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Serum Electrophoresis
Comments

 Code        Description

EPC

Total protein, albumin, and all globulin fractions within reference intervals.

 

 

Albumin

EPX

Hypoalbuminemia

 

EPX1

Hypoalbuminemia consistent with albumin wasting disorder.

 

EPH

(see also EPY)

Hypoalbuminemia. Decreased alpha-2 globulins. Hypergamma-globulinemia with beta-gamma bridging. Pattern consistent with chronic inflammatory hepatic disorder (?cirrhosis).

 

 

ADA

If albumin differs  between SPEP and  ordered (routine chem.), this comment can be used at the discretion of the reviewer. It should FOLLOW all other interpretations.

Visual interpretation of the electrophoretic pattern suggests decreased albumin, confirmed at __g/dL by an accurate (immunochemical ; chemical) method.

 

Alpha-1 globulins 

EPD

Increased alpha-1 globulins (alpha-1-antitrypsin, acute phase reactant)

 

EPD1

Decreased alpha-1 globulins (alpha-1-antitrypsin, acute phase reactant). We recommend alpha-1 antitrypsin quantitation and phenotyping, if clinically indicated.

 

Alpha-2 globulins

EPJ

Increased alpha-2 globulins (haptoglobin and  alpha-2 macroglobulin, acute phase reactants)

 

EPJ1

Decreased alpha-2 globulins (haptoglobin and  alpha-2 macroglobulin, acute phase reactants)

 

EPM

Pattern is consistent with non-selective protein loss and/or underproduction with a compensatory increase in alpha-2 globulin production.

 

Beta globulins

EPE

Increased beta-1 globulins (transferrin and  beta lipoproteins, acute phase reactants).

EPE 1

Decreased beta-1 globulins (transferrin and  beta lipoproteins, acute phase reactants).

 

 

Gamma globulins

EPN

Hypogammaglobulinemia

EPA

Hypergammaglobulinemia of polyclonal origin. Pattern is consistent with inflammatory process.

 

EPY

Hypergammaglobulinemia with

(confluence between the beta and gamma zones (beta-gamma bridging)

                                              or

 increased beta globulins, secondary to bridging with gamma zone) .

Pattern is consistent with chronic inflammatory disorder (?cirrhosis.)

EPO

Hypergammaglobulinemia with multiple small discrete bands detected within a broad zone of increased polyclonal gamma globulins. This pattern is suggestive of an oligoclonal expansion of a restricted number of B-cell clones associated with active hepatic inflammation, autoimmune, immunodeficient, or  immunosuppressive conditions involving altered immunoregulatory mechanisms.  We recommend serum immunofixation electrophoresis for clarification, if clinically indicated.

EPL

Polyclonal immunoglobulins  appear (mildly, moderately, severely) decreased; estimated level is  _________g/dL.

(Interpreter: fill in the blank by subtracting total gamma, g/dL – abnormal protein, g/dL)

 

EPK

A discrete band representing an M-protein, previously identified by immunofixation electrophoresis (alternately write clinically classified) as ___is detected at a level of __g/dL in the __zone. Previous level was ___g/dL on _  /   /__.

 

EPK 1

The prominent (or other modifier ) monoclonal ______ protein is detected at a level of ______g/dL (use alternate appropriate units for urine) in the _____zone. Previous level was _____g/dL (or alternate units) on _  /   /__.

 

EPZ

No monoclonal bands seen.

 

EPZ1

No monoclonal or oligoclonal bands seen

 

TRIAGE

 

RTC

 

Refer to concurrent  (write date inside parentheses) _________(fill in the blank for serum or urine IFE or PEP).

 

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Last modified: 03/05/06