I am not aware of any guideline, Mike, but we use a variation of the
second approach in commenting on the "residual normal gamma globulins.
However, we also provide quantitative nephelometric measurements of the
other immunoglobulins eg. we would report A and M if the M protein were
IgG.
On 17 Mar 1999, McNeely, Michael wrote:
> We have a local "dispute" regarding the reporting of serum protein electrophoretic patterns in which a monoclonal gammopathy has appeared.
>
> Both "camps" believe that reporting a quantitation of the monoclonal band is appropriate.
>
> However, the difference lies in how the rest of the gamma globulin region should be reported.
>
> 1. One camp feels that the "gamma globulin" should be all the gamma globulin (the sum of the monoclonal plus all the "normal" gamma globulin).
> 2. The other camp wishes to report the monoclonal and then "all the rest" of the gamma globulin as a separate amount (total gamma minus the monoclonal).
>
> The arguement for option 2 is that it provides a better indication of hypogammaglobulinemia or "nromal" gamma proteins. The counter arguement is that the monoclonal measurement includes a portion of the "normal" gamma globulin within it.
>
> Is there a guideline covering this?
>
> Michael McNeely MD FRCPC
>
>
>
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