Measurement of Total Protein Is a Useful Inclusion in Liver Function Test Profiles

The letter by Watts et al. (1) indicated that the routine inclusion of total protein in liver function tests does not appear to contribute to patient management. We undertook a retrospective audit to assess the value of the addition of serum total protein to liver and bone profiles in detecting new patients with paraproteins. Requests for liver and bone profiles received by our laboratory during a 6-month period in 1999 were examined. A search of the computer system (William Woodard Associates) was made to select all cases with a total protein measurement >80 g/L, the upper limit of our reference interval. Each of these patient requests was analyzed to determine whether laboratory-initiated electrophoresis should be carried out or whether clinical details or other results suggested that this was not required.Total protein was measured by the Biuret method (2) on a Dax 72 analyzer (Bayer plc, Diagnostics Division). Our liver profile included total protein, albumin, calculated globulin, bilirubin, alkaline …