David F. Keren
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View article: An atypical finding on serum immunofixation: a case report
An atypical finding on serum immunofixation: a case report Open
Introduction Multiple myeloma (MM) is characterized by the abnormal proliferation of plasma cells, resulting in the overproduction of distinctive monoclonal proteins (M-protein). Suspected MM necessitates screening for M-protein through a …
View article: Implementation of INHERET, an Online Family History and Cancer Risk Interpretation Program for Primary Care and Specialty Clinics
Implementation of INHERET, an Online Family History and Cancer Risk Interpretation Program for Primary Care and Specialty Clinics Open
Background: Individuals at increased risk for cancer are ascertained at low rates of 1% to 12% in primary care (PC). Underserved populations experience disparities of ascertainment, but data are lacking. INHERET is an online personal and f…
View article: Multiple myeloma presenting as cryoglobulinemic vasculitis
Multiple myeloma presenting as cryoglobulinemic vasculitis Open
View article: Prenatal Hemoglobinopathy Evaluation
Prenatal Hemoglobinopathy Evaluation Open
View article: An international multi-center serum protein electrophoresis accuracy and M-protein isotyping study. Part I: factors impacting limit of quantitation of serum protein electrophoresis
An international multi-center serum protein electrophoresis accuracy and M-protein isotyping study. Part I: factors impacting limit of quantitation of serum protein electrophoresis Open
Background Serum protein electrophoresis (SPEP) is used to quantify the serum monoclonal component or M-protein, for diagnosis and monitoring of monoclonal gammopathies. Significant imprecision and inaccuracy pose challenges in reporting s…
View article: An international multi-center serum protein electrophoresis accuracy and M-protein isotyping study. Part II: limit of detection and follow-up of patients with small M-proteins
An international multi-center serum protein electrophoresis accuracy and M-protein isotyping study. Part II: limit of detection and follow-up of patients with small M-proteins Open
Background Electrophoretic methods to detect, characterize and quantify M-proteins play an important role in the management of patients with monoclonal gammopathies (MGs). Significant uncertainty in the quantification and limit of detectio…
View article: Commentary
Commentary Open
of the world.Those groups designing PT/EQA challenges should consider providing similar rare samples where possible; from an educational standpoint, one option would be to provide gel images if the sample itself is not easily obtained.Give…
View article: Utility of Reflexing Suspicious Beta Region Findings on Capillary Serum Protein Electrophoresis to Immunofixation for Detecting Monoclonal Gammopathies
Utility of Reflexing Suspicious Beta Region Findings on Capillary Serum Protein Electrophoresis to Immunofixation for Detecting Monoclonal Gammopathies Open
Serum protein electrophoresis (SPEP) detects alterations suspicious for monoclonal immunoglobulins (M-protein/MP). Immunofixation (IFE) confirms/characterizes MPs. Beta region (BR) proteins, transferrin, and C3 can obscure beta-migrating M…
View article: A Novel Approach to Estimating M-Protein Concentration: Capillary Electrophoresis Quantitative Immunosubtraction
A Novel Approach to Estimating M-Protein Concentration: Capillary Electrophoresis Quantitative Immunosubtraction Open
Introduction M-protein quantification is routinely performed by demarcating serum protein electrophoresis (SPE) regions. However, quantification of β-migrating M-protein is hindered by overlapping nonimmunoglobulin protein. Immunosubtracti…
View article: The Lifecycle of an Evidence-Based Laboratory Practice Guideline: Origin, Update, Affirmation, and Impact!
