There are various metabolites that relate to oncomarkers, compounds indicating the presence in the body of malignant neoplasms. But some of these compounds are formed when tumors occurred, and a healthy person practically does not occur. Beta-2 protein Microglobulin refers to other connections. It is almost in all cells of our body, that is, it can be found in healthy people. In addition to organs and tissue cells, it is also located in most physiological fluids, which include blood, urine, some secrets of internal organs, as well as other liquid media. The greatest diagnostic value is the study of beta-2 microglobulin in blood plasma, as well as in the urine.
The study of beta-2 Microglobulin in modern laboratories is carried out using immunohemiallyuminescent analysis, which relate to, that is, to immune methods. There is another name of this metabolite: thymotoxin, or β -2 M. Therefore, if you ordered the analysis on beta-2 microoglobulin, and as a result you see beta-2 m, then you do not need to think that the laboratory was wrong. This is the same name.
What role does this compound play in the body and under what diseases and states can this analysis be useful in diagnostic search?
β 2 m - what is it?
This protein refers to low weight compounds, with a mass of up to 12 daltons. The function of this protein is quite complex, it is a structural component of the main histocompatibility complex, which is related to the recognition of signals "its own or someone". Contains microoglobulin in all cells of the human body that have a nuclei. Recall that nuclei is not in one very large population of blood cells: it is. They carry oxygen and carbon dioxide, and any extraneous inclusion, including the kernel, reduce the volume of erythrocyte, reducing the volume of portable oxygen molecules and carbon dioxide.
In adults, the microglobulin content in the blood reflects the greatestly function of lymphocytes, since it is in these cells it is presented in the greatest quantity. This is not surprising, since it is the lymphocytes that are trained in immune bodies to recognize their own and other people's compounds must be the most aware of all the "intruders" of the immune system.
It is important that the speed of production of this substance is supported almost at the same level, and does not change during life. This protein is distinguished by the kidneys, and in the urine in a healthy person you can find only traces of this compound. Thus, beta 2 microoglobulin in the blood increases with those conditions under which the human immune system is experiencing the greatest voltage. These are various inflammatory processes, autoimmune pathology, reactions associated with rejection of the graft in the body, as well as various malignant blood formation, which affect immune cells. These include, above all, multiple myeloma and various lymphomas.
The amount of this protein increases sharply with such a disease as amyloidosis. Beta-2 microoglobulin in the kidneys in patients with amyloidosis is able to condense, and forms long chains. They are "scored" membranes of renal glomers, reduce the filtering rate, and thus, the microglobulin concentration in patients with amyloidosis can affect the activity of the process.
For the reason that the microglobulin is a protein of a minor molecular weight, if it is in elevated amounts in the blood plasma, then it is able to accumulate in the liquor, or cerebrospinal fluid in excessive quantities. Most often, such conditions and diseases such as lymphoma, leukemia, as well as viral damage of the nervous system, for example, neurospide with HIV infection are given.
When is the analysis in clinical practice, and what are the indications for the purpose of the study?
What is the analysis for?
Most often it is used as an oncomarker. Beta 2 microoglobulin increases if the patient has leukemia associated with the rebirth of immunocompetent cells. These are various lymphomas. The second indication is to control the activity of the process in patients with amyloidosis. It must be remembered that in itself a separate study is not able to diagnose amyloidosis.
One of the main testimony to the appointment of this analysis is:
- suspicion of multiple faith in the patient;
- indirect determination of the stage of this malignant process.
It is also important to control the level of microglobulin to assess the effectiveness of treatment. Above it was said that his number of a healthy person is constantly, and if after applying antitumor specific therapy, its number falls, this may indicate the success of treatment. After all, the total volume of this protein directly corresponds to the total number of secreting tumor mass.
Important! Reducing beta-2 microoglobulin in patients with diagnosed myeloma in the treatment process improves the forecast.
The study of the concentration of this metabolite in the blood plasma is shown to patients after kidney transplantation to detect the earliest signs of the transplant rejection and take action. In some cases, the study of this protein helps to diagnose the damage to the central nervous system in viral infections, and with the same myelomee, since it accumulates in the cerebrospinal fluid.
