electrophoresis

Hypoalbuminemia

decrease albumin peak, congenital analbuminemia

Hypoalbuminemia cause

↓ synthesis (cirrhosis, inflammation), ↑ loss (nephrotic syndrome, burns), ↑ metabolism, chronic malnutrition

Acute inflammation

increase in alpha-1 (alpha-1 antitrypsin) and Alpha-2 (haptoglobin)

Chronic inflammation

albumin decreases, alpha 2 increase and polyclonal increase in gamma region

polyclonal hyperglobulinemia

broad-based increase in the gamma region

polyclonal hyperglobulinemia caused

hepatitis infection, AIDS, autoimmune disease, and Chronic inflammation

hypogammaglobulinemia

decrease in gamma region

hypogammaglobulinemia cause

primary immunodeficiency, secondary to immunosuppresive therapy, and light chain myeloma

oligoclonal

multiple bands on the gamma region

oligoclonal cause

autoimmune disease (RA, Lupus), antibodies against viral protein, autoimmune response in transplant patients under immunosuppressive therapy, CSF in multiple sclerosis

hemolysis

extra bands in the alpha 2 region due to free hemoglobin–haptoglobin complexes

fibrinogen in the sample

sharp peak at beta 2 region, can mimic M-spike

fibrinogen in the sample cause

seen when plasma or incompletely clotted serum is used, removed by thrombin treatment

Multiple Myeloma

sharp monoclonal (M) spike at gamma region (sometimes on the beta region), suppresion of normal immunoglobulins and associated with CRAB features

MGUS

small M spike, no CRAB features, stable over time and low tumor burden

SMM

larger M-spike than MGUS but smaller then MM, high plasma burden, no CRAB, high risk of progession to MM