A RETROSPECTIVE STUDY OF THE RELATIVE UTILITY OF ELECTROPHORESIS, IMMUNOELECTROPHORESIS, IMMUNOFIXATION, AND NEPHELOMETRY IN THE INVESTIGATION OF SERUM-PROTEINS

Objectives: To assess the relative value of visual inspection of prote in electrophoresis patterns, immunoelectrophoresis, immunofixation, an d specific protein quantitation in the investigation of serum proteins . Design and Methods: A retrospective study of protein results on 372 sera analyzed by electrophoresis and immunoelectrophoresis. A subsecti on of specimens (276) also had immunoglobulin quantitation by immunone phelometry and 30 were studied by immunofixation. Results: Total gamma globulin levels were correctly assessed visually in 84.4% of cases. D iscrete bands seen visually were mainly monoclonal in 74 of 80 (92.5%) . Six monoclonal proteins were not detected visually. Twenty-five mono clonal proteins required immunofixation for typing, and 60 were typed by immunoelectrophoresis. The visual assessment of the level of normal immunoglobulins in the presence of a monoclonal gammopathy was correc t in 58% of cases. Conclusions: The majority of monoclonal gammopathie s could be evaluated by a combination of protein electrophoresis and i mmunoelectrophoresis. Except for quantitating monoclonal immunoglobins , protein electrophoresis was unreliable as a quantitative procedure a nd nephelometry was preferred.