scholarly journals Simple thrombin-based method for eliminating fibrinogen interference in serum protein electrophoresis of haemodialysed patients

2020 ◽  
Vol 30 (2) ◽  
pp. 265-271
Author(s):  
Anamarija Rade ◽  
Anamarija Đuras ◽  
Irena Kocijan ◽  
Patricija Banković Radovanović ◽  
Ana Turčić
Keyword(s):  
Serum Protein ◽  
Venous Catheter ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Blood Collection ◽  
Serum Samples ◽  
Becton Dickinson ◽  
Vascular Access Devices ◽  
Hospital Protocols ◽  
Clot Activator

Introduction: Serum samples of haemodialysed patients collected through vascular access devices, e.g. central venous catheter (CVC) can contain residual heparin, which can cause incomplete clotting and consequently fibrinogen interference in serum protein electrophoresis (SPE). We hypothesized that this problem may be overcome by addition of thrombin and aimed to find a simple thrombin-based method for fibrinogen interference removal. Materials and methods: Blood samples of 51 haemodialysed patients with CVC were drawn through catheter into Clot Activator Tube (CAT) and Rapid Serum Tube Thrombin (RST) vacutainers (Becton Dickinson, New Jersey, USA) following the routine hospital protocols and analysed with gel-electrophoresis (Sebia, Lisses, France). Samples were redrawn in the CAT tubes and re-analysed after being treated with thrombin using two methods: transferring CAT serum into RST vacutainer and treatment of CAT serum with fibrinogen reagent (Multifibren U, Siemens, Marburg, Germany). Results: Direct blood collection in RST proved to be slightly more efficient than CAT in removing the interfering band in beta fraction (CAT removed 6/51 and RST removed 12/51, P = 0.031). Transferring CAT serum into the RST vacutainer proved to be more efficient for subsequent removal of interfering band from CAT serum than the addition of fibrinogen reagent (39/45 vs. 0/45 samples with efficiently removed interfering band, P < 0.001). Conclusion: Fibrinogen interference caused by incomplete clotting because of residual heparin can be overcome by addition of thrombin. Transferring CAT serum into the RST vacutainer was the most efficient method.

Electrophoretic patterns post daratumumab

2017 ◽  
Vol 55 (2) ◽  
pp. 299-301 ◽  
Author(s):  
Joanna Sheldon ◽  
Rachel D Wheeler ◽  
Ray Powles
Keyword(s):  
Multiple Myeloma ◽  
Monoclonal Antibody ◽  
Serum Protein ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Serum Samples ◽  
Monoclonal Protein ◽  
Electrophoretic Patterns ◽  
Small Band ◽  
Human Igg1

Background Daratumumab (Darzalex) is a human IgG1 kappa monoclonal antibody targeting CD38 that has been recently approved for the treatment of refractory multiple myeloma. As it is a monoclonal protein, it can be detected on routine serum protein electrophoresis and by immunofixation. Methods Serum samples from four patients were analysed by serum protein electrophoresis immediately pre- and post-treatment with daratumumab. Results For all four patients, daratumumab was visible on serum protein electrophoresis as an additional small band (approximately 1 g/L) in the slow gamma region. Conclusion Diagnostic laboratories should be aware that daratumumab can be detected on routine serum protein electrophoresis of myeloma patients and should liaise closely with clinicians to ensure the presence of daratumumab is not misinterpreted as development of a new monoclonal protein.

