Protein Electrophoresis, Random Urine With Reflex to IFE, Random Urine

CPT: 84156; 84166
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Test Details

Synonyms

  • Electrophoresis, Protein, Random Urine With Reflex to IFE, Urine

Test Includes

Random urine protein electrophoresis with automatic reflex to urine immunofixation (IFE) at additional charge if M-spike is present.

Use

Work up myeloma, macroglobulinemia of Waldenström, lymphoma, amyloidosis; differentiate between normal renal function, glomerular proteinuria, and tubular proteinuria. Increased glomerular permeability leads to higher concentrations of large proteins in the glomerular filtrate. Diminished tubular reabsorptive capacity results in a marked increase in urinary excretion of low molecular weight problems.

Limitations

May not detect pathologic light chains due to insufficient sensitivity. Should be followed with immunoelectrophoretic or immunofixation study performed on concentrated urine. Optimal specimen when looking for a free monoclonal light chain (Bence Jones protein) is a 24-hour collection.

Methodology

Electrophoresis on agarose media

Additional Information

A serum protein electrophoresis should be reviewed concurrently if one has not been recently studied. In nonselective glomerular proteinuria, the urine electrophoretic pattern is often a nonspecific one which may be called “mirror image” to that of the serum. Contamination of the urine with blood can give a similar pattern. With selective glomerular permeability, albumin, α1 proteins, and transferrin are the predominant proteins identified on the urine protein electrophoresis, with a relative absence of heavier molecular weight proteins (ie, α2-macroglobulin and immunoglobulins). With tubular proteinuria, low molecular weight proteins (α2-macroglobulin) are predominant, with trace amounts of albumin. So called “overflow proteinuria” occurs when low molecular weight proteins are filtered through the glomerulus in increased amounts.

Specimen Requirements

Specimen

Urine (random)

Volume

20-mL aliquot

Minimum Volume

11-mL aliquot

Container

12-mL plastic transport tube (LabCorp N° 23597) without preservative

Collection

Collect first morning urine; mix well.

Storage Instructions

Refrigerate at 2°C to 8°C.

Causes for Rejection

Preservative added

Clinical Information

Special Instructions

For 24-hour urine specimens, order test 123018.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
003715 PE(Rfx IFE), Random Ur 013664 Protein,Total,Urine mg/dL 2888-6
003715 PE(Rfx IFE), Random Ur 003718 Albumin, U % 13992-3
003715 PE(Rfx IFE), Random Ur 003719 Alpha-1-Globulin, U % 13990-7
003715 PE(Rfx IFE), Random Ur 003720 Alpha-2-Globulin, U % 13993-1
003715 PE(Rfx IFE), Random Ur 003721 Beta Globulin, U % 13994-9
003715 PE(Rfx IFE), Random Ur 003722 Gamma Globulin, U % 13995-6
003715 PE(Rfx IFE), Random Ur 003723 M-Spike, % % 42483-8
003715 PE(Rfx IFE), Random Ur 133800 Please note: 77202-0
003715 PE(Rfx IFE), Random Ur 003716 . N/A
003715 PE(Rfx IFE), Random Ur 003724 PDF 11502-2
Reflex Table for .
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 120725 IFE Reflex, Random Urine 013482 Immunofixation Result, Urine 13440-3

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