title: Clinical associations of an increased transthyretin band in routine serum and urine protein electrophoresis.
abstract: The 9697 electrophoretograms performed over an 8 year period were reviewed to identify the frequency and clinical associations of the finding of a prominent transthyretin band in serum or urine, the concentration of which was equal to or greater than a 64 mg/dL protein calibrator. All samples were electrophoresed at a constant 90 V using agarose gels with a barbital buffer pH 8.6 and Ponceau S staining. Reference calibrators were used as standards to identify increased transthyretin bands and the patients' clinical records were subsequently reviewed. High values were found in 46 patients' sera and a further nine patients' urines representing 0.57% of the total workload. Renal impairment was present in 58% of cases including those with chronic renal failure, the nephrotic syndrome and paraproteinaemia. The high levels were not persistent in three myeloma cases where there was a recovery in renal function following chemotherapy. In some nephrotics, a high urine transthyretin may be secondary to a general hepatic albumin and transport protein synthesis response to severe proteinuria. Why the serum transthyretin was elevated in many other cases remains unclear.
authors.affiliation: Department of Chemical Pathology, Beaumont Hospital, Dublin, Ireland.
authors.forename: W P
authors.initials: WP
authors.lastname: Tormey
authors.forename: P A
authors.initials: PA
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001797:Blood Protein Electrophoresis; D002138:Calibration; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000378:metabolism* / Q000652:urine; D007676:Kidney Failure, Chronic / Q000097:blood / Q000652:urine; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000652:urine; D009404:Nephrotic Syndrome / Q000097:blood / Q000652:urine; D010265:Paraproteinemias / Q000097:blood / Q000503:physiopathology / Q000652:urine; D011228:Prealbumin / Q000032:analysis* / Q000652:urine*; D011507:Proteinuria
chemical_list: D011228:Prealbumin