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22613 Immunofixation, Urine 24 Hour

Immunofixation, Urine 24 Hour
Test Code: BJ-24HR
Synonyms/Keywords
Quantitative Light Chains, Urine Protein Electrophoresis, Kappa/Lambda Urine Light Chains, Bence-Jones Protein​
Test Components
Urine Protein and Bence-Jones Protein Electrophoresis​
Useful For

This test is useful in determining if Bence-Jones (free light chain) protein is present in the urine.  Bence-Jones proteins are monoclonal kappa or lambda immunoglobulin light chains, which are not attached to a heavy chain portion of the immunoglobulin molecule.  They may be seen in urine of plasma cell myeloma patients, where a monoclonal heavy chain and light chain, or just a free light chain is being produced.  Bence-Jones protein may occur as a result of protein overload, where high concentrations of serum monoclonal protein appear in the urine.  Free light chains may filter through the glomerulus of the kidney due to their small molecular size, and accumulate in the tubules.  Renal impairment may result from the toxicity of the light chains.​

Polyclonal light chains may be detected, but are not Bence-Jones proteins. The polyclonal light chains are generated by increased catabolism of polyclonal light chains in the serum. They may be found in large quantities in autoimmune diseases such as Lupus Erythothematosis and Rheumatoid Arthritis.

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​
Urine,
24 hour​
24 hour Urine Jug, no preservative​Sage cup + 10 mL aliquot in Sarstedt urine aliquot tube​10 mL aliquot from a well-mixed 24 hr collection - collected without a preservative​ 10 mL aliquot​6 mL aliquot​
Collection Processing Instructions
Indicate the collection times. The total volume collected must be measured, recorded, and included with the test request.​
Specimen Stability Information
Specimen Type Temperature Time
Urine, 24 hour​ Refrigerate​ 3 days​
Rejection Criteria
Specimens collected with a preservative
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 6-8 hours, but if Bence-Jones protein needs to be quantitated, an addition 24 hours is required.​ Agarose gel electrophoresis and immunofixation/Sebia Hydrasys System​
Test Information
If the sample is:
1) Positive for monoclonal light chains and
2) The specimen is a 24 HR collection, and
3) the urinary total protein is > 30 mg/dL
Then urine electrophoresis is performed to quantitate the kappa or lambda monoclonal light chain component.
Reference Range Information
Performing Location Reference Range
Marshfield​ No Bence-Jones protein detected.​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86335​ ​ ​ ​ ​
Synonyms/Keywords
Quantitative Light Chains, Urine Protein Electrophoresis, Kappa/Lambda Urine Light Chains, Bence-Jones Protein​
Test Components
Urine Protein and Bence-Jones Protein Electrophoresis​
Ordering Applications
Ordering Application Description
​Centricity

​a. Bence Jones-24hr

b. Immunofix. Ur-24hr

​Cerner ​Immunofixation, Urine 24Hr
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​
Urine,
24 hour​
24 hour Urine Jug, no preservative​Sage cup + 10 mL aliquot in Sarstedt urine aliquot tube​10 mL aliquot from a well-mixed 24 hr collection - collected without a preservative​ 10 mL aliquot​6 mL aliquot​
Collection Processing
Indicate the collection times. The total volume collected must be measured, recorded, and included with the test request.​
Specimen Stability Information
Specimen Type Temperature Time
Urine, 24 hour​ Refrigerate​ 3 days​
Rejection Criteria
Specimens collected with a preservative
Useful For

This test is useful in determining if Bence-Jones (free light chain) protein is present in the urine.  Bence-Jones proteins are monoclonal kappa or lambda immunoglobulin light chains, which are not attached to a heavy chain portion of the immunoglobulin molecule.  They may be seen in urine of plasma cell myeloma patients, where a monoclonal heavy chain and light chain, or just a free light chain is being produced.  Bence-Jones protein may occur as a result of protein overload, where high concentrations of serum monoclonal protein appear in the urine.  Free light chains may filter through the glomerulus of the kidney due to their small molecular size, and accumulate in the tubules.  Renal impairment may result from the toxicity of the light chains.​

Polyclonal light chains may be detected, but are not Bence-Jones proteins. The polyclonal light chains are generated by increased catabolism of polyclonal light chains in the serum. They may be found in large quantities in autoimmune diseases such as Lupus Erythothematosis and Rheumatoid Arthritis.

Test Components
Urine Protein and Bence-Jones Protein Electrophoresis​
Reference Range Information
Performing Location Reference Range
Marshfield​ No Bence-Jones protein detected.​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 6-8 hours, but if Bence-Jones protein needs to be quantitated, an addition 24 hours is required.​ Agarose gel electrophoresis and immunofixation/Sebia Hydrasys System​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86335​ ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.