When To Consider Ordering Serum Protein Electrophoresis from emedicine.medscape.com

In this post I link to and excerpt from emedicine.medscape.com‘s article, Serum Protein Electrophoresis, on when to consider ordering serum protein electrophoresis*:

*Here is the TOC for the article:

This diagram is from the Curbsiders episode #247 SPEP It Up

And here is the excerpt from Background:


Serum protein electrophoresis is generally considered in any patient with an elevated total protein, especially those with elevated globulin level relative to albumin, or any signs and symptoms suggestive of an underlying plasma cell disorder such as multiple myeloma, Waldenstrom’s macroglobulinemia, or primary amyloidosis. [5These include any of the following:

  • Unexplained anemia, back pain, bone pain, fatigue

  • Unexplained pathologic fracture or lytic lesions

  • Unexplained peripheral neuropathy

  • Hypercalcemia secondary to possible malignancy

  • Hypergammaglobulinemia

  • Rouleaux formation noted on peripheral blood smear

  • Renal insufficiency with bland urine sediment

  • Unexplained proteinuria

  • Bence Jones proteinuria

  • Recurrent infections

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