Specimen Collection
20 mL Urine (Random)
24hr Urine.
Reference Intervals
Uncertainty of Measurement:
The band quantitation is expressed in mg/mmol creatinine (random and 24h urine samples) and in g/24h (only for 24h collects).
Turnaround Time:
Frequency
: Daily (not performed on weekends and stat days)
TAT is 5 working days
for the immunofixation, with
up to 3 extra days if band quantitation is required
.
Diagnostic Use and Interpretation
-
Urine gel protein electrophoresis alone (with or without urine concentration) is not a sensitive test for monoclonal gammopathy.
-
From April 2025, by default urine immunofixation is performed for all urine protein electrophoresis requests. Urine band quantitation is not routinely done if a quantifiable monoclonal band is found, unless specifically specified on the request form or if the sample has been registered under an established trial protocol. It can be added within 2 weeks from date of receipt at our laboratory (via LabPlus Lablink 09-3074949 ext 22000 or e-mail
ChemicalPathologist@adhb.govt.nz
).
-
Urine band quantitation is done by densitometry method on urine gel electrophoresis (separate from urine immunofixation).
-
The combination of serum free light chain levels/ratio test and serum immunofixation test is able to diagnose most clonal gammopathies. However, there is still a unique role for urine immunofixation in the diagnosis of some patients with AL amyloidosis, light chain myeloma or oligo-secretory multiple myeloma.
For information on serum protein electrophoresis, please refer to Testguide entry: serum protein electrophoresis.
References:
-
Tate J, Caldwell G, Daly J, Gillis D, Jenkins M, Jovanovich S, Martin H, Steele R, Wienholt L and Mollee P on behalf of the Working Party on Standardised Reporting of Protein Electrophoresis. Recommendations for standardized reporting of protein electrophoresis in Australia and New Zealand. Ann Clin Biochem 2019; 49; 242-256
-
Tate JRT,Smith JD, Wijeratne N, Mollee P. Proposed Addendum to 2012 Recommendations for Standardised Reporting of Protein Electrophoresis in Australia and New Zealand. Clinical Biochemists Review 2019; 40(1): 23-30
-
Dispenzieri A et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia, 2009. 23(2): p. 215-24
Contact Information
For any further information contact the chemical pathologist via email
chemicalpathologist@adhb.govt.nz
or via Lablink (Auckland City Hospital) EXT 22000 or 09 3078995.
Dr Cam Kyle (Clinical Head):
CampbellK@adhb.govt.nz
ext 22052
Dr Weldon Chiu:
WeldonC@adhb.govt.nz
ext. 23427
Dr Samarina Musaad
:
SamarinaM@adhb.govt.nz
ext. 22402
Dr Campbell Heron:
CHeron@adhb.govt.nz
ext. 23427
Dr Sakunthala Jayasinghe
:
sakunthala@adhb.govt.nz
ext. 23427
Dr Owen Yi (Registrar):
wenyiyi@adhb.govt.nz
ext. 22045