Beta-2 Microglobulin, Serum, Urine, Cerebrospinal Fluid

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Beta-2 Microglobulin, Serum, Urine, Cerebrospinal Fluid

Definition

  • Ž ²2-Microglobulin is a cell membrane " “associated 100-amino-acid peptide, a component of the lymphocyte HLA complex. Because it is present on all nucleated cells and is almost totally reabsorbed and catabolized by the proximal tubules, it serves as a marker of immune activation and proximal tubular function. It is found in nearly all body fluids.
  • Normal range: Serum: males: 0.60 " “2.28 mg/L; females: 0.60 " “2.45 mg/L Urine: 0 " “300 Ž ¼g/L CSF: 1.5 + 0.2 mg/L
  • Serum: males: 0.60 " “2.28 mg/L; females: 0.60 " “2.45 mg/L
  • Urine: 0 " “300 Ž ¼g/L
  • CSF: 1.5 + 0.2 mg/L

Use

  • Prognostic marker for some lymphoproliferative disorders (adult acute lymphocytic leukemia, AIDS).
  • Prognosis assessment of multiple myeloma (as a tumor marker, it reflects burden of tumor cells).
  • Evaluation of renal tubular disorders, index of GFR.
  • CSF Ž ²2-microglobulin levels have been used as a disease indicator of a variety of conditions, including multiple sclerosis, neuro-Beh ƒ §et disease, sarcoidosis, AIDS " “dementia complex, and meningeal metastases, especially meningeal dissemination of acute leukemia and malignant lymphoma.

Interpretation

Increased In

  • AIDS
  • Aminoglycoside toxicity
  • Amyloidosis
  • Autoimmune disorders
  • Breast cancer
  • Crohn disease
  • Felty syndrome
  • Hepatitis
  • Hepatoma
  • Hyperthyroidism
  • Inflammation of all types
  • Leukemia (chronic lymphocytic)
  • Lung cancer
  • Lymphoma
  • Multiple myeloma
  • Poisoning with heavy metals, such as mercury or cadmium
  • Renal dialysis
  • Renal disease (glomerular): serum only; renal disease (tubular): urine only
  • Sarcoidosis
  • SLE
  • Vasculitis
  • Viral infections (e.g., CMV)

Decreased In

  • Renal disease (glomerular): urine only; renal disease (tubular): serum only
  • Response to zidovudine (AZT)

Limitations

  • Drugs and proteins that may increase serum Ž ²2-microglobulin levels include cefuroxime, cyclosporin A, gentamicin, interferon-α, pentoxifylline, tumor necrosis factor, lithium, and radiographic contrast media.
  • Drugs that may decrease serum Ž ²2-microglobulin levels include zidovudine.
  • Drugs that may increase urine Ž ²2-microglobulin levels include azathioprine, cisplatin, cyclosporin A, furosemide, gentamicin, mannitol, nifedipine, sisomicin, and tobramycin.
  • Drugs that may decrease urine Ž ²2-microglobulin levels include cilostazol.