Putting some PEP in your step: A hands-on guide and best practices for everyday protein electrophoresis and immunotyping interpretation

Course ID: 191204
3.0 ACCENT credits /3.0 CME credits
Sunday, July 26, 2026
Afternoon course | 1 p.m. – 4 p.m. US Pacific Time
Anaheim Marriott (next to Anaheim Convention Center)

Protein electrophoresis (PEP) and immunofixation/immunosubtraction are routinely ordered diagnostic tests for the identification, classification, and monitoring of monoclonal gammopathies. Given the subjective nature of PEP testing, selecting the appropriate testing and intrepretingroutine and complex PEP test results in both the serum and urine can be challenging. The goal of this course is to provide hands-on experience and discuss best practice recommendations for how to tackle these challenges. The course will begin with a review of PEP testing, followed by a series of interactive cases highlighting best practices. Cases will involve the review of physical immunofixation gels using lightboxes and capillary electrophoresis-based cases. Participants will gain skills in how to review testing for analytical quality and test utilization for initial diagnosis and monitoring. Reflex testing, factors affecting accurate quantitation, common interferences, and certain disease states, such as AL amyloidosis, will be covered through interactive cases and a hands-on format.

Faculty

Moderator: Katherine Turner, PhD, DABCC, FADLM, Michigan Pathology Specialists
Robert Maynard, PhD, DABCC, NRCC, University of Kentucky
David Manthei, MD, PhD, University of Michigan

Adding a ticketed event to an existing registration

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Course details

After participating in this course, participants will be able to:

Explain the fundamentals of protein electrophoresis, including different methodologies, gating practices, and supplemental testing.
Identify best practices for testing workflows, reporting, and working up challenging cases and now to implement them in our own practice.
Identify what diseases are assessed by protein electrophoresis and which additional tests to perform for different diseases.

(15 minutes) Welcome and introduction

The course will open with an overview of the agenda, materials, and faculty. The course will heavily rely on small-group, case-based learning where participants work through real-world laboratory cases. This includes hands-on review of physical gels and discussion key lessons and best practices. The course will include polling, small group discussion, and facilitated hands-on exercises.

Overview of agenda, materials, and faculty introductions
Small-group breakout sessions with interactive, case-based learning
Review of real-world laboratory cases, including physical gels on lightboxes
Group discussion of key lessons and best practices
Polling to reinforce learning throughout

(30 minutes) Level 1 protein electrophoresis methods and interpretation practices

The faculty will provide a blended and interactive presentation reviewing available protein electrophoresis methodologies, including gel-based and capillary electrophoresis, along with commonly used supplemental tests such as immunotyping, serum free light chains, and quantitative immunoglobulins. Audience polling will be used to assess participants’ baseline familiarity with current techniques and practices, as well as to highlight current International Myeloma Working Group and College of American Pathologists recommendations for monoclonal gammopathy testing. A series of introductory cases will be presented to reinforce foundational concepts, including routine PEP and immunotyping interpretation, the value of complementary use of standard and supplemental testing, and recognition of common interpretation pitfalls.

Protein electrophoresis methods and supplemental tests
Audience polling and current guidelines (IMWG/CAP)
Introductory case studies
Complementary testing and common pitfalls

(15 minutes) Break

(45 minutes) Level 2 interpretation and reporting practicum

This section will build on foundational concepts through a series of advanced, case-based exercises. The faculty will guide participants through in-depth evaluation of immunotyping, including both gel-based immunofixation and capillary-based immunosubtraction. Basic interpretation principles will be reviewed alongside advanced tips and techniques. Working in small groups, participants will analyze cases using physical gels viewed on lightboxes and immunosubtraction spectra, followed by facilitated group discussion to reinforce best practices in immunotyping interpretation and reporting.

Hands-on gel examination exercises
Routine PEP and immunotyping interpretation
Complementary use of standard and supplemental testing
Gel-based and capillary immunotyping cases
Small-group case review with physical gels and spectra
Discussion of best practices and common pitfalls

(15 minutes) Break

(45 min) Case workups, oddities, and reporting consistencies

The faculty will lead a case-based session that expands on prior sections by addressing testing recommendations tailored to patient characteristics, variations in testing methods and reporting approaches, and atypical or challenging cases. These include examples of analytical interferences and mimics. Participants will independently examine gels before engaging in group discussions and a facilitated Q&A session. Case topics will include general interpretation principles; indications for additional upfront or reflex testing based on clinical context or initial results; differing approaches to M‑protein quantitation, such as tangent skim, perpendicular drop, or immunoglobulin-based methods; assessment of treatment response and therapeutic monoclonal antibody interference; and confounding conditions including IgG4-related disease, imaging contrast agents, hemolysis, and incomplete serum clotting.

Hands-on gel examination exercises
Patient-tailored testing and method variations
Analytical interferences and mimics
M‑protein quantitation approaches and treatment response assessment
Confounding conditions (IgG4 disease, contrast agents, hemolysis, incomplete clotting)
Individual gel review followed by group discussion and Q&A

(15 minutes) Closing and Q&A (All)

The course will conclude with a comprehensive question and answer session, allowing faculty to address remaining questions, clarify complex cases, and reinforce key take‑home messages for practical application in clinical practice.

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