[Elizabeth85]

Random urine protein electrophoresis & total protein results

by Elizabeth85 on Mon Jul 28, 2014 8:46 pm

Hi! I was wondering if someone could help me understand the results of this random urine total protein electrophoresis.

My primary care doctor has scheduled a UPEP and an SPEP next. But I would like to under­stand these results. Are these good? bad?

Creatinine, Random Urine 447 High mg/dL
Protein, Total, Random Urine 63 Normal mg/g creat
Protein, Total, Random Urine 28 High mg/dL

Albumin 65%
Alpha 1 Globulins 1%
Alpha 2 Globulins 11%
Beta Globulins 13%
Gamma Globulins 9%

Interpretation: Possible abnormal protein band detected in the beta globulins. This band may represent beta-2 micoglobulin, monoclonal immunoglobulin, or free light chain (bence jones protein). Immunofixation analysis is available if clinically indicated.

My previous SPEP was all within normal limits.

Albumin 4.0 g/dL
Alpha-1-globulins 0.2 g/dL
Alpha 2 Globulins 0.9 g/dL
Beta Globulins 1.3 g/dL
Gamma Globulins 1.3 g/dL

I have since tested positive ANA and HLA-b27. I also have a lot of bone pain and continued high SED rate.

Any insights would be GREATLY appreciated! Thanks!!

[Dr. Adam Cohen]

Re: Random urine protein electrophoresis & total protein res

by Dr. Adam Cohen on Wed Jul 30, 2014 4:35 pm

Hi - You have mildly elevated protein in your urine, Based on the UPEP results you shared, most of this is non-specific, though there is a possible small M-protein noted (too low to be quantitated). To identify this further, they need to run a urine immunofixation to determine the type of M-protein. Ideally, you should have the UPEP and urine immunofixation run on a 24 hour urine specimen to better quantify the total amount of protein in your urine and identify the type.

The SPEP is negative, but to really rule out a monoclonal protein in the blood, they should do a serum immunofixation and serum free light chain assay as well.

It's hard to comment on the significance of these tests without the clinical context. Were they drawn due to worsening kidney function, concern about myeloma or amyloidosis, concern about a possible autoimmune disease such as lupus? These results can be seen in any of these diseases, or could just reflect a monoclonal gammopathy of unknown significance (MGUS), which is a benign condition. If the serum or urine immunofixation confirm a monoclonal protein, then an evaluation by a hematologist/oncologist would be appropriate.

I think it's best to discuss these results with your doctor, who can better explain why he / she ordered the tests and what the next steps are for further evaluation.