The Lifecycle of an Evidence-Based Laboratory Practice Guideline: Origin, Update, Affirmation, and Impact! Open
The College of American Pathologists (CAP) made a strategic decision 10 years ago to develop and publish evidence-based laboratory practice guidelines (LPGs). As the CAP had worked previously with the American Society of Clinical Oncology …
View article: Commentary
Commentary Open
View article: 22 Expression of Peak Migration as Relative to Transferrin Improves Identification of Elotuzumab and Daratumumab on Capillary Electrophoresis
22 Expression of Peak Migration as Relative to Transferrin Improves Identification of Elotuzumab and Daratumumab on Capillary Electrophoresis Open
The new therapeutic monoclonal antibodies (t-mAbs) daratumumab and elotuzumab have introduced a pitfall for interpreters of serum protein electrophoresis (SPEP), in that some patients being followed for multiple myeloma (MM) will have an M…
View article: Screening and Diagnosis of Monoclonal Gammopathies: An International Survey of Laboratory Practice
Screening and Diagnosis of Monoclonal Gammopathies: An International Survey of Laboratory Practice Open
Context.— Serum tests used for the screening and diagnosis of monoclonal gammopathies include serum protein electrophoresis (SPE; agarose gel or capillary zone), immunofixation (IFE) and immunosubtraction capillary electrophoresis, serum f…
View article: Transforming Laboratory Utilization Review into Laboratory Stewardship: Guidelines by the PLUGS National Committee for Laboratory Stewardship
Transforming Laboratory Utilization Review into Laboratory Stewardship: Guidelines by the PLUGS National Committee for Laboratory Stewardship Open
Appropriate utilization of clinical laboratory services is important for patient care and requires institutional stewardship. Clinical laboratory stewardship programs are dedicated to improving the ordering, retrieval, and interpretation o…
View article: Therapeutic Complications: A Caveat for M-Protein Detection
Therapeutic Complications: A Caveat for M-Protein Detection Open
For the past three-quarters of a century, detecting a monoclonal immunoglobulin (also called M-protein) by serum protein electrophoresis (SPEP)2 and immunofixation (IFE) has been evidence of a monoclonal gammopathy. However, deployment of …
View article: Predictive Value of Hypogammaglobulinemia in Monoclonal Gammopathies Detected by Reflex Immunofixation of Serum Protein Electrophoresis Samples
Predictive Value of Hypogammaglobulinemia in Monoclonal Gammopathies Detected by Reflex Immunofixation of Serum Protein Electrophoresis Samples Open
View article: Detection of Polyclonal Increases in Immunoglobulin G4 Subclass by Distinct Patterns on Capillary Serum Protein Electrophoresis
Detection of Polyclonal Increases in Immunoglobulin G4 Subclass by Distinct Patterns on Capillary Serum Protein Electrophoresis Open
Increased polyclonal IgG4 has a characteristic SPEP pattern that may mimic monoclonal gammopathy, even on immunosubtraction. κ Pseudo-restriction might reflect the naturally high κ/λ ratio of the IgG4 subclass. Autoantibodies were common, …
View article: Multiple myeloma and multiple plasmacytomas associated with free gamma heavy chain, free kappa light chain and IgGk paraproteins: an unusual triple gammopathy
Multiple myeloma and multiple plasmacytomas associated with free gamma heavy chain, free kappa light chain and IgGk paraproteins: an unusual triple gammopathy Open
Multiple myeloma is a malignant plasma cell dyscrasia that is becoming more prevalent in an increasingly ageing population. It is a complex disease with clinical phases ranging from the premalignant monoclonal gammopathy of undetermined si…
View article: Protein Electrophoretic Findings Suggest IgG4-Related Systemic Disease
Protein Electrophoretic Findings Suggest IgG4-Related Systemic Disease Open
Serum protein electrophoresis (SPEP) is routinely performed to detect monoclonal gammopathies.Large polyclonal increases in IgG4 subclass produce a distinctive, relatively broad restriction in the anodal portion of the gamma globulin regio…
View article: <scp>ICSH</scp> recommendations for assessing automated high‐performance liquid chromatography and capillary electrophoresis equipment for the quantitation of HbA<sub>2</sub>
<span>ICSH</span> recommendations for assessing automated high‐performance liquid chromatography and capillary electrophoresis equipment for the quantitation of HbA<sub>2</sub> Open
Summary Automated high performance liquid chromatography and Capillary electrophoresis are used to quantitate the proportion of Hemoglobin A 2 (HbA 2 ) in blood samples order to enable screening and diagnosis of carriers of β‐thalassemia. …