The determination of serum globulins is mainly used to diagnose and monitor patients with monoclonal gammopathies and other pathological conditions.
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Globulins are plasma proteins formed mainly in the liver, lymphatic, and reticuloendothelial systems. The globulin family includes three types of proteins: alpha, beta, and gamma.
- α1 globulins include α1-antitrypsin, α1-acid glycoprotein, α-fetal protein (αFP), cortisol-binding protein, and thyroxine-binding globulin.
- α2 globulins include haptoglobin, α2-macroglobulin and seruloplasmin.
- B-globulins include transferrin, β-lipoproteins, and complement components.
- γ globulins include IgG, IgA, IgM, IgD and IgE immunoglobulins.
Globulins regulate the acid-base balance and transport blood components such as lipids, vitamins, hormones, iron, copper, various enzymes, and antibody activity.
Possible Interpretations of Pathological Values
- Increase in α-globulins: Acute phase response to inflammation (α1, α haptoglobin), acute rheumatic fever (α2), age (α2), analbuminemia (α2), chronic glomerulonephritis (α2), cirrhosis (elevated α1 with normal or only slightly elevated α2), diabetes mellitus (α2), familial idiopathic dysproteinemia, glomerular protein loss (α2 macroglobulin), liver injury, liver metastases (elevated α1 with normal α2), Hodgkin's disease (α1, α2), hypoalbuminemia, infancy (α2 band dominated by macroglobulin), acute infection, meningitis (α2), metastatic carcinomatosis (α1, α2), myocardial infarction, myxedema, nephrosis (α2), nephrotic syndrome (α2), osteomyelitis (α2), peptic ulcer (α1, α2), pneumonia (α2), polyarteritis nodosa (α2), pregnancy (increased α1 with normal α2), protein-losing enteropathy (α1, α2), rheumatoid arthritis (α2), sarcoidosis (α2), stress (α1, α2), systemic lupus erythematosus (α2), ulcerative colitis (α1, α2). Medications: Estrogens (increase α1 with little change in α2)
- Increased β-globulins: Acute phase response (β2), analbuminemia, diabetes mellitus (inadequately controlled), familial idiopathic dysproteinemia, glomerular protein loss, viral hepatitis, hypercholesterolemia, hyperlipidemia, iron deficiency anemia (β1), obstructive jaundice, macroglobulinemia, nephrotic syndrome, pregnancy (β1), rheumatoid arthritis, sarcoidosis. Medications: Estrogens, oral contraceptives (increase β1)
- Increase in γ-globulins: Acute viral hepatitis (sometimes), amyloidosis, analbuminemia, advanced carcinoma, chronic hepatitis (appearance of oligoclonal bands), chronic liver disease (IgM), chronic lymphocytic leukemia (IgM paraprotein), chronic viral infections (appearance of oligoclonal bands), cirrhosis (IgA), cryoglobulinemia, cystic fibrosis (IgG, IgA), Hashimoto's disease, liver disease, Hodgkin's disease, hypergammaglobulinemia, hypersensitivity reaction, severe infection, juvenile rheumatoid arthritis (IgG, IgA, IgM), Laennec cirrhosis, leukemia (myelogenous, monocytic), lymphosarcoma (IgM paraprotein), macroglobulinemia, multiple myeloma, respiratory tract infection (IgA), rheumatoid arthritis (IgA, IgM), sarcoidosis, scleroderma (sometimes), skin diseases (IgA), Sjögren's syndrome (IgG), systemic lupus erythematosus (IgM), Waldenstrom's macroglobulinemia (IgM paraprotein)
- Decrease of α-globulins: Acute viral hepatitis (α1, α2), congenital hypo-haptoglobulinemia (α2 haptoglobin), liver disease, intravascular hemolysis (hemolytic anemia, liver metastases, cirrhosis, splenomegaly cause a decrease in α2 haptoglobin), malabsorption, pulmonary emphysema (α1), scleroderma, starvation, steatorrhea
- Decrease of β-globulins: Autoimmune disease, metastatic cancer, liver disease (β1), immune complex disease (β2), leukemia (lymphocytic, monocytic, myeloid), lymphoma, malabsorption, malnutrition (β1), nephrosis, scleroderma, starvation, steatorrhea, systemic lupus erythematosus, ulcerative colitis
- Decrease of γ-globulins: Acute viral hepatitis (sometimes), agammaglobulinemia, glomerular protein loss, hypogammaglobulinemia, lymphocytic leukemia, lymphoma, nephrosis, nephrotic syndrome, malabsorption, protein-losing enteropathy, scleroderma (sometimes), starvation, steatorrhea, ulcerative colitis.
Important Note
Laboratory test results are the most critical parameter for diagnosing and monitoring all pathological conditions. Between 70 to 80% of diagnostic decisions are based on laboratory tests. Correctly interpreting laboratory results allows a doctor to distinguish "healthy" from "diseased."
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be analyzed based on each case and family history, clinical findings, and the results of other laboratory tests and information. Your physician should explain the importance of your test results.
At Diagnostiki Athinon, we answer any questions you may have about the test you perform in our laboratory and contact your doctor to ensure you receive the best possible medical care.
