SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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Ch. Kast1 , Ch. Schild1 , F. Egger1 , U. Marti

1Institute of Clinical Chemitry, University of Bern, Inselsoital, CH-3010 Bern

Our laboratory routinely uses the capillary electrophoresis system Paragon CZE 2000 to analyse blood samples of patients for the presence of paraproteins. We compared this method to the more recently launched Capillarys protein (Sebia) and the Capillarys b1- b2 (Sebia) systems. The detection limit for paraproteins was determined by dilution series of patient samples containing an IgG- or an IgM- paraprotein at high concentrations. The detection limit was similar in all the methods (paraprotein concentrations 0.9 g/l and 0.7 g/l, respectively). Blood samples from patients (n=316) were submitted for serum electrophoresis and further analysed by immunofixation (Sebia) or immunosubtraction (Paragon CZE 2000). This confirmed the presence of paraproteins in 63 blood samples. While the Paragon CZE 2000 method showed no irregularities within the b-and/or g-globulin fractions of four of these paraproteins (paraproteins present at low concentrations), the Capillarys protein and Capillarys b1- b2 systems missed 9 and 5 of the paraproteins, respectively. On the other hand, the rate of blood samples free of paraproteins showing abnormalities within the b-and/or g-globulin fractions was substantially higher using the Paragon CZE 2000 method as compared to both Capillarys systems. In our study, the Paragon CZE 2000 method displayed highest sensitivity. However, the specificity of this method was low and therefore may lead to higher costs for further immunofixation analysis. Vice versa, the Capillarys b1- b2 system had a lower resolution for paraproteins, but substantially better specificity.

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