Clinical Significance of Laboratory Findings in a 10-Year-Old Boy
These laboratory values are within normal limits for a healthy 10-year-old child and require no further evaluation or intervention. 1, 2
Interpretation of Laboratory Values
Total Protein and Albumin Assessment
- Total protein of 6.6 g/dL is normal for a pediatric patient, falling within the expected reference range for this age group 3, 1
- Albumin of 4.9 g/dL is excellent and indicates normal hepatic synthetic function, as albumin is produced exclusively by the liver 1, 4
- Normal albumin levels (≥3.5 g/dL) rule out hypoalbuminemia and its associated complications such as nephrotic syndrome, protein-losing enteropathy, or chronic liver disease 1, 4
Globulin and A/G Ratio Analysis
- Globulin of 1.8 g/dL is at the lower end of normal but not pathologically low for a pediatric patient 2, 5
- Albumin-to-globulin ratio of 2.7 is elevated but reflects the relative proportion of albumin to globulin rather than an absolute deficiency 2, 6
- The calculated globulin (total protein minus albumin = 1.7 g/dL) is consistent with the reported value and does not meet criteria for antibody deficiency screening (which requires calculated globulin <18 g/L or 1.8 g/dL) 5
Gamma Globulin Evaluation
- Gamma globulin of 0.7 g/dL is within normal range for a 10-year-old child 7
- Historical data shows that gamma globulin levels ≤0.5 g/dL during the first year of life may be associated with dietary protein insufficiency, but this threshold does not apply to a 10-year-old 7
- The gamma globulin level in this patient does not suggest immunodeficiency or chronic infection 1, 7
Clinical Context and Reassurance
Why No Further Workup Is Needed
- The slightly elevated A/G ratio is physiologic and reflects robust albumin production relative to globulins, not a pathologic state 2, 6
- All protein fractions are adequate to support normal growth, immune function, and metabolic processes in a healthy child 3, 7
- The absence of hypoalbuminemia (albumin <3.5 g/dL) excludes the major differential diagnoses that would require investigation, including chronic kidney disease, chronic liver disease, autoimmune disorders, and protein-losing conditions 1, 4
Common Pitfalls to Avoid
- Do not overinterpret the elevated A/G ratio as indicating globulin deficiency when absolute globulin levels are normal 2, 6
- Do not pursue immunodeficiency workup unless calculated globulin falls below 1.8 g/dL (18 g/L) or clinical signs of recurrent infections are present 5
- Do not attribute normal variations in protein fractions to pathology in an otherwise healthy child without supporting clinical evidence 3, 1
Monitoring Recommendations
No specific monitoring is required for these laboratory values in a healthy child. Routine pediatric care with age-appropriate health maintenance visits is sufficient 3