THE ASSOCIATION OF TOTAL PARAPROTEIN, TOTAL PROTEIN, ALBUMIN AND GLOBULIN CONCENTRATION WITH PARALLEL BANDS PRESENCE IN IMMUNOFIXATION ELECTROPHORESIS: A SEVEN-YEAR RETROSPECTIVE STUDY
Keywords:
Paraprotein, Plasma cell myeloma, Parallel band, ElectrophoresisAbstract
The presence of parallel bands at all heavy and light chain lanes of immunofixation electrophoresis (IFE) gel obscures paraprotein isotyping, thus preventing accurate diagnosis of paraproteinemia. Several reasons, including immunoglobulin polymerization and rheumatoid factor presence, have been implicated as the possible causes. The high concentration of several routine biochemistry parameters is believed to be a contributory factor too, but the association is yet to be determined. This study aims to determine the association of total protein, albumin, globulin, and total paraprotein concentrations with samples showing parallel bands at all lanes of IFE. Serum protein electrophoresis (SPEP) and IFE samples sent from May 2015 to May 2022 were screened and grouped into plasma cell myeloma (PCM) and non-PCM cases. The total protein, albumin, globulin, and total paraprotein were compared with the presence of parallel bands in PCM and non-PCM cases. From 1150 samples, 45 (3.9%) exhibited parallel bands at all lanes. 34 (75.6%) belong to PCM samples. Total paraprotein concentration among samples with parallel bands at all lanes demonstrated a significant difference with median (IQR) of 7.6 (20.4) g/L in PCM, and 2.0(4.4) g/L in non-PCM (p=0.039). However, no statistical difference was observed in total protein, albumin, and globulin concentration for both groups (p=0.354, p=0.948, p=0.506, respectively). Only total paraprotein concentration could influence the presence of parallel bands at all lanes of IFE. Further studies using a larger sample population could elicit this finding better and help determine a specific total paraprotein cut-off associated with parallel bands at all lanes.
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