Serum Protein Electrophoresis: Italian Survey 1986

1989 ◽  
Vol 26 (3) ◽  
pp. 249-253 ◽  
Author(s):  
F Aguzzi ◽  
C Petrini ◽  
C Gasparro
Keyword(s):  
Serum Protein ◽  
Clinical Biochemistry ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Serum Samples ◽  
Diagnostic Interpretation ◽  
Laboratory Capacity ◽  
Italian Survey ◽  
Three Samples

In 1986 the Protein Commission of the Italian Society of Clinical Biochemistry (SIBIOC) carried out its second survey on the use of serum protein electrophoresis in Italian laboratories. Three serum samples plus a questionnaire were sent to the 253 laboratories which agreed to take part. The three samples had the following characteristics: Serum 1: a 60 g/L IgM-lambda monoclonal component (MC); Serum 2: an artificially split alpha-2 zone; Serum 3: a very faint lambda chain MC. These features were chosen to assess (a) the type of report; (b) the resolution quality of the electrophoretic technique; and (c) the laboratory capacity to detect a small MC. The most significant features revealed by the survey were: (a) the poor capacity of assessment of the small MC in Serum 3 (only detected by 23·1% of laboratories); (b) the discouraging tendency to delegate electrophoretic diagnostic interpretation to ward physicians (44·4% of participating laboratories provided only densitometric values and graphs).

scholarly journals Our Laboratory Experience: Comparison of Capillary Electrophoresis/Immunosubtraction and Agarose Gel/Immunofixation

2020 ◽  
Vol 2 (7) ◽  
pp. 267-277
Author(s):  
Massimo Pieri ◽  
Flaminia Tomassetti ◽  
Caterina Iodice ◽  
Rosa Piazzolla ◽  
Elena Riboldi ◽  
...  
Keyword(s):  
Serum Protein ◽  
Wide Spectrum ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Common Denominator ◽  
Agarose Gel ◽  
Serum Samples ◽  
Suitable Alternative ◽  
Immunofixation Electrophoresis ◽  
Monoclonal Proteins

Abstract. Monoclonal gammopathies represent a wide spectrum of related diseases. The common denominator is the presence of a monoclonal protein in the serum or urine, which can be in the form of intact immunoglobulin, immunoglobulin fragments, and/or free light chains (κ and λ). We can detect these abnormalities by immunofixation electrophoresis (IFE) in which specific antibodies are overlaid after electrophoresis and the corresponding immunoglobulin. In our study, we compared gel-based and capillary-based serum protein electrophoresis methods to identify and characterize monoclonal immunoglobulins in serum samples. We analyzed 500 serum samples by Sebia Hydragel agarose gel electrophoresis (AGE)/immunofixation electrophoresis (IFE) and CAPILLARYS 2 capillary zone electrophoresis (CZE)/immunosubtraction (IS). AGE/IFE and CZE/IS had an overall agreement of 98% on serum protein electrophoresis. In our hands, AGE/IFE and CZE/IS had the same specificity for detection of monoclonal proteins; however, CZE/IS seems to be more sensitive than AGE/IFE for the detection of some critical cases. However, CZE/IS is an analytically suitable alternative to AGE/IFE, although laboratories should need to combine, for singular samples, both electrophoretic methods in their clinical routine. A combined use of AGE/IFE and CZE/IS is necessary to lead to an accurate diagnosis and clinically error-free results.

scholarly journals Diagnosing Paraproteinemic Keratopathy: A Case Report

2021 ◽  
pp. 337-343
Author(s):  
Eugenie Mok ◽  
Ka Wai Kam ◽  
Anthony J. Aldave ◽  
Alvin L. Young
Keyword(s):  
Optical Coherence Tomography ◽  
Genetic Testing ◽  
Serum Protein ◽  
Molecular Genetic ◽  
Anterior Segment ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Optical Coherence ◽  
Molecular Genetic Testing ◽  
Corneal Opacities

