tnlandis21 Posted January 12, 2011 Share Posted January 12, 2011 Help! I have had several patients over the last few months that when I have added PEG to their plamsa it flocculates. What causes the flocculation? I read in the reagent package insert that increased number of immunoglobulins causes a gel to form (such as in multiple myeloma) but that was all that I could find. My searches on the internet have not come up with anything either. If anyone can help answer my question it would be really appreciated! Thank You,Tiffany MS MLS (ASCP) Link to comment Share on other sites More sharing options...
mstuckey Posted January 12, 2011 Share Posted January 12, 2011 I have always understood that if the patient has an increased protein of any kind you will see floculation when the PEG is added to the tube. This has given us problems sometimes after using the automatic cell washer because the cells can look sort of "kissy" due to the protein floculation. When we have patients whose plasma flocculates, we hand wash as opposed to using the automatic cell washer and the problem corrects itself. Not sure if you are having that problem when reading your final results, but that was just something we had noticed. Good luck in your search! Link to comment Share on other sites More sharing options...
David Saikin Posted January 13, 2011 Share Posted January 13, 2011 I always wash by hand when using PeG . . . cell washers do not always do a good job with that enhancement. Link to comment Share on other sites More sharing options...
BrianD Posted February 6, 2011 Share Posted February 6, 2011 if you've started seeing flocs more frequently, try another lot.....we had a problem a few years ago with this and investigation showed the problem was lot specific and the flocculating vials had PEG at a higher concentration AND molecular weight than specified Link to comment Share on other sites More sharing options...
Deny Morlino Posted February 7, 2011 Share Posted February 7, 2011 Thanks for that info BrianD. Will have to tuck that into memory for troubleshooting info. Link to comment Share on other sites More sharing options...
Dr. Pepper Posted February 8, 2011 Share Posted February 8, 2011 You may have less problems using serum rather than plasma. Link to comment Share on other sites More sharing options...
Yanxia Posted February 13, 2011 Share Posted February 13, 2011 You may have less problems using serum rather than plasma.Dr.Pepper, you mean serum has less high molecular protein than plasma? Does it because they differ in febrin?. Link to comment Share on other sites More sharing options...
Dr. Pepper Posted February 14, 2011 Share Posted February 14, 2011 Yanxia, PEG may precipitate plasma proteins, including fibrinogen. The Immucor package insert specifically warns that this may happen when testing with plasma, and you may need to perform extra washes before adding your antiglobulin reagent. Our experience is that we have better success at having our antiglobulin control cells work properly when using serum instead of plasma. Link to comment Share on other sites More sharing options...
Yanxia Posted February 14, 2011 Share Posted February 14, 2011 Thank you,Dr.Pepper! Link to comment Share on other sites More sharing options...
Dar Posted February 15, 2011 Share Posted February 15, 2011 I have seen this with MM patients. If you are seeing a lot, it could be attributed to being exposed to the severe cold in shipping??? Just a thought... Link to comment Share on other sites More sharing options...
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