The clinical application of paper electrophoresis in sarcoidosis: a preliminary report.

We have studied the serum electrophoretic patterns in 25 patients with sarcoidosis. The electrophoretic serum analysis was made by the method of MacDonald et al,1 normal values in paper electrophoresis are presented in Table I. The diagnosis of sarcoidosis was established in each case by clinical and laboratory studies, the biopsy showing the usual microscopic picture of non-casting epitheloid cell tubercle present in every case. The serum electrophoretic pattern of these patients with sarcoidosis is described in Table II. The electrophoretograms were characterized by an increase in the alpha 2, beta, and a marked increase in the gamma globulin, while the albumin showed a decrease. These findings were also observed by Sunderman and Sunderman2 by Seibert and her co-workers1 by Fisher and Davis4 and by Harrell and Fisher. We compared the electrophoretograms of patients with sarcoidosis with the electrophoretic patterns of the serum from 31 patients suffering from other diseases. The serum analysis of eight patients suffering from cancer of the lungs revealed a decrease in the serum albumin and an increase in the alpha 2 globulin. This was also observed in five patients with pneumonia. In five cases of tuberculous effusion and in two of pulmonary tuberculosis. The electrophoretic patterns of the serum proteins in six patients with lymphocytic leukemias, monocytic leukemia, aleukemic leukemia and polycythemia revealed an increase in the alpha 2 globulin, and a marked reduction in the gamma globulin. In five cases of congestive heart failure the serum analysis disclosed a reduction in the serum albumin, an increase in alpha 2 globulin and a normal gamma globulin. There were nonspecific changes in the electrophoretic serum analysis of our patients with carcinoma of the lungs, pneumonia, tuberculosis, and congestive heart failure. These changes were characterised by a reduction in the serum albumin and an increase in the alpha 2 globulin. The mean electrophoretic patterns in our 25 patients with sarcoidosis differed from those in the above 31 cases in the following manner. The electrophoretograms were characterized by an increase in the alpha 2, the beta, and a marked increase in the gamma globulin, while the concentrations of the albumin was decreased. The presence of a characteristic mean electrophoretic pattern in sarcoidosis can be of great help in differentiating this disease from tuberculosis, carcinoma of the lungs, and various types of lymphomas, as well as certain granulomatous conditions of known cause, such as leprosy, histoplasmosis, berylliosis and brucellosis.