Serum protein electrophoresis (SPE) is mainly indicated to detect monoclonal gammopathy in patients who have clinical symptoms and signs related to multiple myeloma, amyloidosis, or Waldenstrom macroglobulinemia. It may also be performed in certain uncommon diseases associated with a monoclonal protein like POEMS syndrome and some forms of polyneuropathy.
About 3% of the population above the age of 50, have a monoclonal gammopathy of undetermined significance (MGUS). Current practice guidelines do not recommend routine screening for MGUS in the general population because of the lack of proven benefit, absence of actionable preventive therapy and creation of unnecessary anxiety for some patients.
SPE is not a sensitive test to detect inflammation, C-reactive protein is a better and less costly alternative that is more responsive to changes in the patient status. For more information:
Alberta Health Services (AHS). Multiple myeloma. Clinical practice guideline LYHE-003. Calgary, AB 2015
Chami N, Simons JE, Sweetman A, Don-Wauchope AC. Rates of inappropriate laboratory test utilization in Ontario. Clin Biochem. 2017 Oct;50(15):822-827. PMID: 28483406.
Go RS, Rajkumar SV. How I manage monoclonal gammopathy of undetermined significance. Blood. 2018 Jan 11;131(2):163-173. PMID: 29183887.
Institut national d’excellence en santé et en services sociaux (INESSS). Usage judicieux de 14 analyses biomédicales. Rapport rédigé par Faiza Boughrassa et Alicia Framarin avec la collaboration du Comité d’experts sur la pertinence-OPTILAB. Montréal, Québec : INESSS; 2014. 33p. [Internet].
Khouri J, Samaras C, Valent J,et al.Monoclonal gammopathy of undetermined significance: A primary care guide. Cleve Clin J Med. 2019 Jan;86(1):39-46. PMID: 30624183.
Moreau P, San Miguel J, Sonneveld P, et al.; ESMO Guidelines Committee. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28(suppl_4):iv52-iv61. PMID: 28453614.