Serum protein electrophoresis in nephrotic syndrome (minimal change disease) typically shows:

• A Decreased albumin with increased alpha-2 globulin fraction ✓
• B Monoclonal spike in the gamma region
• C Diffuse hypergammaglobulinemia with beta-gamma bridging
• D Elevated beta-1 (transferrin) fraction with normal albumin

Explanation

In nephrotic syndrome, urinary albumin loss causes hypoalbuminemia. The liver compensatorily increases synthesis of larger proteins including alpha-2 macroglobulin, causing elevated alpha-2 globulin on SPEP. Smaller immunoglobulins are also lost in urine, giving relative hypogammaglobulinemia. Monoclonal spike characterizes myeloma; beta-gamma bridging suggests cirrhosis; elevated transferrin with normal albumin is not a typical nephrotic pattern.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.