Question

CLINICAL CHEMISTRY – PROTEIN/AMINO ACID CASE STUDY

A 73-year old male been hospitalized for 2 days with fatigue and bone pain. His family stated he has been in a confused state. Routine laboratory testing has been ordered on the patient and the chemistry results are as follows:

Total Protein 14.8 g/dl

Albumin 2.9 g/dl

Calcium 10.3 mg/dl

Phosphorus 4.0 mg/dl

BUN 28 mg/ dl

Creatinine 2.8 mg/dl

Urine Protein Positive SSA test

All other urine dipstick tests are normal

1. What laboratory tests are abnormal?

2. What is the patient’s globulin value?

3. A serum electrophoresis was preformed and has a normal pattern except for the decreased albumin. A urine protein electrophoresis was ordered. The urine pattern showed a monoclonal peak in the gamma region. What diagnosis would be appropriate for this patient?

4. Is this patient producing equal amounts of light chains and heavy chains?

5. What further testing could be done to identify the specific monoclonal proteins being produced?

6. Does this patient appear to have any renal dysfunction?

Answer 1

Result * Total Protein - 14.89/de | Albumin 2.99 1 dl I calcium id 10. malal Phosphorus 4.0 mejdl BUN 28 mg/dl creatinine . 2. 8mg/dl Normal Range 6-8.3 g 1 dl 3.4 to 5.ugl du 8.5 to 10.5 malal 2.5 to 4. smelal 6-20mg / de Lage above Ğo →8-23mg lalu 0.6 to 1.2 mg lal Total. Protein Albumin BUN creatinine 14.8 9.1 dese High - 299 1 dl hd Low - 28 mg/dl High - 2.8 mg / dl High - 2b Globulin value Total Protein - Albumin Globulin value → 14.8 -2.9 11.9 g/dl (Normal. ; tantum i Jlange 3:59 - Oy & According to my diagnosis, there I some absormally in kidney is - Total Protein is High means albumin or glubin is High. Total Protein High in Kindly and liver disease

I BUN High BUN is waste Product from liver and end which up in is relased a Rabba Kidney. • If BUNis High means with kidney there is some problem High creatinine - Occier due to impared Kidney in kidney disease and function or Albumin low.? - Braun 1,391) 4 Albumin low found in Nephrotic disease 4 Plasma cell Normally produce slightly more light chain than haly chain. so in this patient Production of light Chain is more than heavy chain and 57 Blood and Drine electrophoresis Test 6+ yes it has renal dysfunction due to abnormal level of Total protein . Albumin, globulin, BUN and creatinine.