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Ordered Items: Protein, Total, Serum; Protein Electrophoresis, Serum (SPEP); Kappa Light Chain, Free, Serum
Clinical Indication: Screen for a monoclonal gammopathy / plasma-cell dyscrasia (MGUS, Waldenström/Schnitzler, light-chain disease, AL amyloidosis) in the setting of a chronic multi-system inflammatory illness. This directly addresses a previously open workup gap.
Serum Total Protein & Protein Electrophoresis (SPEP) — 07/02/2026
Serum protein electrophoresis separates total protein into fractions (albumin and the alpha/beta/gamma globulins). A discrete spike in the gamma region ("M-spike") is the hallmark of a monoclonal (clonal plasma-cell) protein.
Total Protein
6.5
g/dL (Ref: 6.1-8.1)
Albumin
4.5
g/dL (Ref: 3.8-4.8)
Gamma Globulin
0.7
g/dL (Ref: 0.6-1.7)
M-Protein
None
No monoclonal band
| Fraction |
Result |
Flag |
Units |
Reference Interval |
| Protein, Total, Serum |
6.5 |
Normal |
g/dL |
6.1-8.1 |
| Albumin |
4.5 |
Normal |
g/dL |
3.8-4.8 |
| Alpha-1 Globulin |
0.2 |
Normal |
g/dL |
0.2-0.4 |
| Alpha-2 Globulin |
0.5 |
Normal |
g/dL |
0.4-0.8 |
| Beta-1 Globulin |
0.4 |
Normal |
g/dL |
0.3-0.6 |
| Beta-2 Globulin |
0.3 |
Normal |
g/dL |
0.2-0.5 |
| Gamma Globulin |
0.7 |
Normal |
g/dL |
0.6-1.7 |
Laboratory Interpretation (verbatim): "No specific abnormalities seen and no abnormalities suggestive of the presence of monoclonal protein."
All protein fractions fall within their reference intervals. There is no discrete M-spike. Gamma globulin (0.7 g/dL) sits at the low end of normal — i.e., no hypergammaglobulinemia and no hypogammaglobulinemia flagged.
Serum Free Light Chains — 06/29/2026
Serum free light chains are more sensitive than SPEP for detecting a clonal light-chain process. A single free kappa was resulted in this order; free lambda and the kappa/lambda ratio were not part of this panel.
| Test |
Result |
Flag |
Units |
Reference Interval |
| Kappa Light Chain, Free, Serum |
10.6 |
Normal |
mg/L |
3.3-19.4 |
| Lambda Light Chain, Free, Serum |
Not performed |
Not ordered |
mg/L |
5.7-26.3 |
| Kappa / Lambda Free Ratio |
Not calculable |
Not ordered |
ratio |
0.26-1.65 |
Result
Serum Free Kappa 10.6 mg/L — within reference range (3.3-19.4)
The absolute free kappa is normal. Because free lambda was not measured, the diagnostic kappa/lambda ratio — the most sensitive marker of a clonal light-chain process — could not be calculated from this order.
Overall Summary — Plasma-Cell / Monoclonal Screen:
Reassuring (argues against a plasma-cell dyscrasia):
- SPEP shows a normal pattern with no monoclonal protein / no M-spike.
- Total protein (6.5) and all globulin fractions are within range — no hypergammaglobulinemia.
- Serum free kappa (10.6 mg/L) is normal.
What this does NOT fully exclude (honest limits):
- A normal SPEP can miss a small monoclonal band — serum immunofixation (IFE) is the sensitive confirmatory test and was not part of this order (no reflex was triggered because there was no visible M-spike).
- Only free kappa was measured. A low-level light-chain (AL amyloidosis / light-chain MGUS) process is best excluded with free lambda + the kappa/lambda ratio.
- No urine studies (UPEP / urine immunofixation) were done.
To completely close this workup: add serum free lambda with kappa/lambda ratio, serum immunofixation, and a 24-hour urine with immunofixation. Quantitative immunoglobulins (IgG/IgA/IgM) would further characterize the low-normal gamma fraction.
Patient Details
Bishop, Tyler
3434 VOYAGER CIR, SAN DIEGO, CA, 92130
Phone: 636-448-1747
DOB: 05/26/1987 | Age: 39 | Sex: Male
Patient ID: 916221
Ordering / Physician of Record
Michael Bauer, MD
Ulta Lab Tests — University Services
9237 E Via De Ventura Ste 220
Scottsdale, AZ 85258-3602
Phone: 480-681-4081 | Client #: 97512001
Specimen Details
Specimen ID: ZD140998N
Requisition: 0042241
Lab Reference ID: 1547194
Date Collected: 07/02/2026 13:53 (Free Kappa: 06/29/2026)
Date Received: 07/02/2026 13:54
Date Reported: 07/03/2026 23:15
Report Status: FINAL
Performing Labs:
Kappa Light Chain, Free, Serum — Quest Diagnostics, West Hills, 8401 Fallbrook Ave, West Hills, CA 91304-3226 (Laboratory Director: Thomas J McDonald)
Total Protein & Protein Electrophoresis — Quest Diagnostics, ordered through Ulta Lab Tests