Performance of the Sebia CAPILLARYS 2 for Detection and Immunotyping of Serum Monoclonal Paraproteins

Department of Pathology, University of Alabama, Birmingham, AL 35233, USA.
American Journal of Clinical Pathology (Impact Factor: 2.51). 09/2007; 128(2):293-9. DOI: 10.1309/1L3CG8GK6F8VYNYH
Source: PubMed


We evaluated the performance of the CAPILLARYS 2 (Sebia, Norcross, GA) capillary electrophoresis system for detection and identification of monoclonal proteins in serum samples. We analyzed 104 serum specimens by Sebia Hydragel serum protein electrophoresis (agarose gel electrophoresis [AGE]/immunofixation electrophoresis [IFE]) and CAPILLARYS 2 capillary zone electrophoresis (CZE)/immunosubtraction. AGE and CZE had sensitivities of 90% and 81%, respectively, based on IFE as the "gold standard," and all bands detected were confirmed by IFE (100% specificity). AGE and CZE had an overall agreement of 91% on serum protein electrophoresis. In the population tested, IgG was detected in 29% of samples by IFE and 30% using immunosubtraction. Similarly IgA was detected in 9% of cases by IFE and 8% by immunosubtraction. IgM and light chains were detected in 6% and 3% of cases, respectively, by IFE, whereas CZE/immunosubtraction did not detect any IgM or light chains. In our hands, AGE and CZE had the same specificity for detection of monoclonal proteins; however, CZE/immunosubtraction seems to be less sensitive than IFE for the detection of IgM and, possibly, serum light chains.

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    • "There are multiple published studies comparing AGE and CZE for the detection of monoclonal proteins demonstrating following sensitivity rates: 91% (95% CI 86.2– 95.6%) vs. 92% (95% CI 85.9–97.1%) by McCudden et al., 99% vs. 97% by Bossuyt et al, 87% and 90% by Bakker et al. and 90% (95% CI 81–98%) vs. 81% (95% CI 70–92%) by Yang et al. but the characterized specimens in these studies did not contain a HCD (9–12). Yang et al. report that in their study both methods “missed” samples with monoclonal IgA which often migrates in the beta region similar to our described gamma HC protein (12). "
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