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HelpEpic Test Code LAB21034 Monoclonal Protein Quantitation, 24 Hour, Urine
Additional Codes
MML:MPQU
Shipping Instructions
Refrigerate specimen during collection and send refrigerated.
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Supplies: Urine Container, 60 mL (T313)
Submission Container/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 50 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Aliquot between 30 mL and 50 mL urine into plastic, 60-mL urine bottle.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Useful For
Monitoring patients with monoclonal gammopathies using 24-hour urine collections
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PTU3 | Protein, Total, 24 HR, U | Yes, (Order PTU) | Yes |
| PEU | Protein Electrophoresis, 24 Hr, U | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MPTU | M-protein Mass-Fix, 24 HR, U | No | No |
Testing Algorithm
Urine protein electrophoresis alone is not considered an adequate screening for monoclonal gammopathies.
If a discrete electrophoresis band is identified, the laboratory will evaluate the urine protein electrophoresis and, if necessary, perform urine M-protein isotyping by Mass-Fix at an additional charge.
The following algorithms are available:
Special Instructions
Method Name
PTU3: Turbidimetry
PEU: Agarose Gel Electrophoresis
MPTU: Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)
Reporting Name
M-protein Quantitation, 24 HR, USpecimen Type
UrineSpecimen Minimum Volume
30 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 5 days | ||
| Ambient | 24 hours |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitabilityClinical Information
Urine proteins can be grouped into 5 fractions by protein electrophoresis:
-Albumin
-Alpha-1
-Alpha-2
-Beta-globulin
-Gamma-globulin
One or more quantifiable monoclonal proteins may be present and reported as M spike
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.
The following algorithms are available:
Reference Values
PROTEIN, TOTAL
<229 mg/24 hours
Reference values have not been established for patients who are younger than 18 years of age.
ELECTROPHORESIS, PROTEIN
The following fractions, if present, will be reported as mg/24 hours:
Albumin
Alpha-1-globulin
Alpha-2-globulin
Beta-globulin
Gamma-globulin
MASS-FIX M-PROTEIN ISOTYPE
M-protein Isotype MS:
No monoclonal protein detected
Flag M-protein Isotype MS:
Negative
Interpretation
The presence of a monoclonal immunoglobulin light chain in the urine is seen in multiple myeloma, macroglobulinemia, primary systemic amyloidosis and light-chain deposition disease, monoclonal gammopathy of undetermined significance, and idiopathic Bence Jones proteinuria. The presence of a monoclonal light chain can produce kidney insufficiency, may be deposited as amyloid fibrils, may damage the proximal tubes producing Fanconi syndrome, or light chains may deposit in the glomerulus and cause light-chain deposition disease.
Heavy chain fragments as well as light chains may be seen in the urine of patients with multiple myeloma or amyloidosis.
Cautions
Patients suspected of having a monoclonal gammopathy may have a normal urine protein electrophoretic pattern, and these patients should have M-protein isotyping performed.
Monoclonal gammopathies are rarely seen in patients younger than 30 years of age.
Hemolysis may cause a discrete band on protein electrophoresis, which will be negative on M-protein isotyping.
Penicillin may split the albumin band.
Radiographic agents may produce an uninterpretable pattern.
Day(s) Performed
Monday through Friday
Report Available
4 to 6 daysSpecimen Retention Time
See Individual Test IDsPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
84156
84166
0077U (if appropriate)
NY State Approved
YesForms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.