Inverted A:G ratio is significant in which condition?

• A. Monoclonal Gammopathy
• B. Cirrhosis
• C. Acute Hepatitis
• D. Iron Deficiency Anemia

Answer: (A)

The albumin-to-globulin (A:G) ratio reflects the balance between the main serum proteins: albumin, made by the liver, and globulins, including immunoglobulins produced by plasma cells. In a healthy person, this ratio is usually above 1 because albumin makes up a larger share of the protein pool. When a monoclonal gammopathy develops, a single clone of plasma cells overproduces a specific immunoglobulin, causing a marked rise in gamma globulins. This disproportionate increase lowers the A:G ratio and can invert it (ratio below 1). That sizable shift toward a high globulin fraction is a classic clue pointing to a monoclonal gammopathy, such as multiple myeloma. Other conditions can affect the ratio, but they don’t typically produce the characteristic inversion driven by a monoclonal spike in immunoglobulins.