γ/IgG ratio: role in distinguishing monoclonal spikes from fibrinogen

Serum protein electrophoresis (SPEP) is a standard screening method for detecting monoclonal gammopathies. Presence of fibrinogen, however, can mimic a true monoclonal spike and interfere with accurate monoclonal protein identification. We describe a novel approach for distinguishing fibrinogen spik...

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Published in:Journal of clinical laboratory analysis 2011, Vol.25 (5), p.332-336
Main Authors: Lee, Maria Teresa, Caturegli, Patrizio, Humphrey, Richard L., Thompson, Richard E., Detrick, Barbara
Format: Article
Language:English
Subjects:
Aged
Blood Protein Electrophoresis - methods
Blood Protein Electrophoresis - standards
Female
fibrinogen
Fibrinogen - analysis
Fibrinogen - chemistry
Humans
Immunoglobulin A - blood
Immunoglobulin A - chemistry
Immunoglobulin G - blood
Immunoglobulin G - chemistry
Immunoglobulin M - blood
Immunoglobulin M - chemistry
Male
Middle Aged
monoclonal gammopathy
Multivariate Analysis
Original
Paraproteinemias - blood
ROC Curve
serum protein electrophoresis (SPEP)
Statistics, Nonparametric
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container_issue 5
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container_title Journal of clinical laboratory analysis
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creator Lee, Maria Teresa
Caturegli, Patrizio
Humphrey, Richard L.
Thompson, Richard E.
Detrick, Barbara
description Serum protein electrophoresis (SPEP) is a standard screening method for detecting monoclonal gammopathies. Presence of fibrinogen, however, can mimic a true monoclonal spike and interfere with accurate monoclonal protein identification. We describe a novel approach for distinguishing fibrinogen spikes from true monoclonal spikes. We classified 600 individual patient samples into four groups: group 1, 58 samples with a fibrinogen spike; group 2, 127 samples with a spike due to a monoclonal gammopathy; group 3, 181 samples with previously established monoclonal gammopathies but resolved posttreatment; and group 4, 234 control samples without monoclonal gammopathies. The value of using a γ regionfraction/IgG ratio in distinguishing fibrinogen from true monoclonal spikes was assessed. The γ/IgG ratio in the fibrinogen group is significantly (P
doi_str_mv 10.1002/jcla.20480
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The probability cut‐off is 0.756, corresponding to a γ/IgG ratio of 1 (93% sensitivity, 91% specificity). Using the γ/IgG ratio improves the screening power of SPEP and offers a simple and reliable diagnostic tool for distinguishing fibrinogen spikes from true monoclonal spikes. J. Clin. Lab. 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Clin. Lab. Anal</addtitle><description>Serum protein electrophoresis (SPEP) is a standard screening method for detecting monoclonal gammopathies. Presence of fibrinogen, however, can mimic a true monoclonal spike and interfere with accurate monoclonal protein identification. We describe a novel approach for distinguishing fibrinogen spikes from true monoclonal spikes. We classified 600 individual patient samples into four groups: group 1, 58 samples with a fibrinogen spike; group 2, 127 samples with a spike due to a monoclonal gammopathy; group 3, 181 samples with previously established monoclonal gammopathies but resolved posttreatment; and group 4, 234 control samples without monoclonal gammopathies. The value of using a γ regionfraction/IgG ratio in distinguishing fibrinogen from true monoclonal spikes was assessed. The γ/IgG ratio in the fibrinogen group is significantly (P&lt;0.0001) higher than this ratio in the other three groups. 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subjects Aged
Blood Protein Electrophoresis - methods
Blood Protein Electrophoresis - standards
Female
fibrinogen
Fibrinogen - analysis
Fibrinogen - chemistry
Humans
Immunoglobulin A - blood
Immunoglobulin A - chemistry
Immunoglobulin G - blood
Immunoglobulin G - chemistry
Immunoglobulin M - blood
Immunoglobulin M - chemistry
Male
Middle Aged
monoclonal gammopathy
Multivariate Analysis
Original
Paraproteinemias - blood
ROC Curve
serum protein electrophoresis (SPEP)
Statistics, Nonparametric
title γ/IgG ratio: role in distinguishing monoclonal spikes from fibrinogen
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