text:
Test ID: EPU
Electrophoresis, Protein, 24 Hour, Urine
Useful For Suggests clinical disorders or settings where the test may be helpful
Monitoring patients with monoclonal gammopathies
Urine protein electrophoresis alone is not considered an adequate screening for monoclonal gammopathies
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Urine proteins can be grouped into 5 fractions by protein electrophoresis:
-Gamma globulin
The urine total protein concentration, the electrophoretic pattern, and the presence of a monoclonal immunoglobulin light chain may be characteristic of monoclonal gammopathies such as multiple myeloma, primary systemic amyloidosis, and light chain deposition disease.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
<167 mg/24 hours
Reference values have not been established for patients <18 years of age.
Reference values have not been established for patients >83 years of age.
If protein concentration is abnormal, the following fractions, if present, will be reported as a percent of the protein, total.
Reference value applies to 24-hour collection. Specimens collected for periods other than 24 hours will be reported in concentration units.
Interpretation Provides information to assist in interpretation of the test results
A characteristic monoclonal band (M-spike) is often found in the urine of patients with multiple myeloma (MM). The initial identification of an M-spike or an area of restricted migration should be followed by MPSU / Monoclonal Protein Study, 24 Hour, Urine that includes immunofixation to identify the immunoglobulin heavy chain and/or light chain. Immunoglobulin heavy chain fragments as well as free light chains may be seen in the urine of patients with monoclonal gammopathies.
The presence of a monoclonal light chain M-spike of >1 g/24 hours is consistent with a diagnosis of MM or macroglobulinemia.
The presence of a small amount of monoclonal light chain and proteinuria (total protein >3 g/24 hours) which is predominantly albumin is consistent with amyloidosis (AL) or light chain deposition disease (LCDD). Because patients with AL and LCDD may have elevated urinary protein without an identifiable M-spike, urine protein electrophoresis is not considered an adequate "screen" for the disorder. MPSU / Monoclonal Protein Study, 24 Hour, Urine that includes immunofixation should be performed if the clinical suspicion is high.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Patients suspected of having a monoclonal gammopathy may have a normal urine protein electrophoretic pattern, and these patients should have immunofixation (MPSU / Monoclonal Protein Study, 24 Hour, Urine) performed. Monoclonal gammopathies are rarely seen in patients <30 years of age.
Hemolysis may cause a discrete band on protein electrophoresis, which will be negative on immunofixation.
Penicillin may split the albumin band.
Radiographic agents may produce an uninterpretable pattern.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Kyle, RA, Katzmann, JA, Lust, JA, Dispenzieri A: Clinical indications and applications of electrophoresis and immunofixation. In Manual of Clinical Laboratory Immunology. Sixth edition Edited by NR Rose, RG Hamilton, B Detrick: Washington, DC. ASM Press, 2002, pp 66-67
2. Kyle, RA, Katzmann, JA, Lust, JA, Dispernzieri, A: Immunochemical characterization of immunoglobulins. In Manual of Clinical Laboratory Immunology. Sixth edition, Edited by NR Rose, RG Hamilton, B Detrick. Washington, DC. ASM Press, 2002, pp 71-91


