Seric proteins electrophoresis: clinical interpretation and correlation

ABSTRACT

Seric proteins electrophoresis (SPE) is a simple method that allows the separation of the human plasma proteins in fractions. Its interpretation gives useful information to the physician, which makes it an important tool for several diseases investigation and diagnosis. The exam consists in applying the serum sample into a solid medium and put it under an electrical potential. The proteins run different distances, forming bands named: albumin, alpha-1-globulin, alpha-2-globulin, beta globulin and gamma globulin. These bands are then quantified. It is noted a reduction of the albumin concentration in situations that promote its loss, low protein ingestion or high catabolism. The Alpha globulin fractions present increased levels in inflammatory, infectious and immune processes. The increase of beta globulin may be noted in situations of the lipid metabolism disorder or in the iron deficiency anaemia. The absence or reduction of the band-gamma indicates congenital or acquired immunodeficiency, while the increase suggests immunoglobulin polyclonal elevation related to inflammatory , neoplasic or infectious conditions, besides the monoclonal elevation typically noted in the multiple myeloma and other linfoproliferative disorders, such as Waldenstrm s macroglobulinemia. The knowledge of each electrophoretic band main components makes easy the clinical reasoning and helps in the identification of electrophoretic patterns that characterize given diseases. Key words: Electrophoresis; Blood Proteins Electrophoresis; Blood Proteins /analysis

A blood sample is needed. For information on giving a blood sample from a vein, see venipuncture. Electrophoresis is a laboratory technique. The blood serum (the liquid part of the blood without the cells) is placed on specially treated paper and exposed to an electric current. The proteins in the serum move on the paper to form bands that show the proportion of each protein fraction. A fraction may contain several different types of proteins. Individual proteins, except albumin, are not usually measured. However, protein fractions or groups ARE measured. The levels of protein fractions can be estimated by measuring the total serum protein and then multiplying that by the relative percentage of each protein fraction. Lipoprotein electrophoresis is a type of protein electrophoresis that determines the amount of proteins made up of protein and fat, called lipoproteins (such as LDL cholesterol). How to Prepare for the Test You may be asked not to eat or drink for 12 hours before a lipoprotein electrophoresis test. Your health care provider may ask you to stop taking drugs that could affect the test. Do not stop taking any medications without first talking to your health care provider. Drugs that can affect the measurement of total proteins include chlorpromazine, corticosteroids, isoniazid, neomycin, phenacemide, salicylates, sulfonamides, and tolbutamide. How the Test Will Feel When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the Test is Performed Proteins are made from amino acids and are important components of all cells and tissues. There are many different kinds of proteins in the body with many different functions. Examples of proteins include enzymes, certain hormones,

hemoglobin, low-density lipoprotein ("bad" cholesterol), and others. Serum proteins are classified as albumin or globulins. Albumin is the protein of highest concentration in the serum. It carries many small molecules, but is also important for keeping fluid from leaking out from the blood vessels into the tissues. Globulins are divided into alpha-1, alpha-2, beta, and gamma globulins. In general, alpha and gamma globulin protein levels increase when there is inflammation in the body. Normal Results

Total protein: 6.4 to 8.3 g/dL Albumin: 3.5 to 5.0 g/dL Alpha-1 globulin: 0.1 to 0.3 g/dL Alpha-2 globulin: 0.6 to 1.0 g/dL Beta globulin: 0.7 to 1.2 g/dL Gamma globulin: 0.7 to 1.6 g/dL

Note: g/dL = grams per deciliter Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens. What Abnormal Results Mean Decreased total protein may indicate:

Cirrhosis Malnutrition Nephrotic syndrome Gastrointestinal protein-losing enteropathy Acute inflammatory disease

Increased alpha-1 globulin proteins may be due to:

Cancer Chronic inflammatory disease (for example, rheumatoid arthritis, SLE) Alpha-1 antitrypsin deficiency Acute inflammation Chronic inflammation Hemolysis Hyperlipoproteinemia (for example, familial hypercholesterolemia) Estrogen therapy Congenital coagulation disorder Consumptive coagulopathy Disseminated intravascular coagulation Multiple myeloma Chronic inflammatory disease (e.g., rheumatoid arthritis, SLE) Hyperimmunization Acute infection Waldenstrom's macroglobulinemia Chronic liver disease

Decreased alpha-1 globulin proteins may be a sign of:

Increased alpha-2 globulin proteins may indicate:

Decreased alpha-2 globulin proteins may indicate: Increased beta globulin proteins may indicate:

Decreased beta globulin proteins may indicate:

Increased gamma globulin proteins may indicate:

Note: Blood test results may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. Risks There is very little risk involved with having your blood

taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others. Other risks associated with having blood drawn are slight but may include:

Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)

Alternative Names Lipoprotein electrophoresis References Rajkumar SV. Plasma cell disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 193. Update Date: 2/8/2012 Updated by: Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Bleeding Disorders Cancer Chronic Kidney Disease Cirrhosis Kidney Diseases Liver Diseases Lupus Malnutrition Multiple Myeloma Rheumatoid Arthritis

http://www.nlm.nih.gov/medlineplus/ency/article/003540.ht m