Overview
Serum electrophoresis is a laboratory technique used to separate and analyze serum proteins based on their electrical charge and size. At an alkaline pH, serum proteins carry a negative charge and migrate toward the anode at different rates. This separation allows identification and quantification of major protein fractions such as albumin and globulins. Serum electrophoresis is a highly sensitive and specific method, especially useful for detecting abnormal proteins like monoclonal proteins.
Symptoms
Serum electrophoresis is not performed based on symptoms alone but is indicated when patients present with clinical features suggestive of protein abnormalities. These may include bone pain, recurrent infections, unexplained anemia, fatigue, weight loss, peripheral neuropathy, renal dysfunction, or pathological fractures. Many patients may be asymptomatic, with abnormal protein patterns detected during routine evaluation or investigation of abnormal laboratory findings.
Causes
Abnormal serum electrophoresis patterns arise due to changes in protein synthesis, loss, or immune activity. Monoclonal gammopathies result from clonal proliferation of plasma cells producing a single immunoglobulin, seen in multiple myeloma, Waldenström macroglobulinemia, and related disorders. Polyclonal gammopathy occurs due to chronic infections, autoimmune diseases, liver disease, and inflammatory conditions. Reduced albumin levels may be seen in malnutrition, liver disease, nephrotic syndrome, burns, or protein-losing enteropathies, while acute phase reactions increase alpha globulin fractions.
Risk Factors
Risk factors for abnormal serum electrophoresis include advancing age, plasma cell disorders, chronic inflammatory or infectious diseases, autoimmune conditions, liver and kidney disease, and malignancy. Patients with unexplained anemia, hypercalcemia, renal failure, or rouleaux formation on peripheral smear are at higher risk. Technical factors and the presence of low-level monoclonal proteins may influence detection.
Prevention
Although protein abnormalities cannot always be prevented, early detection through serum electrophoresis helps prevent complications and guides timely management. Regular monitoring in patients with known monoclonal gammopathies allows assessment of disease progression and treatment response. Proper interpretation in conjunction with clinical findings and confirmatory tests such as immunofixation improves diagnostic accuracy and patient outcomes.
