Pattern of serum protein electrophoresis and immunofixation in plasma cell disorders

Background: Abnormal accumulation monoclonal plasma cells in the bone marrow cause the primary characteristics of multiple myeloma. Myeloma cells produce abnormal immunoglobulin (M protein), light chain proteins (? and ?), and other factors, such as cytokines.Objective: To analyze the pattern of serum protein electrophoresis and immunofixation in plasma cell disorder.Methodology: The study was conducted at central research laboratory at ESI-PGIMSR Manicktala, Kolkata. During the period of one year, Biochemical parameters and SPEP was performed for total 40 patients of plasma cell disorder diagnosed by bone marrow examination. The bone marrow aspirate and biopsy results were reviewed and the diagnosis was confirmed by doing immunofixation.Results: Mean age of patients was 57.35 years while male to female ratio was 3:1. Globulin >5g/dL was found in 50% of pt while 70% had A/G ratio less than 1. Renal insufficiency was present in15%. M spike was present in all patients when SPEP was done; 70% was in gamma and 30% in beta region. Paraprotein heavy chain IgG was present in gamma region in 80% cases while IgA and IgM was more commonly present in beta region (60%). Mean concentration of M protein was 2.6g/dL. In 65% patients M protein was >1.0g/dL. The most frequent heavy chain paraprotein was G (75%) followed by M (15%) and A (10%). Kappa constituted 85% for light chain paraprotein. IgG-Kappa was the most commonly found paraprotein.Conclusion: Abnormal concentrations of total serum protein, serum globulin and A/G ratio was present in >50% of patients while M spike in SPEP and M band in IF was found in all the patients. For early diagnosis patients suspected to have plasma cell myeloma the serum protein electrophoresis and immunofixation remain an easy gold standard test for cases with secretory plasma cell myeloma.