It is known that a long-term impact with such industrial poisons as cadmium and mercury can cause a violation of the immune system and kidney tissues (toxic nephropathy). Therefore, in professional pathology in chronic intoxications, cadmium and mercury, the level of this protein also reflects the activity of kidney damage. Do I need to somehow prepare the patient to carry out this analysis?
Preparation for research
Preparing for the study of this oncomarcker is not too difficult. We can assume that these are general recommendations for the delivery of blood tests with minor additions. So, this study is desirable to spend in the morning, an empty stomach, after a period of ordinary night sleep. You can drink water in the morning. The following recommendations are important:
- it is necessary to completely abandon fatty food per day;
- 30 minutes before blood is prohibited, excessive physical activity is prohibited;
- in the morning, it is advisable to eliminate stress, both household and production.
It is very important to smoke to know that each cigarette, dropped earlier than 3 hours before the analysis, can significantly distort its result.
Results and their deviations from the norm
Perhaps a person without medical education does not need to know all the subtleties of the oscillation of this protein in the blood plasma in a healthy person of different ages. We can say that:
- starting from the 19th year, that is, in adults, the rate of beta-2 microglobulin varies from 0.67 to 2.329 mg per liter (mg / l) in the blood plasma. Differences between men and women do not exist, just like there is no difference between the pregnant and non-death female;
- starting from childhood, and before reaching the age of 19 years, significant fluctuations in this metabolite occur in blood plasma: the highest value of beta-2 microglobulin in blood plasma is found in infants. In the kids, from the first day of life, before reaching the age of one month, the value can reach - in the boys 4.7, and in girls - 4.5 mg per liter.
This is natural because Microglobulin is a protein that provides the work of the immune system, and the immune system is growing and developing, starting from early childhood, during the dating period of the body with various antigenic factors of the external environment, microorganisms, when familiarizing with children's infections, and so on.
Deviations from reference values
Despite the significant scatter of reference values, it should be remembered that the low content of this protein is normal. And in the event that you do not exceed 0, 7, or 0.9 mg per liter, then everything is in order, as well as with a value of 2.5 mg / l. The greatest fear causes a significant increase in concentration, but it is definitely impossible to judge the nature of pathology on this analysis.
This may be suspicious of malignant neoplasm, on autoimmune diseases whose treatment is engaged in rheumatologists and so on. A full-fledged survey is required. In the event that the protein concentration is exceeded significantly, the patient is required primarily to the consultation of the hematologist, since there is a suspicion of the multiple faith, or a tumor of blood.
If a patient with myeloma after treatment, the level of this protein decreases with respect to the original, this fact speaks of a properly selected treatment, and reducing the total tumor mass. If patients with myeloma, the concentration of protein in the blood plasma has not changed, or, on the contrary, it has increased, then this indicates a worsening of the forecast and (or) on ineffective treatment.
In the event that a patient has a sign of renal pathology, for example, protein in the urine, high blood pressure, edema, signs of nephropathy, then in terms of microglobulin, you can judge the dysfunction of the kidney glomeruli capsules. But this sign is important only if the Beta-2 blood is high, the microoglobulin is high, and in the urine is low. If the situation is reverse, and metabolit has a low concentration in the blood plasma, and high in the urine, then there is most often a disease associated with damage to the renal tubules. It is this fact that is important in suspected chronic intoxication of mercury and cadmium. After all, these metals are able to cause the defeat of the canal, causing the tubular necrosis.
If the level of this protein in the blood plasma increases in patients after kidney transplantation, this may indicate the beginning of a formidable complication: the beginning of the reaction of the transplant rejection.
The study of beta-2 microglobulin in blood plasma belongs to such analyzes that, when exceeding the permissible norms, entail a full range of laboratory and instrumental research methods. From the above, it can be seen that the increase, even significant, this substance in the blood plasma cannot be unambiguously considered a sign as a malignant disease and kidney damage. Need additional research methods.
In addition, various severe infectious processes, drug intake, for example aminoglycosidic antibiotics, lithium, cytostatics, can affect the change in the concentration of microoglobulin in blood plasma. In the event that the patient gives this analysis shortly after computer tomography or MRI using contrasting substances, such as an Omnipa, it can also lead to false positive results and to an increase in protein concentration in the blood.
Synonyms: Beta-2-Microglobulin, B2M, Thymotaxin, Beta2-Microglobulin.
