Calculating Serum Globulins

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)