An audit of immunofixation requesting practices at a South African referral laboratory
African Journal of Laboratory Medicine
| Field | Value | |
| Title | An audit of immunofixation requesting practices at a South African referral laboratory | |
| Creator | Gounden, Verena Rampursat, Yashna | |
| Description | Background: It is common practice in most chemical pathology laboratories for reflective immunofixation electrophoresis (IFE) to occur following the detection or suspicion of a paraprotein on serum protein electrophoresis (SPEP). The chemical pathology laboratory at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, South Africa, is currently the only non-private laboratory in the KwaZulu Natal province that performs SPEP analysis, with current practice requiring that the clinician request IFE following suggestion by the laboratory after a suspicious SPEP result.Objectives: To review the current process for IFE at IALCH in the context of reflective testing and to examine the use of the alpha-2-globulin/alpha-1-globulin ratio as a predictor of a positive IFE result.Methods: Data for 1260 consecutive SPEP tests performed at the IALCH National Health Laboratory Service were collected between February and July 2011. SPEP and IFE were performed with a Sebia Hydrasys automated electrophoresis system. The alpha-2-globulin/alpha-1-globulin ratio was calculated using density of corresponding fractions on SPEP.Results: Analysis revealed that of the 1260 SPEPs performed during the analysis period, 304 IFEs were suggested by the reviewing pathologist. A total of 45 (15%) of the suggested IFEs were subsequently requested by the attending clinicians. Almost half (46.5%) (n = 20) of the suggested IFEs that were performed revealed the presence of a paraprotein. There was no statistically-significant difference between the alpha-2-globulin/alpha-1-globulin ratio for patients with positive or negative IFEs (p-value = 0.2).Conclusions: This study reveals the need for reflective addition of IFE testing by the laboratory following suspicious findings on SPEP. | |
| Publisher | AOSIS | |
| Date | 2014-10-08 | |
| Identifier | 10.4102/ajlm.v3i1.91 | |
| Source | African Journal of Laboratory Medicine; Vol 3, No 1 (2014); 5 pages 2225-2010 2225-2002 | |
| Language | eng | |
| Relation |
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https://ajlmonline.org/index.php/ajlm/article/view/91/211
https://ajlmonline.org/index.php/ajlm/article/view/91/215
https://ajlmonline.org/index.php/ajlm/article/view/91/216
https://ajlmonline.org/index.php/ajlm/article/view/91/202
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