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Blood test
Blood test

Immunoelectrophoresis - serum
Definition:
Immunoelectrophoresis - serum is a test that detects the presence or absence of immunoglobulins in the blood and assess the qualitative character (polyclonal vs. monoclonal) of the immunoglobulins. (See "What do abnormal results mean".)

Alternative Names:
IEP - serum; Immunoglobulin electrophoresis - serum; Gammaglobulin electrophoresis; Serum immunoglobulin electrophoresis

How the test is performed:

Adult or child:
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

Immunoelectrophoresis is a laboratory technique. It uses a combination of protein electrophoresis (see protein electrophoresis - serum), and an antigen-antibody interaction. Protein electrophoresis indicates immunoglobulins as a group. Immunoelectrophoresis enhances the ability to identify the specific immunoglobulins through the use of specific antibodies to the proteins of interest.

Specific lab technique: Monospecific (that is, specific for one antigen such as kappa or lambda immunoglobulin light chains) antiserum is overlaid on the zone of the electrophoretogram (the paper graph used with protein electrophoresis), which contains the unidentified protein. The presence of a precipitin band indicates that the specific protein identified by the monospecific antiserum used is present.
How to prepare for the test:
Adults:
No special preparation is necessary.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:
This test is performed to assess the clonality (monoclonal or polyclonal) of immunoglobulins. (See "What do abnormal results mean".)
Normal Values:
No monoclonal antibodies are detected.
What abnormal results mean:
In some malignant disorders (that is, multiple myeloma, chronic lymphocytic leukemia) a single clone of lymphocytes produces one type of protein -- a monoclonal immunoglobulin. This is identifiable as monoclonal (all the same type) by immunoelectrophoresis. Some people have monoclonal immunoglobulins, but do not have a malignant disorder.
What the risks are:
  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
  • Multiple punctures to locate veins
Special considerations:
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Review Date: 10/21/2001
Reviewed By: Rebecca Elstrom, M.D., Division of Hematology-Oncology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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