Protein Electrophoresis, Serum With Reflex to IFE, Serum and Free κ and λ Light Chains, Serum

CPT: 84155; 84165
Updated on 5/28/2019
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Synonyms

  • Free Light Chains, Quantitative, Serum
  • Freelite®
  • Globulins, Serum
  • IEP, Serum
  • IFE, Serum and Protein Electrophoresis, Serum
  • Immunoelectrophoresis for Myeloma Proteins
  • Immunoelectrophoresis, Serum
  • Immunofixation, Serum
  • Kappa Free Light Chains, Quantitative, Serum
  • Kappa/Lambda Free Light Chains, Quantitative, Serum
  • Kappa:Lambda Free Light Chains Ratio, Quantitative, Serum
  • Lambda Free Light Chains, Quantitative, Serum
  • Light Chains, Free Kappa and Free Lambda, Quantitative, Serum

Test Includes

Serum protein electrophoresis with automatic reflex to serum immunofixation (IFE) at an additional charge if M-spike is present


Expected Turnaround Time

2 - 5 days

2 - 5 days


Related Documents


Specimen Requirements


Specimen

Serum


Volume

5.5 mL


Minimum Volume

2.2 mL


Container

Red-top tube or gel-barrier tube


Collection

Sample should be allowed to clot and the serum separated as soon as possible to prevent hemolysis.


Storage Instructions

Refrigerate at 2°C to 8°C.


Patient Preparation

Patient should be fasting for eight hours to avoid lipemic sample interference.


Causes for Rejection

Lipemia; hemolysis; plasma instead of serum


Test Details


Use

Detect and identify monoclonal immunoglobulin gammopathies. Diagnose myeloma, macroglobulinemia of Waldenström. Immunofixation is used to evaluate monoclonal gammopathy (M protein) found on serum protein electrophoresis; evaluate amyloidosis. Has application to the evaluation of lymphoproliferative disease (malignant lymphoma and others) and collagen disease in general. Of use in the diagnosis and characterization of immune deficient and dysgammaglobulinemic states. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) recommend the use of serum free light chain assays for use in the initial diagnostic workup of multiple myeloma and related disorders. "Use of free light chain (FLC) assay along with SPEP and SIFE yields high sensitivity while screening for MM and related plasma cell disorders. Therefore, this assay is now included as a part of the initial diagnostic workup in the NCCN Multiple Myeloma Guidelines."1


Methodology

PE: electrophoresis on agarose media; IFE: electrophoresis followed by immunodiffusion against monospecific antisera to immunoglobulin and individual heavy and light chains; Immunoglobulins: turbidimetric quantitation; FLC: immunologic quantitation


Footnotes

1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) for Multiple Myeloma, Version 1.2011. Fort Washington, Pa: NCCN; 2011.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123041 PE (Rfx IFE+FLC), S 001073 Protein, Total g/dL 2885-2
123041 PE (Rfx IFE+FLC), S 001488 Albumin g/dL 2862-1
123041 PE (Rfx IFE+FLC), S 001489 Alpha-1-Globulin g/dL 2865-4
123041 PE (Rfx IFE+FLC), S 001490 Alpha-2-Globulin g/dL 2868-8
123041 PE (Rfx IFE+FLC), S 001491 Beta Globulin g/dL 2871-2
123041 PE (Rfx IFE+FLC), S 001492 Gamma Globulin g/dL 2874-6
123041 PE (Rfx IFE+FLC), S 001493 M-Spike g/dL 33358-3
123041 PE (Rfx IFE+FLC), S 001498 PDF 11502-2
123041 PE (Rfx IFE+FLC), S 001499 IFE Reflex N/A
123041 PE (Rfx IFE+FLC), S 011052 Globulin, Total g/dL 10834-0
123041 PE (Rfx IFE+FLC), S 011149 A/G Ratio 1759-0
123041 PE (Rfx IFE+FLC), S 011150 Please note: 77202-0
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001496 Immunofixation Reflex, Serum 001792 Immunoglobulin M, Qn, Serum mg/dL 2472-9
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001496 Immunofixation Reflex, Serum 149519 Immunofixation Result, Serum 13169-8
Reflex 2 149532 Immunofixation Interp.,Sr 149532 Immunofixation Interp.,Sr 13169-8
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 001776 Immunoglobulin G, Qn, Serum mg/dL 2465-3
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 001784 Immunoglobulin A, Qn, Serum mg/dL 2458-8
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 001792 Immunoglobulin M, Qn, Serum mg/dL 2472-9
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 149519 Immunofixation Result, Serum 13169-8
Reflex 2 149532 Immunofixation Interp.,Sr 149532 Immunofixation Interp.,Sr 13169-8
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001496 Immunofixation Reflex, Serum 001776 Immunoglobulin G, Qn, Serum mg/dL 2465-3
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 001496 Immunofixation Reflex, Serum 001784 Immunoglobulin A, Qn, Serum mg/dL 2458-8
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 121138 Free Kappa Lt Chains,S mg/L 36916-5
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 121139 Free Lambda Lt Chains,S mg/L 33944-0
Reflex Table for IFE Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 123000 IFE+Kappa/Lambda Qn S 121140 Kappa/Lambda Ratio,S 48378-4

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