Fibrinogen in plasma may interfere with the interpretation of protein electrophoresis. Pretreatment of plasma with reptilase is superior to ethanol precipitation.
Problem with ethanol precipitation: residual irregularity in the gamma-globulin fraction that can mimic a monoclonal protein. It also may increase the alpha-2 fraction while decreasing the beta fraction.
Situation: plasma sample and order for protein electropheresis
Preferred options:
(1) collect a new sample of serum
(2) pretreat with reptilase (batroxobin from Bothrops species)
If the only option is ethanol precipitation, and if an abnormal band is seen in the gamma region, then immunofixation should be performed.
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