Alpha-2 Globulin "Spike" in Renal Carcinoma

Abstract

A 44-year-old man was found to have a renal carcinoma after 8 months of constitutional symptoms. Initial study showed a puzzling array of laboratory abnormalities, including a prominent alpha-2 globulin "spike" on serum protein electrophoresis. Since the patient had plasmacytosis of the bone marrow, the diagnosis of multiple myeloma was considered but was discarded when the globulin proved to be haptoglobin. This case serves as a reminder of the propensity of early renal carcinoma to produce constitutional symptoms and of the variety of proteins that may produce alpha-2 peaks on electrophoresis.