Required section · Section 1 of 6

A restricted gamma pattern arrives at the bench

A serum protein electrophoresis (SPEP) trace from a 68-year-old patient shows total protein 8.6 g/dL, above the local reference interval of 6.4-8.3 g/dL. The gamma fraction is 3.3 g/dL, and the trace has a narrow, sharply bordered peak. Whether this is a true restricted protein pattern and what study should follow depends on specimen and interference review.

SPEP separates proteins into visible migration zones, then estimates fraction concentration from the trace area. It is a screening and characterization result, not an immunoglobulin type or disease diagnosis. A narrow peak can be meaningful, but it also needs specimen and interference review.

Start with what the instrument shows: zone, width, border, and specimen status. Release only the supported pattern description and follow the local reflex pathway.

Chart shows a gamma fraction of 3.3 g/dL above a light-blue 0.80 to 1.35 g/dL reference range, with narrow trace, IgG-kappa IFE result, and free-light-chain ratio 17.5 noted. — Figure 1Guided-case gamma fraction against a representative CZE reference interval.

Initial SPEP results, CZE method. Representative intervals require local verification.
Analyte	Result	Reference interval	Trace observation
Total protein	8.6 g/dL	6.4-8.3 g/dL	Delta check: prior 6.9 g/dL
Albumin	3.4 g/dL	4.02-4.76 g/dL	Low
Gamma	3.3 g/dL	0.80-1.35 g/dL	Narrow, sharply bordered peak

Knowledge checks

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Knowledge check 1

What is the most defensible initial statement about the guided CZE trace?

Choose one option.

It proves multiple myeloma.

It shows a restricted gamma pattern that needs characterization.

It identifies IgG-kappa without another test.

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