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Calculated globulin is clinically useful as a screening test for antibody deficiency in Turkish adult patients
  • +11
  • Aslı Akkor,
  • Osman Ozan Yeğit,
  • Pelin Karadağ,
  • Deniz Eyice Karabacak,
  • Nida Oztop,
  • Şengül Beyaz,
  • Can Tuzer,
  • Ali Can,
  • semra demir,
  • Derya Ünal,
  • Halim İşsever,
  • Sema Genç,
  • Beyhan Ömer,
  • Stephen Jolles
Aslı Akkor
Istanbul Universitesi Istanbul Tip Fakultesi

Corresponding Author:[email protected]

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Osman Ozan Yeğit
Istanbul Universitesi Istanbul Tip Fakultesi
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Pelin Karadağ
Istanbul Universitesi Istanbul Tip Fakultesi
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Deniz Eyice Karabacak
Istanbul Universitesi Istanbul Tip Fakultesi
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Nida Oztop
Istanbul Universitesi Istanbul Tip Fakultesi
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Şengül Beyaz
Istanbul Universitesi Istanbul Tip Fakultesi
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Can Tuzer
Istanbul Universitesi Istanbul Tip Fakultesi
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Ali Can
Istanbul Universitesi Istanbul Tip Fakultesi
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semra demir
Istanbul Universitesi Istanbul Tip Fakultesi
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Derya Ünal
Istanbul Universitesi Istanbul Tip Fakultesi
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Halim İşsever
Istanbul Universitesi Istanbul Tip Fakultesi
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Sema Genç
Istanbul Universitesi Istanbul Tip Fakultesi
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Beyhan Ömer
Istanbul Universitesi Istanbul Tip Fakultesi
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Stephen Jolles
University Hospital of Wales
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Abstract

Backgrounds: Heterogeneous clinical features of antibody deficiency (AD) may cause diagnostic delays. Calculated globulin (CG) (total protein minus albumin) has been proposed as a screening test to prevent morbidity due to diagnostic delays in AD. Our aim is to validate CG as a screening test in AD in Turkish adult patients by comparing its role with gamma globulin analysis in protein electrophoresis. Methods: Fifty serum samples were randomly collected for each level of CG from 1.5 to 2.5 mg/dl and tested for serum IgG, IgA, IgM levels and protein electrophoresis. Cut-off values predicting low IgG levels were calculated for electrophoretically determined gamma globulin and CG. Additionally, the data of 47 patients followed up in our clinic with a diagnosis of primary antibody deficiency (PAD) were retrospectively analyzed. Results: A total of 550 adult patients were included in the study. The CG value predicting patients with IgG <600 mg/dl as a screening test was determined as <2.0 with 83.8% sensitivity and 74.9% specificity. The gamma globulin value which predicted patients with the same IgG value of 89.0% sensitivity and 89.4% specificity was determined as <0.7. In the retrospective analysis, 37 of 47 patients (78.7%) with PAD had a CG value of <2.0 at the time of the diagnosis and all 13 patients (%100) whose gamma globulin values were measured at the time of the diagnosis had a gamma globulin value of <0.7. Conclusion: The determined CG cut-off value of <2.0 can be used as a screening test in Turkish adult patients.