Protein Electrophoresis: Best Practices for Everyday Interpretation (Half Day)

Sunday, July 28, 2024
1:30 PM – 4:30 PM US Central Time
McCormick Place Chicago


Navigating and interpreting the appropriate testing for monoclonal gammopathies via protein electrophoresis (PEP) for both serum and urine, and other supplemental testing (isotyping, serum free light chain, etc.) can be challenging. The goal of this course is to convey best practice recommendations in a case-based format. Participants will gain knowledge on test utilization for initial diagnosis and monitoring, reflex testing strategies, factors affecting accurate quantitation, common interferences, and reporting of monoclonal proteins (M-proteins) in an interactive case-based format. All current clinical methodologies will be highlighted (gel, capillary, immunonephelometry, mass spectrometry) along with different quantitation methodologies (perpendicular drop, tangent skimming). This session will be formatted with introductory presentations addressing the fundamentals of protein electrophoresis and appropriate test utilization followed by an interactive set of case examples highlighting best practices.

Target Audience

This activity is designed for lab supervisors, lab directors (and/or assistant directors), lab managers (supervisory and/or non-supervisory), medical technologists, pathologists, and in-training individuals.

Prerequisite Knowledge 

General knowledge of protein electrophoresis is helpful but not required. 

What to Bring

A fully-charged personal laptop if you wish to view presentation on personal device and materials to take notes.

Learning Objectives

  • Discuss the fundamentals of protein electrophoresis, including different methodologies and gating practices.
  • Identify what diseases are assessed by protein electrophoresis and which additional tests to perform for different diseases.
  • Compare best practices for testing workflows, reporting, and working up challenging cases.


Katherine Turner, BS, PhD, DABCC | Corewell Health

David Manthei, MD, PhD | University of Michigan

Maria Alice Willrich, MSc, PhD, DABCC, FADLM | Mayo Clinic

Course Outline

  1. Fundamentals of Protein Electrophoresis (30 mins.)
    This presentation will be a technique introduction including the introduction of PEP, what is a M-protein, the different specimen types, the different methodologies (gel, capillary, mass spectrometry), the different gating methods (perpendicular drop, tangent skimming), and supplemental testing that is needed for the workup. It will include audience polling to understand the participants’ current knowledge of the topic and what techniques they use in their laboratory. 

  2. Indications for Monoclonal Protein Testing and Impact of Detection (30 mins.)
    This presentation will touch on the diseases that are assessed by PEP and how M-proteins, including small M-proteins, play a role in those diseases and the criteria for calling these disease states based on the laboratory’s findings. It will also include what tests should be included in the testing for specific diseases based on current practice, evidence, and guidelines.

  3. Case Presentations Addressing the Best Practices of Protein Electrophoresis (120 mins.)
    This presentation will be interactive cases highlighting best practices, which will include audience polling. Topics that will be discussed: gating small or beta-migrating M-proteins and how accuracy of M-protein quantitation is affected, cases that highlight the new CAP guidelines such as when to reflex cases to isotyping (hypogammaglobinemia, AL amyloid), and unique cases such as IgG4, oligoclonal banding, interference from IV contrast dye, monoclonal therapeutics, and fibrinogen. Cases will highlight the different methodologies, gating practices, and supplemental testing.