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Interpretive Handbook
9289 :
Cancer Antigen 125 (CA 125), Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Cancer antigen 125 (CA 125) is a glycoprotein antigen normally expressed in tissues derived from coelomic epithelia (ovary, fallopian tube, peritoneum, pleura, pericardium, colon, kidney, stomach).
Serum CA 125 is elevated in approximately 80% of women with advanced epithelial ovarian cancer, but assay sensitivity is suboptimal in early disease stages. The average reported sensitivities are 50% for stage I and 90% for stage II or greater.
Elevated serum CA 125 levels have been reported in individuals with a variety of nonovarian malignancies including cervical, liver, pancreatic, lung, colon, stomach, biliary tract, uterine, fallopian tube, breast, and endometrial carcinomas.
Elevated serum CA 125 levels have been reported in individuals with a variety of nonmalignant conditions including: cirrhosis, hepatitis, endometriosis, first trimester pregnancy, ovarian cysts, and pelvic inflammatory disease. Elevated levels during the menstrual cycle also have been reported.
Useful For Suggests clinical disorders or settings where the test may be helpful
Evaluating patients' response to cancer therapy, especially for ovarian carcinoma
Predicting recurrent ovarian cancer or intraperitoneal tumor
Interpretation Provides information to assist in interpretation of the test results
In monitoring studies, elevations of cancer antigen 125 (CA 125) >35 U/mL after debulking surgery and chemotherapy indicate that residual disease is likely (>95% accuracy). However, normal levels do not rule-out recurrence.
A persistently rising CA 125 value suggests progressive malignant disease and poor therapeutic response.
Physiologic half-life of CA 125 is approximately 5 days.
In patients with advanced disease who have undergone cytoreductive surgery and are on chemotherapy, a prolonged half-life (>20 days) may be associated with a shortened disease-free survival.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Not useful as a screening assay for cancer detection in the normal population.
Results cannot be interpreted as absolute evidence of the presence or absence of disease.
Serum markers are not specific for malignancy and values may vary by method. Values obtained with different assay methods cannot be used interchangeably.
Some individuals have antibodies to mouse protein (HAMA), which can cause interference in immunoassays that employ mouse antibodies. In particular, it has been reported that serum specimens from patients who have undergone therapeutic or diagnostic procedures that include infusion of mouse monoclonal antibodies may produce erroneous results in such assays. Rerunning the specimen in question after additional blocking treatment may resolve the issue.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
<35 U/mL
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Devarbhav H, Kaese D, Williams AW, et al: Cancer antigen 125 in patients with chronic liver disease. Mayo Clin Proc 2002;77:538-541
2. Sturgeon CM, Duffy MJ, Stenman UH, et al: National Academy of Clinical Biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular, prostate colorectal, breast, and ovarian cancers. Clin Chem 2008 Dec;54:11-79
3. Sugiyama T, Nishida T, Komai K, et al: Comparison of CA 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitoring of ovarian cancer. Int J Gynaecol Obstet 1996;54:251-256

subset: commoncrawl


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Caregiver Support Group - Beyond Alzheimer's
Beyond Alzheimer's is a support group for caregivers, friends and loved ones of someone with Alzheimer's disease or dementia.
Beyond Alzheimer's
Time: 6:30 - 7:30 pm Mondays at RRMC, room 3-3102.
Cost: Free or donation.
"More than any other disease, Alzheimer's sweeps up entire families. Typically, family members feel that they aren't patients and have no right to ask for care. But they are patients; they are victims of a relentless and mysterious disease that has deep emotional roots and has left them stranded, longing to share what they are feeling. This is an opportunity for them to get the care they deserve." – Patti Davis
For more information, please email Katherine Serrano or call 310-825-8253


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December 2008
Highlights four Centers of Excellence for Physician Information designed to increase physicians' awareness of research on the medical consequences of drug abuse and addiction and incorporate research findings into clinical practice.
Reports prevalence rates of illicit drug abuse among youths and young adults based on 2007 data from a national survey of drug use and health.
September 2008
Offers an overview of some of the NIDA-supported innovative research achievements to reduce the health and social effects of drug abuse and addiction.
Describes research findings demonstrating that the immune system participates in the shaping of brain circuits during a child's development, a finding that may shed light on the origins of neurodegenerative diseases.
Describes research to develop new compounds that match or exceed the pain relief provided by opioids while avoiding their shortcomings.
Describes new tools under development, including one to visualize cells deep in the brain and another one that remotely activates brain cells.
Announces the three winners of the NIDA and Scholastic Corporation 2008 Addiction Science Awards honoring high school students' award-winning addiction-related projects.
Presents research findings linking 89 genes to drug abuse and dependence, found using genome-wide association studies, a new technique for identifying genes.
June 2008
Describes a study of unemployed methadone patients and the use of assertive outreach and motivational techniques to improve the patients' employment outlook.
Describes research providing evidence that maternal smoking during pregnancy contributes to behavioral conduct disorders among toddlers, school-age children, and teens.