Immunoglobulin Electrophoresis

Sample for Immunoglobulin Electrophoresis

1. Venous blood is needed to prepare the serum.
2. A random sample can be taken.

Purpose of Immunoglobulin Electrophoresis (Indications) 

1. It is advised to diagnose many diseases like Multiple Myeloma etc.
2. Waldenstrom macroglobulinemia.
3. Immunoglobulin electrophoresis is advised if there is a spike in the gamma band in serum electrophoresis.
4. Hypersensitivity reactions.
5. Immune deficiency.
6. Autoimmune diseases.
7. Chronic infections.
8. Intrauterine fetal infection.
9. Hypogammaglobulinemia.
10. Agammaglobulinemia.
11. Analbumionemia.
12. Bisalbuminemia.
13. Afibrogenemia.
14. Atransfferenemia.
15. Cirrhosis.
16. Acute-phase proteins.

Definition of immunoglobulin electrophoresis:

1. It is the immunochemical method to separate the various proteins and immunoglobulins.
2. This technique can be used in the serum or cerebrospinal fluid (CSF).
3. It is used to evaluate gammopathies.
4. It is said that no pattern is pathognomonic of any single disease.

Serum proteins consist of:

1. Albumin
2. Globulins.
3. Globulins are of two types:
   1. One formed in the liver.
   2. The second produces by the immune cells.
4. One of the globulin is called gamma globulin.
5. The antibodies are made of gamma globulin called immunoglobulin (Ig).
6. There are five main types of immunoglobulins (Ig) labeled:
   1. IgG, which is 75% of the total Ig.
      1. γ-region is predominantly composed of IgG.
   2. IgM is 10%  to 12%
   3. IgA consists of 15% of the total Ig.
   4. IgE
   5. IgD
      1. IgA, IgM, IgD, and IgE share the junction of β and γ-globulin.

Examples of some immunoglobulin electrophoresis patterns:

Myeloma pattern:

1. In myeloma and Waldenstrom’s Macroglobulinemia showed prominent γ- fraction, monoclonal gammopathy band.
2. A monoclonal gammopathy band has also been seen in idiopathic or secondary gammopathy.

 Immunoglobulins normal level at various ages:

Increased IgG level is seen in:

1. Multiple myelomas (Monoclonal IgG gammopathy).
2. Hyperimmunization reaction.
3. Chronic granulomatous infection.
4. Chronic liver diseases.
5. Autoimmune diseases like rheumatoid arthritis, Sjogren’s syndrome, and SLE.

Decreased IgG level is seen in:

1. Agammaglobulinemia.
2. Wiskott-Aldrich syndrome.
3. AIDS (acquired immune deficiency syndrome).
4. Nephrotic syndrome.
5. Protein-losing enteropathy.

Increased IgM level is seen in:

1. Waldenstrom macroglobulinemia.
2. Chronic infections.
3. Autoimmune diseases like rheumatoid arthritis and SLE.
4. Acute infection is a primary immune response.
5. Chronic liver diseases like biliary cirrhosis.

Decreased IgM level is seen in:

1. Agammaglobulinemia.
2. Hypoproteinemia is seen in nephrotic syndrome and protein-losing enteropathy.
3. AIDS
4. Immunosuppression is due to drugs like steroids and dextran.

Increased level of IgA seen in:

1. Primary biliary cirrhosis.
2. Inflammatory bowel disease.
3. Chronic infectious.

Decreased level of IgA seen in:

1. Hypoproteinemia due to nephrotic syndrome and protein-losing enteropathy.
2. Ataxia.
3. Immunosuppression is due to drugs like steroids.
4. Congenital isolated deficiency of IgA.
5. Telangiectasia.

Increased IgE level is seen in:

1. Allergic reactions like hay fever, asthma, eczema, and parasites.
2. In an anaphylactic reaction.

Decreased IgE level was seen in:

1. Agammaglobulinemia.

Increased monoclonal gammopathy is seen in:

1. Multiple myelomas.
2. Waldenstrom macroglobulinemia.

Increased polyclonal gammopathy is seen in:

1. Amyloidosis.
2. Chronic liver disease.
3. Chronic infections.
4. Autoimmune diseases.

Increased monoclonal gammopathy is  seen in Urine:

1. Waldenstrom macroglobulinemia.
2. Multiple myelomas.

Questions and answers: