When to Order Serum Protein Electrophoresis (SPEP) in an Allergist's Office

The authors assembled the following list for:

Indications for Serum Protein Electrophoresis in an Allergist's Office

1. When patients present with angioedema and paraproteinemia, or lymphoproliferative disorders are suspected as underlying causes

2. When a patient presents with recurrent respiratory tract infections, pneumonia, or more serious systemic infections and other findings suggests paraproteinemia or lymphoproliferative disorders

3. When evaluation reveals hypogammaglobulinemia and other concomitant findings (anemia, bone pain, fractures, renal disease) suggest a systemic process

4. When Schnitzler syndrome or urticarial vasculitis are diagnosed or suspected

5. When a patient presents with pulmonary symptoms and evaluation suggests a systemic process such as IgG4-related disease, vasculitis, or infiltrative disorder (amyloidosis, sarcoidosis)

6. During the evaluation of osteoporosis or fractures in patients with asthma or other allergic disease requiring glucocorticoids (or demonstrating anemia and compression fractures)

7. Dermatologic disorders that present with plaques, papules, or eczema that may be associated with paraproteinemia

Consider SPEP in miscellaneous other conditions, such as unexplained peripheral neuropathy, anemia, renal insufficiency, hypercalcemia, unexplained fractures or lytic lesions observed on radiographs, or unexplained stroke or confusion, also might suggest the need to evaluate for paraproteinemia but are less likely to present in this manner to the allergist.

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Paraproteinemia and serum protein electrophoresis interpretation for the allergist

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