Scientific Editor: M. Merkushev, PSPBGMU. Acad. Pavlova, therapeutic matter.
October, 2018.
Beta-2 microoglobulin is produced by almost all cells of the body, and is also present in the main biological fluids: lymph, liquor, urine, serum, etc. The increase in the content of beta-2 Microglobulin indicates pathological processes, most often malignant.
Analysis on beta-2 Microglobulin in the blood allows you to identify oncology in a patient (lymphoma, myeloma, etc.), serious inflammatory processes, as well as to establish the degree of damage to the central nervous system and the renal apparatus.
General
Beta-2 Microglobulin is a simple protein that is present in the HLA histocompatibility antigen circuit. It is possible to detect it in all liquid mediums of the body, however, the beta-2 level in the serum is maximally reflecting the cellular metabolism (metabolism) and the likely proliferation (reproduction, growth, increasing volume) of lymphocytes, which indicates a pathological process.
In an adult, the protein secretion of beta-2 is stable, so an increase in its concentration is a reason for the differential diagnosis of various diseases.
From the blood of beta-2, the microoglobulin enters the kidneys, where it is filtered and almost completely reabsorbing (absorbed). Thus, in the norm in the urine, this protein or does not come at all, or is found in the form of traces of metabolites. The half-life of beta-2 microglobulin in the blood is just over 100 minutes (2.5 hours).
The concentration of the Beta-2 oncomarcker in the blood increases with the violation of the kidney work, most often with the insufficiency of the filtering function. A similar problem may be a consequence:
- damage to the proximal tubules as a result of transferred inflammatory and infectious processes;
- hereditary kidney disease;
- intoxication with heavy metals, alcohol, drugs, other chemicals;
- radiation impact (irradiation) on the body.
The most common causes of increasing the level of beta-2 microglobulin in the blood are:
- improving the activity of the immune system (reaction to pathogens: fungi, viruses, bacteria, etc.);
- autoimmune pathology;
- antigenic response of the body, including oncological processes (myeloma, lymphoma and others);
- transplant rejection reaction.
The largest content of beta-2 microoglobulin in in lymphocytes. Therefore, the level of this protein increases significantly in malignant processes, which are characterized by aggressive growth of tumor tissues and a tendency to metastasis.
The definition of a marker in the blood is used in oncohematology to compile the predictions of the relapse and remission of the malignant disease. In this case, the analysis is not specific to a particular tumor.
The hypersecretion of beta-2 microglobulin is directly related to the development of amyloidosis, especially in people on hemodialysis. Beta-2 Microglobulin is the main component of amyloid fibrils. It accumulates in the joints and leads to destructive osteoarthropathies and pathological fractures. The most severe complication: the deposition of beta-2 amyloid in paravertebral ligaments and intervertebral discs, which leads to paralysis.
Indications
- Determination of various types of blood cell cancer;
- Differential diagnosis of tubular and glomerious kidney pathologies;
- Diagnosis and treatment of chronic renal failure;
- Determination of the stage and form of myeloma process, evaluation of the effectiveness of treatment, detection of the size of the tumor mass;
- Forecast of the development of other cancer: lymphoma, leukemia, etc.;
- Monitoring the patient's condition after kidney transplant (to determine the reaction reaction);
- Therapy of patients, which inverted with mercury and cadmium concentrates, received intoxication with chemicals, drugs, alcohol, were irradiated;
- Assessment of the state of the central nervous system against the background of any oncological pathologies, AIDS;
- Diagnosis of diseases of the lymphatic system, which are accompanied by the activation of immune reactions (multiple sclerosis);
- Diagnosis and treatment of severe viral infections (cytomegalovirus, HIV, etc.);
- Control the flow and treatment of autoimmune diseases.
Deciphering the test on beta-2 microoglobulin in the blood can conduct an oncologist, surgeon-transplantologist, nephrologist and therapist.
