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HelpTest ID: RMPSU Monoclonal Protein Study, Random, Urine
Reporting Name
Monoclonal Protein Study, Random, UUseful 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:
Specimen Type
UrineAdvisory 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 |
Special Instructions
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:
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 dayMethod 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.
mml-lymphoid-disorders, mml-myeloma-amyloidosis-dysprotenemia