A 65-year-old man presented with bilateral, painless, progressive blurring of vision over 9 years. Slit-lamp examination revealed bilateral subepithelial corneal opacities in clusters located at the mid-periphery. Anterior segment optical coherence tomography, in vivo confocal microscopy (IVCM), serum protein electrophoresis, and molecular genetic testing were performed to evaluate the cause of corneal opacities. Anterior segment optical coherence tomography revealed a band-like, hyperreflective lesion in the Bowman layer and anterior stroma of both corneas. IVCM revealed hyperreflective deposits in the epithelium, anterior stroma, and endothelium. Serum protein electrophoresis identified the presence of paraproteins (immunoglobulin kappa), and molecular genetic testing revealed absence of mutations in the transforming growth factor beta-induced gene (<i>TGFBI</i>) and collagen type XVII alpha 1 gene (<i>COL17A1</i>). The ocular diagnosis of paraproteinemic keratopathy eventually led to a systemic diagnosis of monoclonal gammopathy of undetermined significance by our hematologist/oncologist. Paraproteinemic keratopathy is a rare differential diagnosis in patients with bilateral corneal opacities and therefore may be misdiagnosed as corneal dystrophy or neglected as scars. In patients with bilateral corneal opacities of unknown cause, serological examination, adjunct anterior segment imaging, and molecular genetic testing play a role in establishing the diagnosis.

scholarly journals An Unusual Pattern in Serum Protein Electrophoresis to Take in Mind: A Case Report

2021 ◽  
pp. e00200
Author(s):  
J.M. Gastélum-Cano ◽  
J. Fragoso-Flores ◽  
V.M. Noffal-Nuño ◽  
M. Deffis-Court
Keyword(s):  
Case Report ◽  
Serum Protein ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Unusual Pattern

scholarly journals Serum protein electrophoresis in healthy and injured southern white rhinoceros (Ceratotherium simum simum)

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0200347 ◽  
Author(s):  
Emma H. Hooijberg ◽  
Michele Miller ◽  
Carolyn Cray ◽  
Peter Buss ◽  
Gerhard Steenkamp ◽  
...  
Keyword(s):  
Serum Protein ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Ceratotherium Simum ◽  
White Rhinoceros ◽  
Southern White Rhinoceros ◽  
Ceratotherium Simum Simum

Case report: Interference from isatuximab on serum protein electrophoresis prevented demonstration of complete remission in a myeloma patient

2021 ◽  
pp. 000456322110620
Author(s):  
Rachel D Wheeler ◽  
Micsha V Costa ◽  
Asante Crichlow ◽  
Fenella Willis ◽  
Yasmin Reyal ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Complete Remission ◽  
Capillary Zone Electrophoresis ◽  
Serum Protein ◽  
Plasma Cells ◽  
Survival Rates ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Zone Electrophoresis ◽  
Capillary Zone

Multiple myeloma is a haematological cancer caused by malignant plasma cells in the bone marrow that can result in organ dysfunction and death. Recent novel treatments have contributed to improved survival rates, including monoclonal antibody therapies that target the CD38 protein on the surface of plasma cells. Anti-CD38 therapies are IgG kappa monoclonal antibodies that are given in doses high enough for the drug to be visible on serum protein electrophoresis as a small paraprotein. We present a case where isatuximab, the most recent anti-CD38 monoclonal antibody to be approved for treatment of myeloma, obscured the patient’s paraprotein on gel immunofixation, so that complete remission could not be demonstrated. This was resolved using the isatuximab Hydrashift assay. The interference on gel immunofixation was unexpected because isatuximab migrated in a position distinct from the patient’s paraprotein on capillary zone electrophoresis. We demonstrate the surprising finding that isatuximab migrates in a different position on gel electrophoresis compared to capillary zone electrophoresis. It is vital that laboratories are aware of the possible interference on electrophoresis from anti-CD38 monoclonal antibody therapies, and are able to recognise these drugs on protein electrophoresis. The difference in isatuximab’s electrophoretic mobility on capillary and gel protein electrophoresis makes this particularly challenging. Laboratories should have a strategy for alternative analyses in the event that the drugs interfere with assessment of the patient’s paraprotein.

scholarly journals Visual mnemonics for serum protein electrophoresis

2013 ◽  
Vol 18 (1) ◽  
pp. 22585
Author(s):  
Carlos E. Medina-De la Garza ◽  
Marisela García-Hernández ◽  
María de los Ángeles Castro-Corona
Keyword(s):  
Serum Protein ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Visual Mnemonics
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