Beta-2 microoglobulin is normal
Important! Norms differ depending on the reagents and equipment used in each specific laboratory. Therefore, in the interpretation of the results, it is necessary to use the standards adopted in that laboratory, where the analysis has surrendered. It is also necessary to pay attention to units of measurement.
|
Patient age |
Paul patient | Permissible values mg / L. |
| 1 day - 4.3 weeks. | Men | 1,603 – 4,790 |
| Women | 1,722 – 4,547 | |
| 4.3 weeks - 6 months. | Men | 1,423 – 3,324 |
| Women | 1,024 – 3,774 | |
| 6 months - 1 year | Men | 0,897 – 3,095 |
| Women | 0,999 – 2,282 | |
| 1 - 4 years | Men | 0,827 – 2,228 |
| Women | 0,742 – 2,396 | |
| 4 - 7 years | Men | 0,567 – 2,260 |
| Women | 0,546 – 2,170 | |
| 7 - 10 years | Men | 0,772 – 1,712 |
| Women | 0,736 – 1,766 | |
| 10 - 13 years | Men | 0,699 – 1,836 |
| Women | 0,704 – 1,951 | |
| 13 - 16 years | Men | 0,681 – 1,954 |
| Women | 0,787 – 1,916 | |
| 16 - 19 years | Men | 0,724 – 1,874 |
| Women | 0,555 – 1,852 | |
| 19 years and older | Men | 0,670 – 2,329 |
| Women | 0,670 – 2,329 |
Important! The interpretation of the results is always carried out comprehensively. Put an accurate diagnosis on the basis of only one analysis is impossible.
Enhance values
- Systemic inflammatory, infectious, viral and bacterial processes;
- Autoimmune diseases: multiple sclerosis, red lupus, SHEGREEN syndrome, rheumatoid arthritis, etc.;
- Oncohematological diseases: Hodgkin's disease, Mieloma Multiple, B-cell leukemia, non-Hodgkinsky lymphoma, etc.;
- Viral infections: mononucleosis, HIV (AIDS), cytomegalovirus, etc.;
- Pathology of kidneys: insufficiency, pyelonephritis, glomerulonephritis, kidney infarction, etc.;
- Reaction of rejecting the kidney transplant;
- Hemodialysis (in some patients the level of beta-2 microglobulin rises).
The increase in beta-2 microoglobulin in the liquor is observed in the exacerbation of multiple sclerosis, dementia with a SPID-associated complex, with the meningeal propagation of acute leukemia and malignant lymphoma, neurosarco-shaped.
In the presence of renal pathologies, the high level of beta-2 microglobulin in the blood and reduced in the urine indicates the damage to the glomerular apparatus of the kidney. If the protein concentration is reduced in serum, but rises in urin, then the reason should be sought in the renal tubules.
The increase in beta-2 values \u200b\u200bof the microglobulin immediately after the kidney transplantation can point to the beginning of the transplant rejection reaction.
If the protein grows in the blood and liquor on the background of oncology (leukemia, myeloma, etc.), as well as viral diseases (HIV, AIDS), this may mean that the central nervous system is involved in the pathological process.
The reduced concentration of beta-2 microoglobulin or its complete absence in the blood should be considered the norm.
Factors of influence on the result
- Systemic diseases that accelerate the synthesis and decay of cells (cytomegalovirus infections, inflammation and autoimmune pathologies, activating the immune system);
- Medicinal preparations: cisplatin, carboplatin, cyclosporine, antibiotics (aminoglycosida), drugs of lithium and others;
- Recent X-ray and MRI with contrast;
- Recent PET / CT (positron-emission and computed tomography);
- Methods of performing blood test (it is recommended to undergo a survey in the same laboratory).
Preparation
Biomaterial for research: venous blood.
Method of the Biomaterial Obligation: Venne Venencation.
Mandatory conditions: Strictly on an empty stomach (after 10-hour starvation). Immediately before manipulation, only pure non-carbonated water is allowed.
Additional requirements:
- the day before - light dinner without oily, heavy and spicy food;
- per day - a refusal of alcoholic and tonic drinks, smoking, physical and emotional tension;
- in 2-3 hours - the absence of psycho-emotional stress;
- for 3 hours - the refusal of chewing tobacco and smoking.
Important!1-2 weeks before the planned date of analysis, it is necessary to stop / suspend any courses of treatment (physiotherapy, massage, LFC, etc.), transfer therapeutic and diagnostic manipulations to a later date and cancel the reception of medicines. If it is impossible to fulfill this requirement, it is necessary to coordinate with the attending physician of the therapy, dosage and types of drugs in advance.
