1. MLAB 2401: Clinical Chemistry Keri Brophy-Martinez Assessment of Proteins

2. Total Protein Specimen Collection ◦ Serum ◦ Avoid hemolysis and lipemia Reference Range ◦ 6.4-8.3 g/dL

3. Methods for Total Protein Determination

4. Albumin Determination

5. A/G Ratio Globulin concentration can be calculated by subtracting the albumin from total protein. ◦ Globulin = Total Protein (g/dL) – Albumin (g/dL) The A/G ratio can then be determined by dividing the albumin concentration by the calculated globulin.

6. Urinary Protein Sources ◦ Blood ◦ Kidney, urinary tract, vagina and prostate When proteins appear in the urine, they have not been reabsorbed by the renal tubules ◦ Screen: urine dipstick ◦ Quantitative: 12 or 24 hour urine

7. Urine Protein Methods

8. Urinary Protein: Significance Physiological Causes (transient proteinuria) Pathologic Causes Exercise (causes renal vasoconstruction) Glomerular nephritis Emotional stressPyelonephritis Exposure to heat or coldMalignant hypertension FeverIncreased permeability of glomerulus (toxins, SLE, infections, diabetes) PregnancyDisturbance of reabsorption Orthostatic/Postural (common in teens when rapid growth is occurring) Others: Systemic disorders, drugs, chemicals, myeloma-type disease (Bence-Jones protein)

9. CSF proteins Reference range ◦ 15-45 mg/dL ◦ Increased total CSF proteins  Bacterial, viral, fungal meningitis  Traumatic tap  Multiple sclerosis  neoplasm

10. References Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson.