950

APPENDIX V]

(c) Monoclonal gammopathy

(e) A cute inflam m ation:

high a , an d

a2

(d) N ep h ro tic sy n d ro m e:

low alb u m in , high

a2

a n d p a n d low

y

elev atio n o f im m unoglobulin

F IG U R E V I-1

Serum protein electrophoretic patterns. [Pattern (a) is reproduced, with permission, from Helena Laboratories,

Beaumont, Texas.]

y

-globulin is largely of maternal origin and undergoes

catabolism, reaching its lowest value at about 3 months.

Adult levels for

y

-globulin are not reached until about

2-7 years. After age 40, the level of albumin gradually

declines and the /3-globulin fraction increases.

Albumin

Albumin is synthesized in the liver. Since albumin ac-

counts for about 75% of the osmotic pressure in blood,

it is responsible for the stabilization of blood volume and

regulation of vascular fluid exchange. Therefore, hypoal-

buminemia can give rise to edema.

Hyperalbuminemia

is uncommon, but many types of abnormalities lead to

hypoalbuminemia.

Some hypoalbuminemic conditions

include nephrotic syndrome, proteinlosing enteropathies,

cystic fibrosis (hypoalbuminemia with edema may be an

early abnormality in infants with this disease), glomeru-

lonephritis, cirrhosis, carcinomatosis,

bacterial infec-

tions, viral hepatitis, congestive heart failure, rheumatoid