Prescription d’une électrophorèse des protéines sériques : à propos de 295 examens réalisés en laboratoire de biologie médicale de ville

Abstract : Introduction: Serum protein electrophoresis (SPEP) is a laboratory test used in a wide variety of settings. Performing a SPEP can lead to the diagnosis of monoclonal gammopathy of uncertain significance (MGUS), a clinically asymptomatic premalignant clonal plasma cell or lymphoplasmacyte proliferative disorder that requires monitoring. If the growing incidence of MGUS can be explained by an aging population and more efficient laboratory techniques, the increasing number of SPEP prescriptions is also presumably a factor. We sought to understand the motives for the prescription of SPEP in everyday practice. Methods: A descriptive observational study of 295 SPEP collected from 17 laboratories in Gironde from May the 30th to June the 10th 2016. We gathered informations from patients’ medical records through a standardized questionnaire sent to the prescriber of each test. Results: 60.7% of SPEP were prescribed because patients presented with specific symptoms or abnormal laboratory tests. The main symptoms and signs were fatigue, weight loss, joint pain, repeated infections, raised inflammatory markers. In 24.1% of cases SPEP was prescribed as part of the follow-up of a known disorder (mainly haematological). Finally 14.6% of SPEP were requested as screening tests in asymptomatic patients. Overall, 9 monoclonal gammopathies and 24 hypogammaglobulinaemias were discovered. Conclusion: SPEP is largely prescribed as a screening tool in asymptomatic patients or in those presenting with non-specific symptoms such as fatigue and weight loss, in disagreement with recent recommendations by the HAS.
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Master Thesis
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Marie Minville. Prescription d’une électrophorèse des protéines sériques : à propos de 295 examens réalisés en laboratoire de biologie médicale de ville. Médecine humaine et pathologie. 2018. ⟨dumas-01969620⟩

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