What are important acute phase proteins?
Alpha1 globulins
=alpha1 antitrypsin
=alpha1 acid glycoproteins
Alpha2 globulins
= haptoglobin
= ceruloplasmin
Gamma globulins
= CRP (choice for detecting acute inflammation and monitoring response to Tx)
Describe alpha1 antitrypsin
Key role in lung elasticity
Dec. [ ] = liver disease
Hereditary deficiency = emphysema + liver disease
Describe alpha1 acid glycoprotein
Binding protein for many drugs
Describe haptoglobin
Binds free Hb
Naturally bacteriostatic
Monitored in hemolytic disease
Describe CRP
Can be used to follow disease progression
Used as prognostic indicator of future adverse cardiac events
Describe multiple myeloma
Production of unregulated amounts of monoclonal antibody
Bone pain
Bone marrow “punched out” lesions
What is the acronym associated with multiple myeloma?
CRAB
Calcium (hyper)
Renal injury
Anemia
Bone pain
What is Waldenstrom’s macroglobulinemia?
Lymphoma with IgM monoclonal antibodies that cause hyperviscosity of serum
No bone tenderness
What is MGUS?
Monoclonal gammopathy of undetermined significance
M-protein in persons without evidence of multiple myeloma, etc
Unknown if it will remain stable/benign or develop into something more
What is PCLI and how does it relate to MGUS?
Plasma-cell labeling index
Measures synthesis of DNA and when it is elevated, theres good evidence patient has MM
…or will soon develop it
What does the arrow on immunofixation electrophoresis mean?
Arrow indicates position of monoclonal protein
Order of monoclonal antibodies: G A M K L
