A rare aberrant alpha-2 band in an elderly anemic patient

Serum protein electrophoresis (SPE) is ordered to diagnose cases of multiple myelomas by detecting monoclonal bands of protein. In this case, an elderly female anemic patient was found to have a monoclonal band in the alpha-2 region. As this is an uncommon presentation and there was no derangement in the kappa-lambda ratio and no accompanying band on Serum immunofixation electrophoresis (IFE) a further look was taken into the history and other investigations that were ordered for this patient to determine the cause. A repeat sample was collected 3 days later which revealed attenuation of this band (Institutional ethics committee approval number – Post BH&R 67/02.2025-07).