Elevated Globulin

Globulins are antibodies (found and measured in the blood) that are elevated in inflammatory conditions, infections, and some cancers. We often find the globulin level to be elevated in people with Down syndrome in a non-specific pattern with no clear etiology found. In other words, it seems to be commonly elevated without a known cause.

However, we do want to assess for possible abnormalities associated with an elevated globulin. When we find an elevated globulin, we start by taking the patient’s history and doing a physical exam. We evaluate for:

• History

  • Any symptoms of inflammation or infection

  • Liver disease: Acute and chronic liver disease can be associated with an elevated globulin. Chronic hepatitis B is ten times more common in people with Down syndrome.

  • Diarrhea: Celiac disease is more common in people with Down syndrome and is associated with an elevated globulin.

  • Back pain: This can be a symptom of multiple myeloma, a form of cancer associated with an elevated globulin.

  • Kidney disease: This can be seen with multiple myeloma.

  • Weight loss: This can be associated with celiac disease, multiple myeloma, and forms of chronic inflammation.

• Physical Exam

  • Any signs of inflammation or infection

  • Liver abnormalities

  • Back pain

• Labs

  • Liver transaminases (blood tests evaluating the liver)

  • Anti-tissue transglutaminase IgA (blood test assessing for celiac disease)

  • CBC (blood count)

  • Serum protein electrophoresis (blood test that evaluates the different proteins in the blood including the globulins)