Albumin globulin ratio reversal is seen in

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albumin globulin ratio reversal causes cirrhosis chronic liver disease

Reversal of the albumin:globulin ratio, meaning A:G < 1, is classically seen in:
  • Chronic liver disease/cirrhosis: reduced albumin synthesis with increased immunoglobulins
  • Multiple myeloma and other gammopathies
  • Chronic infections and autoimmune/inflammatory conditions may also cause it
If this is a single-best-answer question, the usual answer is cirrhosis of liver. The medical text also specifically notes A:G reversal in multiple myeloma.
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