Beta-2 Microglobulin (B2M) is a protein that is located on the surface of almost all cells entering blood when they are destroyed. B-lymphocytes and tumor cells contain its largest amount. Therefore, the increase in B2M levels is observed under states when the organism is accelerated by the processes of the formation and destruction of cells. Analysis on beta-2 Microglobulin provides for measuring the content of this protein in the blood, urine and the spinal fluid.
With multiple myeloma and some lymphomas, the B2M test is required to assess the severity and forecast of the disease.
The most often B2M blood content increases with diseases such as multiple myeloma and lymphoma, as well as in autoimmune processes and infections (for example, HIV, CMV). Since the protein content is almost always increased in hemoblastosis (blood cancer), it can be useful as an oncomarker in these diseases. The determination of the content of beta-2 microglobulin in the urine is sometimes useful when assessing the severity of tubular trees (kidney tube pathologies).
How is the material for testing?
A blood sample is obtained by vengeuncture - percutaneous piercing walls of veins hands with a special needle. Watering for testing itself is collected within 24 hours. The spinal fluid is rarely used to analyze, the lumbar puncture (lumbar puncture, lumbar puncture, spinal puncture) is used to obtain it.
Do you need any preparation?
Preparation for analysis is not required.
How is it used?
Beta-2 Microglobulin (B2M) is used as an oncomarcker with some malignant diseases of the hematopoietic system. It does not indicate the presence of a specific disease, and helps to determine the tumor load (the amount of malignant cells in the body). The assessment of the "tumor mass" allows the doctor to receive additional information that is useful for predicting further behavior of oncolic.
The test is often prescribed with multiple myeloma in order to monitor the activity of the disease.
Determining B2M levels in the blood, and sometimes its content in the urine is used to estimate the distribution (stage) of multiple myeloma. Its quantitative indicators in serum and urine correlate with the activity of the oncoprocess with multiple myeloma and lymphoma. It helps to assess the forecast and the effectiveness of the treatment under these cancers.
In clinical practice, the test for the definition of B2M in the spinal fluid is sometimes used. Increased levels of protein in the spinal fluid indicate the involvement of the central nervous system during lymphomas and leukemia.
The content of beta-2 microoglobulin in the blood correlates with the tumor load and the degree of functional disorders of the kidneys in patients with multiple melanoma. Experts of the International Working Group on Multiple Melty Multi Recently, changes were made to the Guide to Stage the Disease. The current classification of this disease takes into account the content of albumin and beta-2 microglobulin in the blood. High B2M indicates a more advanced stage, therefore, on a worse forecast for multiple melanoma.
When is the analysis assigned?
Measurement of beta-2 levels Microglobulin in the blood is used to determine the stage of multiple myeloma. And the analysis can be assigned to patients who are treated for this disease. In this situation, it helps to evaluate the effectiveness of the therapy. Sometimes it is used to find out the forecast of the disease with multiple myeloma and lymphoma.
Practicing doctors are very rarely used by the test for the definition of B2M in the spinal fluid in order to confirm the propagation of lymphoproliferative disease (lymphoma or leukemia) to the central nervous system.
How are the results are interpreted?
Increased beta-2 microglobulin in blood and urine indicates that there are problems. To determine which disease in the patient, other studies are needed, since the analysis is not diagnostic. If a person has already been confirmed the diagnosis of multiple myeloma or lymphoma, then the increase in protein levels indicates the activity of the oncological process. Indicators, significantly exceeding the norm, indicate a bad prognosis in these diseases.
Reducing the level of an oncomarcker in the blood during the therapy of multiple myeloma suggests that the disease reacts to the treatment carried out. Stable indicators or their growth indicates the ineffectiveness of the appointed therapy.
In some diseases (for example, HIV / AIDS), the increased content of beta-2 microglobulin in the spinal fluid indicates the defeat of the central nervous system.
Low levels are regarded as the norm. Beta-2 microoglobulin may not be detected in the urine and the spinal fluid - it is regarded as the norm.
What else should I know about the analysis?
Pathological states that are associated with an increased rate of cell destruction, severe infectious diseases, some viral infections (for example, such as cytomegalovirus) and autoimmune diseases can lead to an increase in B2M levels.
The doctor may assign the analysis to find out how the kidneys work
Normally, the B2M is almost completely reabsorbed by the kidneys. Therefore, in the urine is usually there are only small amounts. In case of damage to the renal tubules, reabsorption decreases, therefore the protein concentration as the disease progressing is growing.
