Blood draw
Total Protein & Protein Electrophoresis
Total protein and electrophoresis; protein spectrum.
€ 35,00
All tests
Liver and pancreas · Blood
Protein electrophoresis
Divides the proteins in the blood into groups and shows which group is abnormal in inflammation, liver or kidney disease.
At a glance
- Measured in blood
- In 2 test panels
- No special preparation
Explanation
Protein electrophoresis: what is measured?
In protein electrophoresis, the proteins in the blood are separated from each other with an electric field. They then form a pattern of bands: albumin and four groups of globulins (alpha-1, alpha-2, beta and gamma). The laboratory measures how much protein is in each group and assesses the shape of the pattern. The gamma group consists mainly of antibodies (immune proteins); the laboratory also checks whether an abnormal, sharp extra band can be seen.
What can it detect?
- A pattern that fits a recent or long-lasting inflammation or infection
- Signs of a liver disease or of protein loss through the kidneys (nephrotic syndrome)
- A shortage of antibodies, or a deficiency of alpha-1 antitrypsin (a rare inherited condition)
- Rarely: an M-protein, one type of antibody in a large amount, usually in MGUS (a condition without symptoms) and very occasionally in Kahler's disease (multiple myeloma)
Result
What does the result mean?
Protein electrophoresis too high
An increase in one or more protein groups usually fits inflammation. With a recent inflammation or infection, the alpha-1 and alpha-2 globulins rise. With a long-lasting inflammation, an autoimmune disease such as rheumatism, a chronic infection or a liver disease, the gamma group as a whole rises, because the body makes many different antibodies. A raised beta group can fit iron deficiency or high cholesterol, and a raised alpha-2 group together with a low albumin can fit protein loss through the kidneys. Rarely: an M-protein, a sharp band of one type of antibody, usually in MGUS (no symptoms, no treatment needed) and very occasionally in Kahler's disease (multiple myeloma).
Protein electrophoresis too low
A low albumin fits inflammation, malnutrition, pregnancy, protein loss through the kidneys or the bowel, or a liver disease. A low alpha-1 group may point to a deficiency of alpha-1 antitrypsin, a rare inherited condition that can damage the lungs and the liver, or to a severe liver disease. A low gamma group fits a shortage of antibodies, for example due to medicines that suppress the immune system or a congenital immune disorder; this often goes with recurring infections. A low alpha-2 group can fit breakdown of red blood cells (hemolysis).
After an abnormal result
With a slightly abnormal pattern due to inflammation, the GP usually repeats the test after recovery or looks for the cause of the inflammation. With an abnormal extra band, a confirmation test (immunofixation) and additional tests of blood and urine follow, including blood count, kidney function and calcium. Depending on the result, monitoring by the GP or referral to an internist-hematologist follows.
Reliability
How reliable is the test?
Protein electrophoresis gives a general picture and is rarely a diagnosis on its own: according to the Dutch Society for Clinical Chemistry (NVKC), the result can only be interpreted properly if the symptoms and medical history are known. The test shows a large amount of one type of antibody but can miss a small amount; an abnormal band must be confirmed with an additional test (immunofixation). Many abnormalities in the pattern are mild and fit a passing inflammation; repeating the test after recovery usually shows this.
What can affect the result?
- An infection or inflammation temporarily changes the pattern; a blood draw during or just after illness makes the result harder to interpret.
- A sample that has not clotted properly can give an extra band that looks like an abnormality (the clotting protein fibrinogen).
- Hemolysis in the tube mainly changes the alpha-2 and beta groups.
- A small amount of abnormal antibody protein, or only loose parts of it (free light chains), is not always seen with this test; additional tests of blood and urine are needed for that.
Who it is for
Who is the test useful for?
Useful for
Useful if a doctor wants to investigate an abnormal total protein, albumin or globulin further, with a suspected long-lasting inflammation or liver disease, with frequently recurring infections and with protein loss through the kidneys. In healthy adults without symptoms and without a previous abnormal result, the test adds little.
How common is it?
Mild abnormalities in the protein pattern due to inflammation are common and usually temporary. An M-protein without symptoms (MGUS) is usually found by chance and occurs in about 3 in 100 people over 50 and in more than 7 in 100 people aged 70 and over, more often in men than in women. Most people with MGUS never develop a malignant disease of the bone marrow.
Jeroen Bosch Hospital; Hematon
Drawbacks and risks
- In people over 50, an M-protein without symptoms (MGUS) is fairly often found by chance. It does not need treatment, but it does lead to additional tests and often years of check-ups, and can cause a lot of worry.
- Mild abnormalities in the pattern due to a passing inflammation can lead to unnecessary further tests without a repeat measurement.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results