Test includes pathologist interpretation of results billed as a separate additional charge. This test is not available without interpretation. Test includes serum protein electrophoresis, total protein, immunoglobulin quantitation (G, A, M), immunoglobulin free light chains, and immunofixation if indicated. Polyclonal elevations are found in acute and chronic inflammation, drug induced cholestatic hepatitis, cirrhosis, biliary cirrhosis, chronic infections, subacute bacterial endocarditis, sarcoidosis, ulcerative colitis, intestinal obstruction, autoimmune disease and others. IgG elevation is seen in IgG myeloma, and chronic active hepatitis. IgA elevation is seen in respiratory and gastrointestinal infections, IgA myeloma, malabsorption and diarrhea. IgM elevation is seen in viral infections, infectious mononucleosis, Waldenstrom's macroglobulinemia, after numerous transfusions and nephrotic syndrome. One or more immunoglobulins may be elevated in benign monoclonal gammopathy. One or more immunoglobulins may be decreased on a congenital basis. Acquired decreases are seen in relation to immunosuppressive therapy, lymphoma, leukemia, myeloma, macroglobulinemia, excessive protein loss (nephrosis, renal disease, gastroenteropathies, cutaneous burns, ascites, eczema), and others. Test includes a pathologist's evaluation of normal and abnormal proteins. Immunofixation requests on patients with previously diagnosed paraproteinemias will be cancelled as test not indicated if the gammopathy persists.