Reception of drugs such as lithium, cyclosporine, cisplatin, carboplatin and aminoglycosidic antibiotics may be accompanied by an increase in the concentration of B2M both in blood and in the urine.
Nuclear medicine procedures, the use of radiocontrase drugs may affect the accuracy of the results obtained.
How much time will required for results?
It depends on the laboratory, where testing is carried out. Usually the result can be obtained already on the next worker.
Oncoscience
general characteristics
Beta-2-microglobulin - low molecular weight protein (11800 yes), component of a light chain system of the main system of histocompatibility of class I (MHC I), presented on all the human body cells (except erythrocytes). Blood - Beta-2-microglobulin levels reflects the main Cellular turnover and proliferation of lymphocytes, in which it is presented in large quantities. In the urine - the level of beta-2-microglobulin increases due to the impaired renal filtering (only the minimum amounts of proteins are detected in the urine, since most of the proteins are rehabbled in the tubules ).
Indications for destination
Blood marker of the development of diseases with the activation of the cell immune system (disease of the lymphatic system), an assessment of the response to therapy and further predictions - a highly sensitive marker of the diffidity of glomerular and tubular damage; Monitoring patients undergoing kidney transplant to identify early signs of rejection; Monitoring persons exposed to high levels of cadmium and / or other heavy metals, such as mercury, primarily due to professional impact; measurements of beta-2-microglobulin in serum and urine - differentiation between the activation of the lymphatic system and the impaired of the kidney function (in the urine with The acidic pH of the protein molecule is unstable). Beta-2-microglobulin can accumulate in joints (synovit) in patients who are long on hemodialysis; This is called amyloidosis associated with dialysis. The study of beta-2-microglobulin can be used in a comprehensive examination of a person to identify amyloidosis associated with dialysis.
Marker
Marker of lymphoproliferative diseases. Marker lesions of proximal renal tubules
Clinical significance
Blood assessment of the development of diseases with the activation of the cellular immune system (disease of the lymphatic system), an assessment of the response to therapy and further predictions - the diffidity of glomerular and tubular damage; Monitoring patients undergoing kidney transplant to identify early signs of rejection; Monitoring persons exposed to high levels of cadmium and / or other heavy metals, such as mercury, primarily due to professional impact; measurements of beta-2-microglobulin in serum and urine - differentiation between the activation of the lymphatic system and the impaired of the kidney function. Beta-2 -Microglobulin can accumulate in the joints (synovit) in patients who are long on hemodialysis; This is called amyloidosis associated with dialysis. The study of beta-2-microglobulin can be used in a comprehensive examination of a person to identify amyloidosis associated with dialysis.
Composition of indicators:
Beta-2-microglobulin
Method
:
Chemiluminescent immunoassay
Measurement range
:
>0.004
unit of measurement
:
Milligrams per liter
Reference values:
Comments
Performance is possible on biomaterials:
Biological material
Terms of delivery
Container
Serum
Delivery Terms:
24 hour. At temperatures from 2 to 25 degrees Celsius
Container:
Vaccuteiner with separation gel
8.5 milliliters
Patient preparation rules
In the morning to 11-00, an empty stomach, after 8-12 hours of fasting. Maybe: During the working day of departments ML "DILE". Break at least 6 hours after meals (eliminate fatty food)
Interference:
- X-ray protection
- In the urine with sour pH, the protein molecule is unstable.
