Abstract
The reliable identification of serum paraproteins requires an immunofixation (IFE) using specific antisera and an electrophoretogram (EPG) on the same sample. Although serum IFE is more labour-intensive, requiring at least six sample spaces per sample, paraproteins may be missed if clinicians request a serum EPG only. There is presently no consensus amongst laboratories on the optimum testing algorithm to minimise missed paraproteins. Performing a single-lane screening IFE with pooled pentavalent antisera (IgG, IgA, IgM,kappa and lambda light chains) routinely may minimise the risk of missed paraproteins.
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