Proteins

Test Simple Type

• Serum

Normal Values

• Total protein

1. 1. Adult: 6.4-8.3 g/dl
   2. Child ( > 3 years): 6.0-8.0 g/dl

• Albumin

1. 1. Adult (18-60 years): 3.5-5.0 g/dl
   2. Child: 3.2-5.4 g/dl

• Globulin: 2.8-4.4 g/dl

• Albumin/globulin ratio: > 1

Purpose of the Test

• Serum albumin is useful in the evaluation of nutritional status, oncotic pressure within the vasculature, and the effects of renal and other chronic diseases
• Abnormal values of globulin indicate the need for specific testing by serum protein electrophoresis.

• A low A/G ratio demonstrates the severity and progression of the disease and indicates the need for specific additional data from serum protein electrophoresis

Increase in

• Total protein

1. 1. Dehydration
   2. Hyperimmunoglobulinemia
   3. Polyclonal or monoclonal gammapathies

• Albumin

– Dehydration

• Globulin

• Inflammatory conditions
• Multiple myeloma
• Collagen diseases
• Sarcoidosis
• Cirrhosis

1. 1. Chronic or active hepatitis

Decrease

• Total protein

1. 1. Crohn’s disease
   2. Ulcerative colitis
   3. Intestinal fistula
   4. Acute thermal injury
   5. Nephrotic syndrome
   6. Severe protein deficiency
   7. Chronic liver disease
   8. Malabsorption syndrome

• Albumin

1. 1. Rapid intravenous hydration
   2. Malnutrition
   3. Cirrhosis
   4. Cancer
   5. Nephrotic syndrome
   6. Crohn’s disease
   7. Ulcerative colitis
   8. Severe thermal injury
   9. Gastrointestinal fistula
   10. Collagen diseases
   11. Infection
   12. Fever

• Globulin

1. 1. Agammaglobulinemia
   2. Protein-losing enteropathies
   3. Lymphoma
   4. Multiple myeloma

• A/G ratio

1. 1. Cirrhosis
   2. Sarcoidosis
   3. Chronic kidney disease
   4. Severe infection
   5. Cachexia
   6. Sarcoidosis
   7. Multiple myeloma
   8. Severe thermal injury

Interfering Factors

• Hemolysis
• Prolonged bed rest
• Massive intravenous infusion
• Venous stasis
• Peripheral vascular collapse
• Hyperlipidemia

• Hyperbilirubinemia