Sign in →

Test ID: RMPSU Monoclonal Protein Study, Random, Urine

Reporting Name

Monoclonal Protein Study, Random, U

Useful For

Diagnosing monoclonal gammopathies

Profile Information

Test ID Reporting Name Available Separately Always Performed
RPEU Protein Electrophoresis, Random, U No Yes
RIFXU Immunofixation, Random, U No Yes
PTCON Protein, Total, Random, U No Yes

Testing Algorithm

The following algorithms are available in Special Instructions:

-Laboratory Approach to the Diagnosis of Amyloidosis

-Laboratory Screening Tests for Suspected Multiple Myeloma

Specimen Type

Urine


Advisory Information


The use of a random urine specimen is sufficient for identifying the presence or absence of a monoclonal immunoglobulin, but a 24-hour specimen is preferred for quantitating and monitoring the abnormality. See MPSU / Monoclonal Protein Study, 24 Hour, Urine.



Shipping Instructions


Refrigerate specimen during collection and send refrigerated.



Necessary Information


 



Specimen Required


Supplies:

Urine Container, 60 mL (T313)

Aliquot Tube, 5 mL (T465)

Submission Container/Tube: Plastic, 60-mL urine bottle and plastic, 5-mL tube

Specimen Volume: 50 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Aliquot at least 25-mL of specimen into a plastic, 60-mL urine bottle and at least 1-mL of specimen into a plastic, 5-mL tube.

3. Label specimens appropriately (60-mL bottle for protein electrophoresis and 5-mL tube for protein, total)


Specimen Minimum Volume

25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  5 days
  Ambient  24 hours

Reference Values

PROTEIN, TOTAL:

No reference values apply to random urine.

 

ELECTROPHORESIS, PROTEIN

The following fractions, if present, will be reported as mg/dL:

Albumin

Alpha-1 globulin

Alpha-2 globulin

Beta globulin

Gamma globulin

Day(s) and Time(s) Performed

Protein, total: Monday through Sunday; Continuously

Electrophoresis, protein: Monday through Friday; 12 p.m.

Immunofixation: Monday through Friday; 8 a.m.

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

84156

84166

86335

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RMPSU Monoclonal Protein Study, Random, U In Process

 

Result ID Test Result Name Result LOINC Value
PTCON Protein, Total, Random, U 2888-6
32526 Immunofixation, Random, U 74666-9
607975 Albumin 6942-7
607976 Alpha-1 globulin 9734-5
606979 Immunofixation Flag, Random, U No LOINC Needed
607977 Alpha-2 globulin 38190-5
607978 Beta globulin 9744-4
607979 Gamma globulin 9745-1
33044 A/G Ratio 44293-9
33045 M spike 40661-1
33046 M spike 40661-1
33047 Impression 49299-1

Clinical Information

Urine proteins can be grouped into 5 fractions by protein electrophoresis:

-Albumin

-Alpha-1

-Alpha-2

-Beta-globulin

-Gamma globulin

 

The urine total protein concentration, the electrophoretic pattern, and the presence of a monoclonal immunoglobulin light chain may be characteristic of monoclonal gammopathies such as multiple myeloma, primary systemic amyloidosis, and light-chain deposition disease.

 

The following algorithms are available in Special Instructions:

-Laboratory Approach to the Diagnosis of Amyloidosis

-Laboratory Screening Tests for Suspected Multiple Myeloma

Interpretation

A characteristic monoclonal band (M-spike) is often found in the urine of patients with monoclonal gammopathies. The initial identification of an M-spike or an area of restricted migration is followed by immunofixation to identify the immunoglobulin heavy chains and light chains.

 

Immunoglobulin free light chains as well as heavy chain fragments may be seen in the urine of patients with monoclonal gammopathies. The presence of a monoclonal light-chain M-spike of greater than 1 g/24 hours is consistent with a diagnosis of multiple myeloma or macroglobulinemia.

 

The presence of a small amount of monoclonal light chain and proteinuria (total protein >3 g/24 hours) that is predominantly albumin is consistent with primary systemic amyloidosis (AL) or light-chain deposition disease (LCDD).

 

Because patients with AL or LCDD may have elevated urinary protein without an identifiable M-spike, urine protein electrophoresis is not considered an adequate screen for these disorders and immunofixation is also recommended.

Clinical Reference

1. Abraham RS, Barnidge DR: Protein analysis in the clinical immunology laboratory. In: Detrick B, Hamilton RG, Schmitz JL, eds. Molecular and Clinical Laboratory Immunology. 8th ed. Wiley; 2016:chap 4

2. Keren DF, Humphrey RL: Clinical indications and applications for serum and urine protein electrophoresis and immunofixation. In: Detrick B, Hamilton RG, Schmitz JL, eds. Molecular and Clinical Laboratory Immunology. 8th ed. Wiley; 2016:chap 8

Analytic Time

Same day/1 day

Method Name

PTCON: Turbidimetry

RPEU: Agarose Gel Electrophoresis

RIFXU: Immunofixation

Forms

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen. 

Mayo Clinic Laboratories | Hematology Catalog Additional Information:

mml-lymphoid-disorders, mml-myeloma-amyloidosis-dysprotenemia