresis uses an electrical field to separate the proteins in the blood serum into groups of similar size, shape, and charge.
Blood serum contains two major protein groups: albumin and globulin. Both albumin and globulin carry substances through the bloodstream. Using protein electrophoresis, these two groups can be separated into five smaller groups (fractions):
- Albumin. Albumin proteins keep the blood from leaking out of blood vessels. Albumin also helps carry some medicines and other substances through the blood and is important for tissue growth and healing. More than half of the protein in blood serum is albumin.
- Alpha-1 globulin. High-density lipoprotein (HDL), the “good” type of cholesterol, is included in this fraction.
- Alpha-2 globulin. A protein called haptoglobin, which binds with hemoglobin, is included in the alpha-2 globulin fraction.
- Beta globulin. Beta globulin proteins help carry substances, such as iron, through the bloodstream and help fight infection.
- Gamma globulin. These proteins are also called antibodies. They help prevent and fight infection. Gamma globulins bind to foreign substances, such as bacteria or viruses, causing them to be destroyed by the immune system.
Each of these five protein groups moves at a different rate in an electrical field and together form a specific pattern. This pattern helps identify some diseases.
Serum protein electrophoresis is most often done to help diagnose and monitor a wide variety of conditions. These include:
- Some forms of cancer.
- Problems with the kidneys or liver.
- Problems with the immune system.
- Conditions that lead to poor nutrition.
High values
High values may be caused by many conditions. Some of the most common are shown here.
- High albumin: Dehydration
- High alpha-1 globulin: Infection; inflammation
- High alpha-2 globulin: Inflammation; kidney disease
- High beta globulin: Very high cholesterol; low iron (iron-deficiency anemia)
- High gamma globulin: Inflammation; infection; liver disease; some forms of cancer
Low values
Low values may be caused by many conditions. Some of the most common are shown here.
- Low albumin: Poor nutrition; inflammation; liver disease; kidney disease
- Low alpha-1 globulin: Some genetic problems
- Low alpha-2 globulin: Kidney disease; some cancers
- Low beta globulin: Poor nutrition
- Low gamma globulin: Problems with the immune system “
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Given the high levels of ferritin yet normal levels of transferrin in my blood, the primary screen has to be for liver disease. But the bullet point for cancer above has quite a list behind it. I guess that the beta globulins may be abnormal in some way because of Iron. Anything weird in the gamma region means more tests…There are rheumatological factors. The tests show inflammation. I don’t think at 100kg I class a malnourished.
Anything non-standard will mean more tests [probably].
I’ll speculate that more tests are somehow “on the cards”.
Dreamyoga 