An elevated serum Globulins (>4 g/dL) suggests some sort of systemic inflammation. It can be noted in active Connective Tissue Disorders, Inflammatory Bowel Disease, chronic infections, paraproteinemias, etc. It warrants further testing, especially:
- Serum Protein Electrophoresis (SPEP), to rule-out Multiple Myeloma
- HIV test (we’ve diagnosed a few asymptomatic cases prompted only by an incidental high globulin on chemistry panel)
But most chemistry panels don’t test for Globulins; you have to calculate it:
- Total Serum Protein minus Serum Albumin = Serum Globulins
BEWARE of simply skimming results for “normals.” “Normal Protein” is usually ≤8 g/dL. “Normal Albumin” is usually 3.5 – 5.2 g/dL. However:
- Protein 7.8 (WNL) minus Albumin 3.6 (WNL) = Globulins 4.2 (high)
- Protein 8.4 (high) minus Albumin 5.0 (WNL) = Globulins 3.4 (WNL)
DiagnosisDude 