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26823 Monoclonal Protein Studies, Random, Urine

Monoclonal Protein Studies, Random, Urine
Test Code: RMPUSO
Synonyms/Keywords

​​​Mass-Fix, Mass Fix, MassFix, Bence Jones Urine, Heavy Chains Urine, Immunoelectrophoresis, Immunofixation Electrophoresis (IFE), Immunofixation, Kappa Chains Urine, Lambda Chains Urine, Light Chains Urine, Paraprotein, Special Protein Studies, M-protein​

Test Components

​MPTRU: Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

​RPEU: Agarose Gel Electrophoresis

RPTU2: Turbidimetry/Enzymatic Colorimetric Assay
Useful For

​Identifying monoclonal gammopathies using random urine specimens​

Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)

​No
​         Urine​
​Urine container, 60 mL (T313)
​60 mL urine bottle
​50 mL
​30 mL
​30 mL
Collection Processing Instructions
Refrigerate specimen during collection and send refrigerated
 
Aliquot between 30 and 50 mL of urine into a plastic, 60 mL urine bottle
Specimen Stability Information
Specimen TypeTemperatureTime


​Urine​​
​
​Refrigerated (preferred)
​14 Days
​Ambient
​24 Hours
​Frozen
​5 Days
Rejection Criteria
​All specimens will be evaluated at Mayo Clinic Laboratories for test suitability
Interference

​Monoclonal gammopathies are rarely seen in patients younger than 30 years of age.                                                                                                                                                            

Hemolysis may cause a discrete band on protein electrophoresis, which will be negative on isotyping.

Penicillin may split the albumin band.

​Radiographic agents may produce an uninterpretable pattern.
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation

200 1st St. SW
Rochester, MN 55905​​​
​Monday through Friday
​5 to 7 days
​Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS), Agarose Gel Electrophoresis,  Turbidimetry/Enzymatic Colorimetric Assay

Reference Lab
Mayo Clinic Laboratories
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.

​The use of a random urine specimen is sufficient for identifying the presence or absence of monoclonal proteins, but a 24-hour specimen is preferred for quantitating and monitoring the abnormality.

 Urine proteins can be grouped into 5 fractions by protein electrophoresis:

-Albumin

-Alpha-1

-Alpha-2

-Beta-globulin

-​Gamma globulin

One or more quantifiable monoclonal proteins may be present and reported as M spike.

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.​

Reference Range Information

CREATININE:

> or =18 years old: 16-326 mg/dL

Reference values have not been established for patients younger than 18 years of age.

PROTEIN/CREATINE RATIO:

> or =18 years: <0.18 mg/mg creatinine

Reference values have not been established for patients younger than 18 years of age.

​ELECTROPHORESIS, PROTEIN:

The following fractions, if present, will be reported as mg/dL:

Albumin

Alpha-1 globulin

Alpha-2 globulin

Beta globulin

Gamma globulin

No reference values apply to random urines.

​MASS-FIX M-PROTEIN ISOTYPE:

M-protein Isotype MS:

No monoclonal protein detected

​Flag M-protein Isotype MS:

Negative​

Interpretation
The presence of a monoclonal immunoglobulin light chain in the urine is seen in multiple myeloma, macroglobulinemia, primary systemic amyloidosis and light-chain deposition disease, monoclonal gammopathy of undetermined significance, and idiopathic Bence-Jones proteinuria. The presence of a monoclonal light chain can produce renal insufficiency, may be deposited as amyloid fibrils, may damage the proximal tubes producing Fanconi syndrome, or light chains may deposit in the glomerulus and cause light-chain deposition disease.
 
Heavy-chain fragments as well as light chains may be seen in the urine of patients with multiple myeloma or amyloidosis.​
Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments

​84156
​     ​1
​​
82570​
​​     1
​​
84166
​​     1
​​
0077U​
​​     1​
​​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.

​​

Synonyms/Keywords

​​​Mass-Fix, Mass Fix, MassFix, Bence Jones Urine, Heavy Chains Urine, Immunoelectrophoresis, Immunofixation Electrophoresis (IFE), Immunofixation, Kappa Chains Urine, Lambda Chains Urine, Light Chains Urine, Paraprotein, Special Protein Studies, M-protein​

Test Components

​MPTRU: Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

​RPEU: Agarose Gel Electrophoresis

RPTU2: Turbidimetry/Enzymatic Colorimetric Assay
Ordering Applications
Ordering ApplicationDescription

​Cerner
​Monoclonal Protein Studies, Random, Urine​
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)

​No
​         Urine​
​Urine container, 60 mL (T313)
​60 mL urine bottle
​50 mL
​30 mL
​30 mL
Collection Processing
Refrigerate specimen during collection and send refrigerated
 
Aliquot between 30 and 50 mL of urine into a plastic, 60 mL urine bottle
Specimen Stability Information
Specimen TypeTemperatureTime


​Urine​​
​
​Refrigerated (preferred)
​14 Days
​Ambient
​24 Hours
​Frozen
​5 Days
Rejection Criteria
​All specimens will be evaluated at Mayo Clinic Laboratories for test suitability
Interference

​Monoclonal gammopathies are rarely seen in patients younger than 30 years of age.                                                                                                                                                            

Hemolysis may cause a discrete band on protein electrophoresis, which will be negative on isotyping.

Penicillin may split the albumin band.

​Radiographic agents may produce an uninterpretable pattern.
Useful For

​Identifying monoclonal gammopathies using random urine specimens​

Test Components

​MPTRU: Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

​RPEU: Agarose Gel Electrophoresis

RPTU2: Turbidimetry/Enzymatic Colorimetric Assay
Reference Range Information

CREATININE:

> or =18 years old: 16-326 mg/dL

Reference values have not been established for patients younger than 18 years of age.

PROTEIN/CREATINE RATIO:

> or =18 years: <0.18 mg/mg creatinine

Reference values have not been established for patients younger than 18 years of age.

​ELECTROPHORESIS, PROTEIN:

The following fractions, if present, will be reported as mg/dL:

Albumin

Alpha-1 globulin

Alpha-2 globulin

Beta globulin

Gamma globulin

No reference values apply to random urines.

​MASS-FIX M-PROTEIN ISOTYPE:

M-protein Isotype MS:

No monoclonal protein detected

​Flag M-protein Isotype MS:

Negative​

Interpretation
The presence of a monoclonal immunoglobulin light chain in the urine is seen in multiple myeloma, macroglobulinemia, primary systemic amyloidosis and light-chain deposition disease, monoclonal gammopathy of undetermined significance, and idiopathic Bence-Jones proteinuria. The presence of a monoclonal light chain can produce renal insufficiency, may be deposited as amyloid fibrils, may damage the proximal tubes producing Fanconi syndrome, or light chains may deposit in the glomerulus and cause light-chain deposition disease.
 
Heavy-chain fragments as well as light chains may be seen in the urine of patients with multiple myeloma or amyloidosis.​
For more information visit:
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation

200 1st St. SW
Rochester, MN 55905​​​
​Monday through Friday
​5 to 7 days
​Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS), Agarose Gel Electrophoresis,  Turbidimetry/Enzymatic Colorimetric Assay

Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments

​84156
​     ​1
​​
82570​
​​     1
​​
84166
​​     1
​​
0077U​
​​     1​
​​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.
This test was developed and its performance characteristics determined by Marshfield Labs.  It has not been cleared or approved by the US Food and Drug Administration.  This test is used for clinical purposes.  It should not be regarded as investigational or for research.

​​

For most current information refer to the Marshfield Laboratory online reference manual.