What does a low a/g [albumin / globulin] ratio mean on the SPEP [serum protein electrophoresis]?
Waiting on full results but globulins are elevated.
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Low albumin / globulin (A/G) ratio on SPEP - meaning?
The information I have read and been provided indicate generally that-- elevated Globulins indicate the body's response to : an infection, trauma of some sort, healing, and the like.
It is a Non-specific indicator--unless it is markedly elevated and/or the various Individual segments (ie Beta 2) indicate one thing or another ( ie. many possibilities impacting Health)
Albumin is a protein that is measured for several items, including estimation of protein reserves /availability. It fluctuates a bit, normally . Each lab has a reference range, including an A/G Ratio. A low Albumin level is not a good specific indicator for various health maintenance issues--especially if it has been low for several months. For example a consistently low Albumin level may indicate the patients overall health, such that the patient can successfully undergo strenuous treatments. ( Surgery, stem cell procedures, skin grafting, healing, etc)
Albumin plays a role in determining overall healing potential, Kidney function, vascular aspects, cardiac status, and other Organ functions.
Both items (Globulins and Albumin) are not specific to just Myeloma--however, they provide part of the overall mosaic of lab results that help clinicians deftly determine the status of the Patients Health.
More of an art form in deciphering all these lab tests and functions, and putting the Mosaic together.
This is why most Hematologists / Oncologists trained as Internists, first.
What are the Kappa / Lambda results and those ratios ?? Those are perhaps felt to be more sensitive for myeloma activity.
Good Luck.
It is a Non-specific indicator--unless it is markedly elevated and/or the various Individual segments (ie Beta 2) indicate one thing or another ( ie. many possibilities impacting Health)
Albumin is a protein that is measured for several items, including estimation of protein reserves /availability. It fluctuates a bit, normally . Each lab has a reference range, including an A/G Ratio. A low Albumin level is not a good specific indicator for various health maintenance issues--especially if it has been low for several months. For example a consistently low Albumin level may indicate the patients overall health, such that the patient can successfully undergo strenuous treatments. ( Surgery, stem cell procedures, skin grafting, healing, etc)
Albumin plays a role in determining overall healing potential, Kidney function, vascular aspects, cardiac status, and other Organ functions.
Both items (Globulins and Albumin) are not specific to just Myeloma--however, they provide part of the overall mosaic of lab results that help clinicians deftly determine the status of the Patients Health.
More of an art form in deciphering all these lab tests and functions, and putting the Mosaic together.
This is why most Hematologists / Oncologists trained as Internists, first.
What are the Kappa / Lambda results and those ratios ?? Those are perhaps felt to be more sensitive for myeloma activity.
Good Luck.
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Rneb
Re: Low albumin / globulin (A/G) ratio on SPEP - meaning?
Hi Rneb,
A/G ratio was normal on the SPEP but not on the comprehensive Metabolic Panel. In fact, total protein on the CMP was 7.8 but 7.0 on SPEP. Not sure why the difference in numbers? No " m-spike" observed.
My husband was experiencing liver inflammation from one of his drugs. They have both dropped by 100 points after stopping meds for 2 days.
A/G ratio was normal on the SPEP but not on the comprehensive Metabolic Panel. In fact, total protein on the CMP was 7.8 but 7.0 on SPEP. Not sure why the difference in numbers? No " m-spike" observed.
My husband was experiencing liver inflammation from one of his drugs. They have both dropped by 100 points after stopping meds for 2 days.
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Low albumin / globulin (A/G) ratio on SPEP - meaning?
Blair77:
Sorry, I'm not "Up enough" on my science to explain difference in lab testings ( Lab to Lab) --except that M Spike staining on an electro phoresis method is an older test that is not extremely accurate. It is accurate enough to clearly denote presence of an M Spike, but not with an exact quantification of the "M-Spike". The Kappa / Lambda measurements and ratios are felt to be a bit more accurate. Some use the term "sensitive".
No M Spike in your family members scenario--so that is good news!
Glad to hear that the elevated Globulins may have been related to medication / Liver interaction and by d/c of those meds--they are now drifting towards normal.
The Albumin may have also be likewise affected. Serial labs can tell if the albumin drifts upwards and into a normal status. More potential good news.
Proteins are usually given off, in the face of inflammation / inflammatory processes. Whether they will also drop, and by how much, will need to be monitored.