Interpretation:
- In the blood, the elevated level of beta-2-microglobulin reflects an increase in synthesis for states associated with an increase in the activity of the immune system: multiple myeloma, Hodgkin's disease, chronic lympholoicosis and other malignant non-Hodgkin lymphoma. Other diseases with the activation of the cell immune system (infection, autoimmune diseases) also cause an increase in the level of beta-2-microglobulin in serum. Vich - reverse correlation between beta-2-microglobulin levels and CD4 + T-lymphocytes. High level beta-2-microbulin level Blood and low content in the urine are characteristic of dysfunction of globs. The well-level beta-2-microglobulin levels in the urine and low blood content are characteristic of damage / diseases of the kidneys. The level of beta-2-microglobulin level in the blood and in the urine is characteristic of chronic lymphoid leukemia. , Nepodgkinsky lymphoma and lymphoma Hodccavnoy urine- increase in the excretion of beta-2-microglobulin is observed in Wilson's disease, fanconi syndrome, interstitial nephrite, diseases of the connective tissue (rheumatoid arthritis, SHEGREEN syndrome), infections of the upper urinary tract, nephrotoxicity with cyclosporine, aminoglycosides, cisplatin therapy . Highly sensitive to the diffidity of the proximal dysfunction, infection of the upper urinary tract from the lower infection, is useful for diagnosing and monitoring therapy of acute pyelonephritis. The level of beta-2-microglobulin level in the urine in patients, long-term hemodialysis occurs during amyloidosis associated with dialysis. Beta-2-microglobulin in the urine in patients with kidney transplantation may indicate an early renal renewal. The level of beta-2-microglobulin in the urine in persons exposed to high levels of cadmium or mercury may be an early kidney dysfunction marker.
Microglobulin - renal channel lesion marker
This indicator is often used in oncohematology, that is, in the section of medicine dedicated to the oncological pathology of the blood formation system, as well as in nephrology as an early indicator of damage to the proximal kidney channels. Accordingly, this marker can be explored in the blood and in the urine.
Beta-2-microglobulin - protein relating to the human leukocyte antigen complex (HLA), whose molecules are available on most cells of the human body. This protein is associated with the Alpha-1 and Alfa-3 molecules located nearby, and together they refer to the main complex of 1 class histocompatibility (MHC 1), which is not only on red blood cells and trophoblast cells.
It was noted that the concentration of the indicator in the blood specially correlates with the amount of lymphocytes, on the surface of which most of all such molecules are located, so to track the processes of the proliferation of these cells are most convenient, which is important in the field of oncohematology.
The second important point is the issue of eliminating protein from the body. The lifetime of beta-2-microglobulin is about 3.5 hours, respectively, accordingly, it is actively being studied and actively eliminated by the kidneys. If we dispose of the plasma protein of the possibility and the renal clearance indicators decreased, it is possible to suspect the pathology of the filtering apparatus of the kidneys, which is important in the field of nephrology and transplantology.
Normal values \u200b\u200bof the indicator
Normal values \u200b\u200bdepend on age
Often the laboratory in which the analysis is carried out, indicates reference values \u200b\u200btaking into account the errors of the equipment, therefore, in different diagnostic centers, normal indicators may differ slightly from each other.
The normal concentration of beta-2-microglobulin in the blood correlates with the age of a person. In children of the first half of the year of life, there is a rather high norm of this protein: on average - 1.6-4 mg / l. At the age of 6-12 months, the indicator is reduced to 0.8-2.5 mg / l. In children under 7 years of age, the level of the protein is kept at a rather stable level of 0.7-2.3 mg / l, after which it is a decrease - 0.6-1.7 mg / l. For persons, an indicator of 0.67-2.3 mg / l is considered over 18 years of age.
The level of beta-2-microglobulin in the urine is more stable - less than 0.3 mg / l regardless of age.
Increased indicator: causes, signs and symptoms
Research is used to identify viral diseases
Increasing the values \u200b\u200bof beta-2-microglobulin in the blood usually indicates one of the processes:
- Tumor lesions of the organs of the hematopoietic system, lymphoproliferative processes. The most frequent diseases are lymphocytic leukemia, myeloma disease, Hodgkin lymphoma, non-Hodgkinsky lymphoma.
- Autoimmune processes associated with the aggressive effect of immune cells on the tissue and organs of the patient. Ethiology is usually not known. Genetic mutations, hereditary predisposition, the action of the genome of viruses on human cells is considered predisposing factors. The most frequent diseases: systemic red lupus, SHEGREEN syndrome, systemic sclerodermia, rheumatoid arthritis.
- Viral diseases for whom a lifetime persistence of a virus in the human body is characteristic. For example, HIV, cytomegalovirus, Epstein-Barr virus. The listed infectious agents destroy the cells of the lymphoid series, as a result of which the concentration of the protein contained in them increases in serum.
- Kidney lesions: transplant rejection, HBP, Lupus jade, infection, toxins.
Beta-2-microglobulin - an indicator, important in nephrology
Increased beta-2-microglobulin values \u200b\u200bin the urine can be in two cases:
Symptoms and signs depend on specific pathology.
