Original Research
An audit of immunofixation requesting practices at a South African referral laboratory
Submitted: 24 June 2013 | Published: 08 October 2014
About the author(s)
Verena Gounden, Department of Chemical Pathology, National health laboratory Services, Inkosi Albert Luthuli Central Hospital and Nelson R Mandela Medical School University of Kwa Zulu Natal, South AfricaYashna Rampursat, Department of Chemical Pathology, National health laboratory Services, Inkosi Albert Luthuli Central Hospital and Nelson R Mandela Medical School University of Kwa Zulu Natal, South Africa
Abstract
Objectives: To review the current process for IFE at IALCH in the context of reflective testing and to examine the use of the alpha-2-globulin/alpha-1-globulin ratio as a predictor of a positive IFE result.
Methods: Data for 1260 consecutive SPEP tests performed at the IALCH National Health Laboratory Service were collected between February and July 2011. SPEP and IFE were performed with a Sebia Hydrasys automated electrophoresis system. The alpha-2-globulin/alpha-1-globulin ratio was calculated using density of corresponding fractions on SPEP.
Results: Analysis revealed that of the 1260 SPEPs performed during the analysis period, 304 IFEs were suggested by the reviewing pathologist. A total of 45 (15%) of the suggested IFEs were subsequently requested by the attending clinicians. Almost half (46.5%) (n = 20) of the suggested IFEs that were performed revealed the presence of a paraprotein. There was no statistically-significant difference between the alpha-2-globulin/alpha-1-globulin ratio for patients with positive or negative IFEs (p-value = 0.2).
Conclusions: This study reveals the need for reflective addition of IFE testing by the laboratory following suspicious findings on SPEP.
Keywords
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