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New test codes for requesting immunoglobulins – Epsom and St Helier hospitals and GPs only

Immunoglobulin and serum protein electrophoresis requesting is changing on 8 July 2026.

The Immunology laboratory has always offered immunoglobulin testing together with serum protein electrophoresis. However, changes to how patients are cared for and the introduction of new medications means that sometimes only immunoglobulin testing (IgG, IgA, IgM) is clinically indicated and serum protein electrophoresis is not needed.

This change will enable doctors to more effectively request the tests that are clinically indicated and streamline laboratory testing, delivering improved turnaround times for these tests.

Clinicians can now request:

Immunoglobulins only:

The laboratory will test IgG, IgA, IgM. 

This test can be used for monitoring patients on medications such as immunoglobulin replacement or anti-CD20 treatments.

Please note, there will be an internal process in the laboratory to review abnormal immunoglobulins and add on serum protein electrophoresis if this has not been done before, or if results have changed significantly from previous.

Immunoglobulins and electrophoresis:

The laboratory will test IgG, IgA, IgM and serum protein electrophoresis.

This test should be requested when ordering blood tests for patients who require a myeloma screen or for follow-up blood testing for a patient known to have a paraprotein.

This change will apply to Epsom & St Helier Hospitals and their associated GPs initially, and will then be rolled out to all service users in south west London. 

Information to aid interpretation for immunoglobulin results that are outside the reference range is available on the South West London Pathology (SWLP) website:

Immunoglobulins IgG, IgA and IgM – South West London Pathology

Impact on care sets and favourites:

  • If you have ‘favourites’ set up in your profile for your local test requesting system, you will need to update the favourites yourself.
  • If your team use any ‘care sets’ that include immunoglobulins, please raise a request with your local IT team who will be able to change this for you.

Please note this change does not affect requests for total IgE or IgD testing.

Clinical advice and queries

The laboratory stores samples for two weeks from the date of receipt. If you require serum protein electrophoresis testing to be added on, please contact the laboratory on 020 8725 0025 or email immunologylabslwp@stgeorges.nhs.uk.

For questions about this change or if you need clinical advice on interpretation of patient results, please telephone the laboratory on the number above or email immunologyclinicalenquiries@stgeorges.nhs.uk

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