Thus, I think the vampire (Phlebotomist) will still be coming around, and more lab results will need to be analyzed. Sorry. We all get "stuck" often.
My Favorite Phlebotomist has a success record of about 96 and 1 . She's pretty darn good.
Good luck to you and hubby.
Sorry, I'm not "Up enough" on my science to explain difference in lab testings ( Lab to Lab) --except that M Spike staining on an electro phoresis method is an older test that is not extremely accurate. It is accurate enough to clearly denote presence of an M Spike, but not with an exact quantification of the "M-Spike". The Kappa / Lambda measurements and ratios are felt to be a bit more accurate. Some use the term "sensitive".
No M Spike in your family members scenario--so that is good news!
Glad to hear that the elevated Globulins may have been related to medication / Liver interaction and by d/c of those meds--they are now drifting towards normal.
The Albumin may have also be likewise affected. Serial labs can tell if the albumin drifts upwards and into a normal status. More potential good news.
Proteins are usually given off, in the face of inflammation / inflammatory processes. Whether they will also drop, and by how much, will need to be monitored.
Thus, I think the vampire (Phlebotomist) will still be coming around, and more lab results will need to be analyzed. Sorry. We all get "stuck" often.
My Favorite Phlebotomist has a success record of about 96 and 1 . She's pretty darn good.
Good luck to you and hubby.
-
Rneb
Re: Low albumin / globulin (A/G) ratio on SPEP - meaning?
blair77,
The SPEP [serum protein electrophoresis] is a laboratory technique used to separate proteins based on their size and charge. The two major types of proteins in our blood include 1) albumin (the most common serum protein) and 2) the globulins (which include a variety of proteins- including immunoglobulins).
Albumin is produced by the liver and is typically the most abundant protein in our blood. But it can be decreased in a variety of circumstances including in the setting of liver disease, malnutrition, nephrotic syndrome (where the kidneys lose protein), hormone therapy, etc...
Globulins comprise a much smaller portion of the total protein content. On the SPEP, these proteins are further separated into alpha, beta and gamma fractions. Because each fraction includes several different proteins, increases or decreases in the size of these fractions are non-specific.
Most of the time the SPEP is being done to evaluate the gamma (and/or beta) fraction where one would expect to find antibodies (immunoglobulins), both normal immunoglobulins (which are important for fighting infections) and the pathologic immnoglobulins that are produced in excess in patients with multiple myeloma. Further, each patient with multiple myeloma produces a unique pathologic immunoglobulin which has to be further characterized.
The A/G ratio is influenced by all of the above and therefore in and of itself is not necessarily a useful measure. I would encourage you to go over your SPEP with your doctor so that he/she can help you identify what is (or are) the most important characteristic (s) of your unique myeloma protein that need to be followed to determine how best to monitor your disease and your health.
Hope that helps!
Best.
The SPEP [serum protein electrophoresis] is a laboratory technique used to separate proteins based on their size and charge. The two major types of proteins in our blood include 1) albumin (the most common serum protein) and 2) the globulins (which include a variety of proteins- including immunoglobulins).
Albumin is produced by the liver and is typically the most abundant protein in our blood. But it can be decreased in a variety of circumstances including in the setting of liver disease, malnutrition, nephrotic syndrome (where the kidneys lose protein), hormone therapy, etc...
Globulins comprise a much smaller portion of the total protein content. On the SPEP, these proteins are further separated into alpha, beta and gamma fractions. Because each fraction includes several different proteins, increases or decreases in the size of these fractions are non-specific.
Most of the time the SPEP is being done to evaluate the gamma (and/or beta) fraction where one would expect to find antibodies (immunoglobulins), both normal immunoglobulins (which are important for fighting infections) and the pathologic immnoglobulins that are produced in excess in patients with multiple myeloma. Further, each patient with multiple myeloma produces a unique pathologic immunoglobulin which has to be further characterized.
The A/G ratio is influenced by all of the above and therefore in and of itself is not necessarily a useful measure. I would encourage you to go over your SPEP with your doctor so that he/she can help you identify what is (or are) the most important characteristic (s) of your unique myeloma protein that need to be followed to determine how best to monitor your disease and your health.
Hope that helps!
Best.
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Dr. Heather Landau - Name: Heather Landau, M.D.
Beacon Medical Advisor
5 posts
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