Beta 2 Microglobulin

Immunity

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No Fasting Required

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Group of blood proteins involved in immune function

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Beta 2 Microglobulin Test Information Guide

Why is it done?
- Test Description: Measures the level of beta-2 microglobulin (B2M), a small protein found on the surface of all cells and released into blood and urine; used as a tumor marker and indicator of kidney function and immune system activity
- Primary Indications: Monitor multiple myeloma progression and prognosis; evaluate kidney disease progression; assess certain viral infections (HIV, CMV); detect lymphoid malignancies; evaluate occupational exposure to toxic substances
- Typical Timing: At diagnosis of multiple myeloma or lymphoproliferative disorders; during treatment monitoring; at baseline for kidney disease assessment; periodic screening in occupational health contexts; during workup of unexplained kidney dysfunction
Normal Range
- Serum Reference Range: 0.8 - 2.4 mg/L (or 0.8 - 2.2 ng/mL depending on laboratory method)
- Urine Reference Range: Less than 300 µg/L or 0 - 0.3 mg/L
- Units of Measurement: mg/L (milligrams per liter) or µg/L (micrograms per liter); ng/mL (nanograms per milliliter) for some assays
- Result Interpretation: Normal (negative) - Within reference range, indicates normal kidney function and cell turnover; Low levels - Unusual, may indicate certain immune conditions; Elevated (positive) - Above reference range, indicates increased cell turnover, kidney dysfunction, or malignancy; Very elevated - Strongly associated with disease progression or severity
- Important Note: Reference ranges vary by laboratory and testing method; always compare results to the specific reference range provided by your laboratory
Interpretation
- Mildly Elevated (2.5 - 5.0 mg/L): May indicate early-stage kidney disease, acute viral infections, autoimmune conditions, or early multiple myeloma; warrants further investigation and monitoring
- Moderately Elevated (5.0 - 10.0 mg/L): Suggests progressive kidney disease, active HIV infection with immune suppression, or established multiple myeloma; indicates intermediate disease burden
- Markedly Elevated (>10.0 mg/L): Indicates advanced kidney disease, severe immunosuppression, multiple myeloma with high tumor burden, or other significant lymphoproliferative malignancy; associated with poor prognosis
- Elevated Urine Levels: Indicates glomerular filtration impairment, tubular reabsorption dysfunction, or occupational/environmental toxic exposure affecting kidney tubules
- Factors Affecting Results: Kidney function (elevated in renal impairment); infection status (elevated in acute/chronic infections); age (tends to increase with age); body composition; dehydration; certain medications; laboratory assay method; timing of collection
- Clinical Significance Patterns: Rising levels over time - Indicates disease progression or worsening kidney function; Stable levels - Suggests controlled disease or stable kidney function; Falling levels - May indicate response to treatment or disease remission; Discordance between serum and urine levels - Suggests specific patterns of kidney dysfunction
Associated Organs
- Primary Organs Involved: Kidneys (primary), immune system (B lymphocytes and plasma cells), bone marrow, lymph nodes
- Associated Conditions - Hematologic: Multiple myeloma (primary indication); Waldenström macroglobulinemia; chronic lymphocytic leukemia (CLL); lymphoma (Hodgkin and non-Hodgkin); acute lymphoblastic leukemia; other B-cell malignancies
- Associated Conditions - Renal: Chronic kidney disease (all stages); acute kidney injury; diabetic nephropathy; glomerulonephritis; membranoproliferative glomerulonephritis; systemic lupus erythematosus (SLE) nephritis; multiple myeloma cast nephropathy; focal segmental glomerulosclerosis
- Associated Conditions - Infectious: HIV/AIDS (high levels correlate with CD4 count); cytomegalovirus (CMV) infection; tuberculosis; hepatitis C; severe viral infections; tuberculosis; opportunistic infections in immunocompromised patients
- Associated Conditions - Other: Systemic lupus erythematosus; rheumatoid arthritis; Sjögren's syndrome; post-transplant lymphoproliferative disorder (PTLD); autoimmune conditions with kidney involvement; occupational exposure to cadmium or other toxins
- Potential Complications/Risks Associated with Abnormal Results: Progressive renal failure requiring dialysis; end-stage renal disease; disease progression in multiple myeloma; treatment resistance; increased infection risk; organ damage; reduced life expectancy; need for intensive therapeutic interventions
Follow-up Tests
- If Multiple Myeloma Suspected: Serum protein electrophoresis; immunofixation electrophoresis; free light chains assay; bone marrow biopsy; cytogenetic testing; FISH analysis; skeletal survey or PET-CT; lactate dehydrogenase (LDH)
- If Kidney Disease Indicated: Serum creatinine; blood urea nitrogen (BUN); glomerular filtration rate (GFR) calculation; urinalysis; urine protein quantification; urinary albumin-to-creatinine ratio; renal ultrasound; kidney biopsy (if indicated); electrolyte panel (sodium, potassium, chloride, bicarbonate); phosphorus and calcium levels
- If HIV/Immunosuppression Suspected: CD4 T-cell count; HIV RNA viral load; CMV testing; absolute lymphocyte count; immunoglobulin levels; opportunistic infection screening based on CD4 level
- If Occupational Exposure Suspected: Urinary cadmium levels; urinary retinol-binding protein; occupational history assessment; pulmonary function tests; chest imaging if indicated
- For Lymphoproliferative Disorders: Complete blood count (CBC) with differential; lactate dehydrogenase (LDH); flow cytometry; lymph node biopsy; imaging studies (CT, PET-CT); additional tumor markers
- Monitoring Frequency for Ongoing Conditions: Multiple myeloma - Every 1-3 months during active treatment, every 3-6 months during remission; Chronic kidney disease - Every 3-6 months based on stage; HIV/AIDS - Every 3 months for CD4 monitoring; Post-transplant - Monthly initially then per protocol; Occupational exposure - Annual or as clinically indicated
- Complementary Tests: Cystatin C (alternative kidney function marker); retinol-binding protein (RBP); alpha-1 microglobulin (other low molecular weight proteins); prealbumin; albumin levels
Fasting Required?
- Fasting Requirement: No
- General Preparation Instructions: No fasting required; can eat and drink normally before test; test can be performed at any time of day; hydration status should be consistent with baseline if monitoring trends
- Sample Collection: Blood sample from venipuncture (serum or plasma); urine sample (random or 24-hour collection depending on clinical indication); morning first void urine is typically preferred for standardization
- Medications to Avoid: No medications need to be discontinued before the test; continue all prescribed medications as directed; some medications may affect results (diuretics, ACE inhibitors, NSAIDs may affect kidney function) - inform laboratory of current medication list
- Other Preparation Considerations: Maintain consistent hydration status for comparable results; avoid strenuous exercise immediately before blood draw; arrive early to sit quietly for 5-10 minutes before venipuncture; inform phlebotomist of recent illnesses or infections; provide information about occupational exposures if relevant
- For 24-Hour Urine Collection: Discard first morning void, then collect all urine for exactly 24 hours; keep collection container cool or refrigerated; record total volume; avoid contamination; inform laboratory of collection timing accuracy

How our test process works!