Interference Rendering Capillary Electrophoresis of Serum Proteins Uninterpretable

Area of Science:

• Clinical Chemistry
• Protein Analysis
• Electrophoresis Techniques

Background:

• A clinical case involving a 72-year-old male patient with lymphadenopathies and hepatocellular failure is presented.
• The patient exhibited chronic renal failure, icteric cholestasis, and hepatic cytolysis.

Observation:

• Serum protein electrophoresis using capillary electrophoresis showed an unusual split peak between albumin and alpha-1 globulins.
• This interference rendered the electrophoretic trace uninterpretable, hindering peak identification and integration.

Findings:

• Immunotyping immunoassay did not reveal monoclonal immunoglobulinopathy but successfully eliminated the supernumerary peaks.
• Agarose gel electrophoresis, while not showing qualitative anomalies, also did not resolve the interference seen in capillary electrophoresis.

Implications:

• This case underscores the critical importance of understanding endogenous interferences in electrophoretic profiling.
• Accurate interpretation of serum protein electrophoresis, particularly capillary electrophoresis, requires awareness of potential biological interferences.