For example, when kidney damage, an ether-minded syndrome is often observed, it can be rapidly, either reduced urination, urine can be muddy, dark or clarified, sometimes it acquires an uncharacteristic smell. Often, a patient has pain in the lumbar region, fever may appear, octants. In the blood tests, it is important to track the indicators of erythrocytes, leukocytes, ESR, CRP, creatinine, urea, electrolytes.
In the case of hematological diseases, for example, lymphoblastic leukemia, the patient is worried about intoxicating sidroma, anemia, thrombocytopenia, an increase in the size of the liver, spleen, etc. In the case of myeloma disease, the destruction of bones is observed, often skulls, vertebrae. The kidneys are affected, symptoms of anemia arise, the level of calcium, serum paraprotein is increased in the blood. In the case of oncohematological diseases, the most informative indicator is the cytological picture of the bone marrow.
Reduced indicator: causes, signs and symptoms
Patients with low indicator should be added to
Special diagnostic value, the decrease in the blood indicator does not carry, it occurs in the case of
- successful treatment of oncohematological diseases;
- with enhanced removal of protein with urine (kidney should be added).
The low rate of beta-2-microglobulin in the urine (up to 0 mg / l) is the norm.
Testimony
In suspected an autoimmune process a study is appointed
- Suspicion of the oncohematological process in the body (leukemia, lymphoma, myeloma disease).
- Suspicion of the autoimmune process in the body, assessing the activity of the disease.
- Pathological processes in the kidneys:
- with chronic renal failure due to autoimmune processes, diabetes, vascular diseases of the kidneys;
- with intoxication due to the action of heavy metals (cadmium, mercury, lead), chemical compounds, including drugs;
- monitoring the kidney state after its transplantation;
- in difficulties in the localization of the infectious process in the urinary system (the differences in the inflammation of the upper and lower urinary tract).
Preparation for analysis
Medicinal preparations are advisable to cancel the day before
This analysis usually does not require careful preliminary preparation. Recommendations for blood analysis Universal:
- it is advisable to donate blood in the morning on an empty stomach (after night starvation 8-10 hours), or at any time of the day no earlier than 4 hours after the last meal;
- before the study, you can drink water in moderate quantity, but with tea, coffee, gas and alcohol, it is better to pay it better;
- on the eve of the study (in 2-3 days), avoid extremes - food overloads of calorie food and hunger;
- do not smoke 30-60 minutes before analysis;
- it is advisable to limit hard physical, mental loads and physiotics 1-2 days before analysis;
- medicinal preparations are not vital for the patient, it is also recommended to cancel 2-3 days before the study.
When taking the urine analysis, it is necessary to comply with the rules of hygiene when collecting urine, use a new sterile container, collect urine directly on the day of analysis in 1-3 hours before it.
Decoding test results
Interprets the results of the doctor
The laboratory issues a conclusion about the concentration of protein in the blood or in the urine. Usually, the conclusion indicates normal reference values, the unit of measure adopted in this laboratory (more often - mg / l), as well as indicators of beta-2-microglobulin in a particular patient. Clinical conclusions The laboratory does not give, but can list a number of pathologies, in which the result can be increased.
Clinical diagnosis can only be installed by a hematologist, nephrologist or other doctor competent in this area. To establish a specific diagnosis of one analysis on beta-2-microglobulin, as a rule, it is part of a large diagnostic complex in which there may be common blood and urine tests, biochemical analyzes, analyzes of the puncture biopsy of bone marrow, lymph nodes, visualizing research methods ( Ultrasound, radiography, CT, MRI) and many others.
What can affect the result?
Physical exertion on the eve of the test results can distort the test results.
- Incorrect preparation.
- Conducting a study without taking into account the drugs taken.
- Malfunction of technology in the laboratory.
Correction of indicators
The correction of the beta-2-microbulin level occurs in the case of the patient's treatment from the main pathological process in the body. For example, from oncohematological diseases are treated in stationary conditions, using long-term chemotherapy, during which the beta-2-microbulin rate can be used to track the dynamics and reduction of lymphoid proliferation in the body.
Only profile doctors, for example, hematologists, nephrologists, rheumatologists, infectiousists are engaged in treating diseases.
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