Policy on Immunoglobulins & Serum Electrophoresis

All areas of the Trust are in the process of ensuring that they deliver a cost effective service within an increasingly limited resource. The immunology laboratory continues to strive to deliver a cost effective service therefore we request that specific requests for serum electrophoresis and immunoglobulins are made as outlined below.

We recommend that requests for Serum Electrophoresis only are made if the identification or exclusion of a paraprotein in the serum (i.e. myeloma, MGUS, etc) is being investigated. Serum Immunoglobulin quantification is then only undertaken if a paraprotein is identified. It is recommended that a urine sample is provided to the laboratory WITH the serum sample to allow identification of free light chain (Bence Jones protein) in the urine if present.

Requests for immunoglobulins only should be made in the context of systemic inflammatory illnesses and immunodeficiency. Serum electrophoresis may be added at the validation stage if thought appropriate. The majority of serum electrophoresis requests from patients with inflammatory or infectious diseases are of low specificity in both diagnosis and management. Repeat samples will be analysed in the same way unless exclusion or identification of a paraprotein is required. We would hope you would carefully consider whether these assays are really necessary.

Serum electrophoresis and Immunoglobulin measurements will both be tested if requested.

Page updated: 10/10/14| Updated by: Anna McHugh