Test Overview

Test Methodology

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Test Usage

To differentiate between monoclonal and polyclonal gammopathies. To identify and type monoclonal immunoglobulins for heavy and light chain specificity. Monoclonal gammopathy evaluation (MGE) is essential when clinical, hematologic, or pathologic findings indicate: multiple myeloma, Waldenstrom's, heavy chain disease, amyloidosis, or Ig deposition disease. MGE is also essential in the presence of abnormal bands on serum protein electrophoresis (TPE), in cryoglobulins, in Bence Jones proteinuria, in pyroglobulins, and in hyperviscosity syndrome. If light chain disease is part of the differential diagnosis, submit a urine specimen for Bence Jones Protein Screen.

Reference Range*

Pathologist interpretation of results provided.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Details

Days Test Performed

Monday - Friday

Analytic Time

72 hours

Soft Order Code

MGE2

MiChart Code

Monoclonal Gammopathy Evaluation

Synonyms

Laboratory

Chemical Pathology

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Specimen Requirements

Offsite Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and refrigerate.

Container

Normal Volume

2 mL serum

Minimum Volume

0.6 mL serum

Additional Information

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.

Billing Information

Fee Codes

CPT Code

84165, 86334, 82784 x3, 83883 x2

Pro Fee Code

84165 TPE, 86334 IFIX

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