C
TSH. If hypergammaglobulinemia on SPEP, check ANA and anti-smooth muscle Ab to assess for autoimmune hepatitis; will need liver biopsy for definitive diagnosis. If alpha-globulin band low on SPEP, check alpha1-antitrypsin level. If Fe/TIBC > 45%, high suspicion of hemochromatosis, send for ferritin. ................
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