Electrophoresis test prevalence, requesting patterns, yield and related bone marrow biopsy findings at a South African tertiary hospital : a 5-year retrospective audit

Naidoo, N. ; Erasmus, R. T. ; Grewal, R. ; Zemlin, A. E. (2017)

CITATION: Naidoo, N., et al. 2017. Electrophoresis test prevalence, requesting patterns, yield and related bone marrow biopsy findings at a South African tertiary hospital : a 5-year retrospective audit. South African Medical Journal, 107(3):270-273, doi:10.7196/SAMJ.2017.v107i3.10960.

The original publication is available at http://www.samj.org.za/index.php/samj

Article

Background. Studies of electrophoresis testing (serum protein electrophoresis (SPE), urine protein electrophoresis (UPE), immunofixation electrophoresis (IFE)) in a South African (SA) pathology laboratory setting are limited. Objectives. To evaluate the prevalence, testing pattern and yield of electrophoresis tests performed over a 5-year period in a tertiary academic laboratory and to relate these findings to bone marrow biopsy findings in a few selected cases. Methods. This was a retrospective audit of all SPE, UPE and IFE tests performed on new and follow-up adult patients (aged ≥18 years) from 2010 to 2015, using data from the Tygerberg Academic Hospital (Cape Town, SA) National Health Laboratory Service hospital information system database. A subgroup analysis of all patients with negative serum (SIFE) and/or urine immunofixation (UIFE) tests who had concurrent bone marrow biopsies close to the time of IFE testing was also performed. Results. A total of 5 086 SPE tests were performed (44.3% were follow-up tests, and of these patients 13.8% had SIFE tests); 1 299 UPE tests were performed (23.3% were follow-up tests, and of these patients 33.6% had UIFE tests). The mean ages of patients who had SIFE and UIFE tests were 59 years (standard deviation (SD) 14.2) and 60 years (SD 15), respectively. The female-to-male ratio was 1.1:1 for both SIFE and UIFE. The negative test yields for SIFE and UIFE were 31.3% and 52.1%, respectively. Bone marrow biopsy findings for patients with negative SIFE tests identified 8 out of the 20 biopsies (40.0%) as positive for myeloma. Conclusion. This audit provides baseline data on the prevalence of test requests, their source and the yield of electrophoresis testing in our laboratory. An increasing trend in SIFE and UIFE was evident.

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