| TEST |
INDICATION |
INTERPRETATION |
| SERUM
PROTEIN EPG |
- High ESR
- Lymphoma, myeloma or lymphocytic
leukaemia
- Acute or chronic inflammatory disease
- Liver and renal disease
- Monitor paraprotein levels
|
- Monoclonal paraprotein band may be
benign or associated with myelom, CLL or lymphoma.
- Raised gamma, polyclonal - inflammatory
disease
- Low gamma (immunoglobulins) -
hypogammaglobulinaemia
- Beta-gamma bridge - alcoholic liver
disease
- Typical patterns in liver, renal or GI
disease.
- Low albumin - liver, renal, and GI
disease and protein deficiency state and some malignancies.
- Low alpha 1 - Antitrypsin deficiency
- High alpha 1 - Inflammatory disease
- Raised alpha 2 - elevated acute phase
response.
|
| SERUM
IF |
- Confirmation of monoclonal origin of
band on EPG
- Identification and categorisation of
paraprotein
|
- Small paraproteins (<8g/L) are common
especially with increasing age and in chronic inflammation.
- Malignant paraprotein suggested by high
concentration (>10 g/L), suppression of normal Ig's or Bence-Jones protein.
|
| URINE
PROTEIN EPG |
- Renal disease
- Low serum albumin
- Paraproteinaemia/myeloma
|
- Distinguishes selective from
non-selective proteinuria
- Monoclonal free light chains (Bence
Jones protein) in Myeloma
- Free Lambda chains associated with
amyloid
|
| URINE
IF |
- Categorisation of Bence Jones and urine
paraprotein
|
- Identification of urine paraprotein
- Free Bence Jones light chains in urine
usually associated with myeloma
|
SERUM
IMMUNO-
GLOBULINS |
- High ESR
- Recurrent infections
- Paraproteinaemia
- Suspected chronic inflammatory disease
- Chronic renal or liver diseases
|
- Low immunoglobulins - suggests renal or
GI protein loss
- Selective or diffuse decrease in primary
or secondary immune deficiency
- Selective increase - possible
paraproteinaemia
- Polyclonal increase in many inflammatory
conditions
- In liver disease raised:
IgG - chronic active hepatitis
IgA - alcoholic liver disease
IgM - primary biliary cirrhosis
|
| SERUM
B2 MICROGLOBULIN |
- Renal disase
- Monitor immune malignancy, eg myeloma,
lymphoma
|
- Increased with reduced glomerular
filtration
- Correlates with myeloma disease activity
- Indicates risk of HIV progression to
AIDS
|
SERUM
CAERULO-
PLASMIN |
|
- Low - Wilson's Disease
- Raised - inflammatory disease
(especially liver) in pregnancy and patient's on oral contraceptives
|
| CRYOPROTEINS |
- Raynaud's phenomenon and vasculitis
|
- Cryoproteins are usually of clinical
significance as aetiological factors
|
| CRYOGLOBULINS |
- Abnormal serum proteins, especially
paraproteinaemia
|
- May be associated with oral
contraceptives
|
| CSF
EPG |
- Routine examination of CSF
- Diagnosis of M.S.
|
- Oligoclonal immunoglobulin in
intracranial inflammatory disease eg M.S.
- High IgG/albumin ratio characteristic of
M.S.
|
