From the Guidelines
I would order a serum protein electrophoresis (SPEP) when evaluating patients with suspected multiple myeloma or other plasma cell disorders, as it is a crucial test for detecting and quantifying monoclonal proteins in the blood. This test is essential for diagnosing and monitoring multiple myeloma, as it helps to identify the type and amount of monoclonal protein present in the blood 1. The SPEP test is often used in combination with other tests, such as urine protein electrophoresis (UPEP) and serum immunofixation electrophoresis (SIFE), to provide a comprehensive evaluation of the patient's condition 1.
Some key points to consider when ordering a SPEP test include:
- The test is used to detect and quantify monoclonal proteins in the blood, which is essential for diagnosing and monitoring multiple myeloma 1
- The test is often used in combination with other tests, such as UPEP and SIFE, to provide a comprehensive evaluation of the patient's condition 1
- The test can help to identify the type and amount of monoclonal protein present in the blood, which is crucial for determining the best course of treatment 1
- The test can also be used to monitor the patient's response to treatment and to detect any changes in the disease over time 1
It's worth noting that the SPEP test is a non-invasive and relatively simple test to perform, and it can provide valuable information for diagnosing and managing multiple myeloma and other plasma cell disorders. According to the most recent and highest quality study, the SPEP test is an essential component of the diagnostic workup for multiple myeloma, and it should be used in combination with other tests to provide a comprehensive evaluation of the patient's condition 1.
From the Research
Reasons to Order Serum Protein Electrophoresis (SPEP)
- To identify patients with multiple myeloma and other serum protein disorders 2
- To evaluate lytic bone lesions of unknown etiology, as SPEP can help rule out plasma cell neoplasms with a high negative predictive value 3
- To detect monoclonal gammopathies, which are associated with a clonal process that is malignant or potentially malignant, including multiple myeloma, Waldenstrom's macroglobulinemia, and amyloidosis 2
- To differentiate multiple myeloma from other causes of monoclonal gammopathy, using the quantity of M protein, bone marrow biopsy results, and other characteristics 2
Clinical Scenarios where SPEP is Useful
- In patients with acute inflammation, malignancy, trauma, necrosis, infarction, burns, or chemical injury, as plasma protein levels display predictable changes in response to these conditions 2
- In the initial work-up of radiolucent bone lesions, as SPEP can provide convincing evidence of the presence or absence of a plasma cell neoplasm 3
- In conjunction with other tests, such as urine electrophoresis, immunofixation electrophoresis, and free light chain assay, to increase diagnostic accuracy 3