What does my capillary electrophoresis result mean?

Interpreting Capillary Electrophoresis Results

Without seeing your actual capillary electrophoresis result, I cannot provide a specific interpretation, but I can guide you through what the test measures and how to interpret common patterns based on the clinical context.

What Capillary Electrophoresis Measures

Capillary electrophoresis is a laboratory technique that separates molecules based on their charge-to-mass ratios, providing high-resolution analysis of various biological compounds 1, 2. The interpretation depends entirely on what is being analyzed:

For Hemoglobin Analysis (Hemoglobinopathies)

Capillary electrophoresis serves as a primary diagnostic method for quantifying hemoglobin variants, including HbA, HbA2, HbF, HbS, and other abnormal hemoglobins 3, 4.

• Normal adult pattern: HbA (95-98%), HbA2 (2-3.5%), HbF (<1%) 4
• Abnormal patterns require confirmatory testing with acid electrophoresis or DNA sequencing, as different hemoglobins may co-migrate and appear identical on capillary electrophoresis alone 4
• Never rely on capillary electrophoresis alone for definitive variant identification—some variants are electrophoretically silent 4

For HbA1c (Diabetes Monitoring)

Capillary electrophoresis is one of two primary methods for measuring HbA1c, separating glycosylated from non-glycosylated hemoglobin based on charge differences 3.

• HbA1c reflects average glucose levels over the past 2-3 months 3
• Target HbA1c <7% for most adults with diabetes, though this should be adjusted based on hypoglycemia risk and individual factors 3
• Measure HbA1c every 3 months until target achieved, then every 6 months 3
• Critical caveat: HbA1c results may be unreliable in patients with hemoglobinopathies—check www.ngsp.org/interf.asp for interference information 4

For Serum Protein Analysis

Capillary electrophoresis separates serum proteins into distinct zones: albumin, alpha-1, alpha-2, beta, and gamma-globulin fractions 5.

• Provides better resolution than traditional agarose gel electrophoresis, particularly for detecting monoclonal proteins and precisely localizing C3 and transferrin 5
• Reproducibility for migration times: 2.3-3.1% for the five major protein zones 5
• Monoclonal components (M-spikes) appear as sharp, narrow peaks in the gamma or beta regions 5

For T-Cell Receptor (TCR) Gene Rearrangements

Capillary electrophoresis detects clonal T-cell populations by analyzing PCR products of TCR gene rearrangements 3.

• Clonal pattern: Sharp, distinct peak(s) at specific size(s) indicating monoclonal T-cell expansion 3
• Polyclonal pattern: Broad, Gaussian distribution indicating normal, diverse T-cell population 3
• Used diagnostically for T-cell lymphomas, including peripheral T-cell lymphomas and breast implant-associated ALCL 3

Key Interpretation Principles

Quality Control Indicators

• Check for proper peak resolution and baseline separation 5
• Verify migration times are within expected ranges (reproducibility should be <3.1%) 5
• Ensure adequate sample quality—hemolysis, lipemia, or improper storage can affect results 3

Common Pitfalls to Avoid

• Do not interpret results in isolation—always correlate with clinical presentation, complete blood count, and other laboratory findings 4
• Recognize limitations in specific conditions: Capillary electrophoresis may be unreliable in severe dehydration, shock, or conditions affecting microcirculation 3
• For hemoglobin variants: Always confirm with a second method (acid electrophoresis or DNA sequencing) 4
• For HbA1c: Results may be falsely elevated or decreased in conditions affecting red blood cell lifespan (hemolysis, recent transfusion, iron deficiency) 3

Next Steps Based on Results

If Abnormal Hemoglobin Pattern Detected

1. Perform confirmatory acid electrophoresis (pH 7.1 or citrate agar) 4
2. Order targeted DNA sequencing of α- and β-globin genes for definitive identification 4
3. Conduct family studies for genetic counseling 4

If Elevated HbA1c

1. Review capillary glucose monitoring patterns to identify specific glycemic issues (fasting vs. postprandial hyperglycemia) 3
2. Adjust diabetes medications based on HbA1c and glucose patterns 3
3. Recheck in 3 months until target achieved 3

If Monoclonal Protein Detected

1. Quantify the M-spike and determine immunoglobulin type 5
2. Order additional testing: serum free light chains, immunofixation, bone marrow biopsy as clinically indicated 5

To provide a specific interpretation of YOUR result, I would need to see the actual electropherogram with peak patterns, percentages, and the clinical context (symptoms, medical history, reason for testing).