Objectives:
To assess the relative value of visual inspection of protein electrophoresis patterns, immunoelectrophoresis, immunofixation, and specific protein quantitation in the investigation of serum proteins.
Design and methods:
A retrospective study of protein results on 372 sera analyzed by electrophoresis and immunoelectrophoresis. a subsection of specimens (276) also had immunoglobulin quantitation by immunonephelometry and 30 were studied by immunofixation.
Results:
Total gamma globulin levels were correctly assessed visually in 84.4% of cases. discrete bands seen visually were mainly monoclonal in 74 of 80 (92.5%). six monoclonal proteins were not detected visually. twenty-five monoclonal proteins required immunofixation for typing, and 60 were typed by immunoelectrophoresis. the visual assessment of the level of normal immunoglobulins in the presence of a monoclonal gammopathy was correct in 58% of cases.
Conclusions:
The majority of monoclonal gammopathies could be evaluated by a combination of protein electrophoresis and immunoelectrophoresis. except for quantitating monoclonal immunoglobins, protein electrophoresis was unreliable as a quantitative procedure and nephelometry was preferred.