MT
Kim Kibby (guest) 13 May 2010 22:47
Thanks. This was very helpful.
Laboratory Diagnosis of Protein Abnormalities / Discussion
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This is the discussion related to the wiki page Laboratory Diagnosis of Protein Abnormalities.
Where can I get the answers to these case studies?
Increased alpha – 2 fraction: acute & chronic inflammatory diseases, nephrotic syndrome, oral contraceptive use, steroid use, hyperthyroidism, adrenal insufficiency, adrenocorticosteroid therapy, advanced diabetes mellitus.
This case seems to be nephrotic syndrome (lab findings, history and low albumin fraction). However, if I had this picture without any clue and if albumin was normal, I guess that I would ask also urine electrophoresis, bence jones (24 h urine) & immunifixation. Rarely a M spike in the rest than gamma fractions may indicate a monoclonal protein.
I have elevated gamma globulin level and my urine tested positive for lambda light chains…. what "could" this mean?
Hi, how can I have the results of these cases?
Thanx
Forough
What are the best ways to perform nutrition assessment
The albumin fraction (the 1st one) on serum protein electrophoresis will be low on malnutrition, but this occurs in medical problems and not in ordinary people. The best way is to check your serum iron, vitamin B12 and folate, as these 3 may cause anemia if deficient.
Serum Total protein & albumin are less expensive that SPE and will show if you have low albumin because of malnutrition or a medical problem (incuding liver, kidney & intestinal). You may also check also serum glucose & electrolytes (sodium, potassium. magnesium and calcium). Moreover, you may check vitamin D (e.g. if you have low calcium, or high parathormone). You should do a CBC (FBC; full blood count) and a basic biochemistry lab exam +_ urinalysis. If you want a complete check up you may do also add an abdominal ultrasound, an ECG and a physical. For all these, you should consult your GP/ family doctor. Nutritional status is essential in specific patients (especially the ones with kidney failure) and it is complicated (e.g. we need to know the Nitrogen levels that relate to protein intake). The vitamin level estimation is expensive, is done in special labs and not indicated unless a specific medical problem is suspected. In any case, nutritional deficiencies are related to medical problems e.g. alcoholism is associated with pyridoxine (B6 vitamin) deficiency.
hi
Thank you for those nice cases
please send me the answers.
I am not sure. It seems a monoclonal protein related to the 2 cancers (lymphoma & thyroid cancer).
An M component may be detected in other lymphoid malignancies and in solid cancers.
But in this case, ESR is high and rouleux are seen in peripheral blood. Also M protein is >3g/dL. Hence, I guess that a multipe myeloma should be excluded with further tests.
If it is positive, then it is weird that the patient has 3 cancers (thyroid, lymphoma, multiple myeloma) probably unrelated.
In any case, this case study is confusing.
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