Immunoelectrophoresis - urine

How the Test is Performed

Collect a "clean-catch" (midstream) urine sample. To obtain a clean-catch sample, men or boys should wipe clean the head of the penis. Women or girls need to wash the area between the labia (lips of the vagina) with soapy water and rinse well.

As you start to urinate, allow a small amount to fall into the toilet bowl. This clears the urethra -- the tube that carries urine from the bladder and opens to the outside. Then, in a clean container, catch about 1 - 2 ounces of urine. Remove the container from the urine stream. Give the container to the health care provider or assistant.

In an infant, thoroughly wash the area around the opening of the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on your infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Place a diaper over the infant (bag and all).

Check your baby frequently, and remove the bag after the infant has urinated into it. For active infants, this procedure may take a couple of attempts. Lively infants can displace the bag, making it difficult to get the specimen. Drain the urine into a container for transport back to the health care provider.

The laboratory technician uses electrical charges to separate and identify various immunoglobulins in the urine.

How to Prepare for the Test

Your health care provider may recommend that you collect the first morning urine, which is the most concentrated.

If you are taking the collection from an infant, you may need extra collection bags.

How the Test Will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

This test is used to measure the amounts of various immunoglobulins in urine. Most often, it is done after a large amount of protein is found in the urine.

Normal Results

Normally there is no, or only a small amount, of protein in the urine. When there is protein in the urine, it normally consists of mainly albumin.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Immunoglobulin in the urine can result from:

• Amyloidosis
• Leukemia
• Multiple myeloma
• Kidney disorders such as IgA nephropathy or IgM nephropathy
• Waldenstrom's macroglobulinemia

Some people have monoclonal immunoglobulins, but do not have cancer. This is called “monoclonal gammopathy of unknown significance," or MGUS.

Alternative Names

Immunoglobulin electrophoresis - urine; Gamma globulin electrophoresis - urine; Urine immunoglobulin electrophoresis; IEP - urine

References

McPherson RA, Massey HD. Laboratory evaluation of immunoglobulin function and humoral immunity. In McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia,Pa: Saunders Elsevier; 2011:chap 46.

Perry MC. Plasma cell disorders. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap193.

Update Date: 6/5/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.