Where did the globulins go?

A decreased A/G ratio may indicate multiple myeloma, autoimmune disease, cirrhosis, or kidney disease. The patient’s electrophoretogram was normal, and subsequent immunofixation was negative, which ruled out monoclonal gammopathy. The SPE (Fig. 1) showed an albumin of 64.4% and normal A/G ratio, which suggests spurious hyperproteinemia. The patient was being treated with dextran (1 ). In the assay of serum proteins by the biuret reaction, dextran can cause turbidity due to formation of an insoluble complex of dextran with copper in strongly alkaline solution, leading to spurious hyperproteinemia. This interference from dextran can be prevented by waiting until the patient is no longer receiving dextran or Department of Biochemistry, Peerless Hospital & B K Roy Research Center, Kolkata, West Bengal, India. * Address correspondence to the author at: Department of Biochemistry, PeerlessHospital & B K Roy Research Center, 360 Panchasayar, Kolkata, West Bengal 700094, India. E-mail: [email protected]. Received August 29, 2014; accepted September 16, 2014. DOI: 10.1373/clinchem.2014.232520 © 2014 American Association for Clinical Chemistry Fig. 1. Serum protein electrophoretogram showing normal pattern with normal A/G ratio. What Is Your Guess?