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UW Health SMPH
American Family Children's Hospital

UW Hospital and Clinics Lab Test Directory

Test Name: Protein Electrophoresis, reflex to Immunofixation

Test Code(s): SPEPR / HCSPEPR

CPT Code(s): 84165, 84155; if reflexed to immunofixation add 86334

Test Description: Test Component:

Serum protein electrophoresis and total protein. Reflex to serum immunofixation if applicable.

Methodology: Gel Electrophoresis and Biuret

Clinical Significance: Frequency Recommendations: Unless clinically indicated, frequency to monitor patient is recommended no more than every 30 days. Serum protein electrophoresis is used to evaluate and follow a monoclonal gammopathy. Immunofixation is used to detect and type a monoclonal gammopathy.

Days Performed: Mon-Fri, dayshift - day varies.

Turnaround Time: Stat: Not available stat.
Routine: 3 working days.

Specimen Requirements

Specimen: Blood

Collection Instructions: If there is the possibility that the patient has cryoprotein, specimens MUST BE DRAWN AND KEPT WARM AT 37C UNTIL AFTER PROCESSING IS COMPLETE.

Before collection, pre-warm a collection tube (e.g., in an infant heel warmer). Have another infant heel warmer on hand to deliver the blood to the laboratory after collection. Keep specimen at 37C by wrapping a hot pack (infant heel warmer) around the tube immediately after collection. Transport specimen to Core Laboratory (B4/220)within 10 minutes of collection. Contact laboratory if unable to assure delivery within 10 minutes.  

Collection Container: Preferred: Red top
Also Acceptable: Red cap with yellow ring (SST)

Collection Volume: Preferred: 3 mL
Pediatrics: 1 mL

Sample Analyzed: Serum

Volume Required: Preferred: 1 mL
Pediatrics: 0.2 mL

Specimen Processing: Centrifuge and transfer cell-free serum to plastic vial.  Refrigerate.

IF THE PATIENT HAS A CRYOPROTEIN, keep the blood specimen at 37C during entire processing procedure. Place collection tube in the 37C incubator for two hours. Spin tube at 3000 rpm for 10 minutes at 37C. Remove spun serum to labeled tube. Put WARM sticker on tube and refrigerate.  

Specimen Transport: Transport speciment to UWHC Core Laboratory (B4/220).  Transport with coolant pack if coming from UWHC Satellite lab locations.

IF THE PATIENT HAS A CRYOPROTEIN, transport to the UWHC Core Laboratory(B4/220)within 10 minutes of collection. Keep specimen at 37C wrapping tube in a hot pack (infant heel warmer). Specimen MUST be processed using the Specimen Processing procedure above prior to transport if coming from UWHC Satellite lab locations. Write WARM on the tube and transport specimen with coolant pack after processing is complete.

Outreach Specimen Transport: IF THE PATIENT HAS A CRYOPROTEIN, specimen MUST be collected and processed using the Collection and Specimen Processing procedures above prior to transport. Write WARM on the tube and transport specimen with coolant pack after processing is complete.

Unacceptable Criteria: Grossly hemolyzed specimens are not acceptable.

Stability: Ambient: Not acceptable
Refrigerated: 1 week
Frozen: 3 months at -20C. Note: Avoid repeat freeze and thaw.


Reference Interval:

> 1 year and up:


 Total protein  6.0-8.0 g/dl
 Albumin  3.90-5.00 g/dl
 Alpha 1

 0.10-0.22 g/dl

 Alpha 2  0.56-0.96 g/dl
 Beta  0.65-1.10 g/dl
 Gamma  0.62-1.32 g/dl
 A:G ratio  1.28-2.06
 M-Spike  0.00-0.00 g/dl













A written interpretive report with the scan is issued as a separate report. 


Reference range not available for patients <12 months of age.

Additional Information:

A professional fee is associated with this test.

Monoclonal Gammopathy Panel,serum protein electrophoresis with reflex,reflex serum protein electrophoresis, SPIFIX

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