Electrophoresis

Front 1

CSF Protein Electrophoresis, MS patient

Back 1

1) CSF, MS patient. Oligoclonal bands. Increased gamma globulins.

2)Serum, MS patient. No banding.

3) CSF, normal.

Front 2

CSF Isoelectric focusing, MS patient

Back 2

On left: normal CSF.

On right: CSF with oligoclonal banding. Serum with no banding.

Front 3

Alpha-1

Back 3

Thyroxine-binding globulin

alpha-1-antitrypsin

alpha-1-lipoprotein (HDL)

Front 4

Alpha-2

Back 4

Alpha-2-macroglobulin

Haptoglobin

Ceruloplasmin

Front 5

Beta

Back 5

Transferrin, Complement, beta-lipoprotein (LDL)

Front 6

Gamma

Back 6

IgG, IgA, IgM, IgD, IgE, and CRP

Front 7

1) intravascular hemolysis (decreased alpha-2)

2) Normal patient

3) In vitro hemolysis Hemoglobin/haptoglobin complex band

Back 7

On protein electrophoresis, depressed serum haptoglobin as occurs with hemolysis in vivo results in a depressed alpha-2 band.When hemolysis occurs in vitro during specimen handling, the released hemoglobin binds to haptoglobin and alters its migration. On protein electrophoresis, this appears as a band between the alpha-2 and beta-1 bands.

Front 8

1) plasma (large fibrinogen band)

2) normal

3) small clot in serum (light band)

Back 8

Plasma is not recommended for electrophoresis because the large fibrinogen band may obscure a monoclonal gammopathy. Serum samples will occasionally not clot completely. When this happens, a small fibrinogen band appears near the point of application. A monoclonal gammopathy is ruled out by immunofixation or by thrombin treatment. Thrombin removes the fibrinogen without affecting the monoclonal gammopathy.

Front 9

Alpha-1-antitrypsin Deficiency.

1) lack of alpha-1 band

2) normal

Back 9

Inhibition ofprotease neutrophil elastase. Mutation in SERPINA1 gene cause deficiency. APRincreased in inflammatory response, pregnancy and contraceptive use.

Can result in emphysema and chronic liver disease.

Front 10

Hypogammaglobulinemia

1)Severe

2)Moderate

3)Normal

Back 10

A broad suppression or absence (acquired or genetic) of immunoglobulins places the patient at risk of recurrent infections. There is a wide spectrum of acquired and genetic disorders affecting immunoglobulin concentration.

Front 11

Bisalbumin

Back 11

Albumin variants are uncommon; however, occasionally a double albumin band (bisalbumin) is detected on serum electrophoresis. One allele produces normal albumin and the other allele produces the variant, which migrates slightly differently

Front 12

Nephrotic syndrome

1) Serum, renal loss. Albumin decreased. Alpha-2-macroglobulin increased. Beta-lipoprotein increased.

2)Normal serum

3) Urine, renal loss. Increased albumin, increased alpha-1-antitrypsin, no alpha-2

Back 12

Markedlydecreased albumin and increased alpha-2 band due to increasedalpha-2-macroglobulin. Beta-lipoprotein increased. Smaller proteins are lostinto urine.

Front 13

Liver Disease

1) beta-gamma bridging, gamma increased, albumin (anodal slurring)

2) Normal

Back 13

Bilirubinalters migration of albumin band. Albumin bind not completely migrated, anodalslurring, beta gamma bridging, gamma (broadly increased)

Front 14

Acute inflammation

1) Albumin decreased, alpha-1 increased, alpha-2 increased, beta-1 decreased, beta-3 increased

2) normal

Back 14

Acute inflammation.Alpha-1,2 increased. Albumin and beta-1 (transferrin) decreased.Beta-3 (complement) increased.

Front 15

Chronic inflammation

1) gamma increased

2) normal

Back 15

Elevation in gammaregion along with same findings as acute inflammation.

Front 16

Monoclonal protein

Back 16

1/3 have malignancy(multiple myeloma, waldenstrom’s). 2/3 will not have diagnosis related toM-protein (MGUS). M spike. Large M protein.dFrauL:

Front 17

Urine, tubular proteinuria

1) alpha-2-microglobulin and beta-2 microglobulin seen

2) normal

Back 17

Increase alpha-2microglobulin, beta-2 microglobulin and free light chains

Front 18

Glomerular Proteinuria

1) Increased albumin, increased alpha-1, increased beta-1

Back 18

Albumin increased,alpha-1-antitrypsin increased, no alpha-2-macroglobulin in urine.