单克隆副蛋白血症患者中通过直接法测得的低密度脂蛋白胆固醇浓度假性降低及高密度脂蛋白胆固醇假性无法检测。

Falsely low LDL-cholesterol concentrations and artifactual undetectable HDL-cholesterol measured by direct methods in a patient with monoclonal paraprotein.

作者信息

Tsai Li-Yu, Tsai Shih-Men, Lee Su-Chen, Liu Shu-Fen

机构信息

Department of Clinical Biochemistry, Faculty of Biomedical Laboratory Science, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.

出版信息

Clin Chim Acta. 2005 Aug;358(1-2):192-5. doi: 10.1016/j.cccn.2005.02.008.

DOI:10.1016/j.cccn.2005.02.008

PMID:15896728

Abstract

INTRODUCTION

Multiple myeloma is a malignant immunoproliferative disorder with lipoprotein abnormalities. We report a case of falsely low concentrations of LDL-cholesterol (LDL-C) and artifactural undetectable HDL-cholesterol (HDL-C) as measured with direct methods in a patient of multiple myeloma with IgGkappa monoclonal gammapathy and significant hyperlipidemia.

CASE REPORT

The patient had HDL-C and LDL-C concentrations in the 0.63-0.71 mmol/l and 2.22-2.36 mmol/l ranges, respectively, as measured by a traditional semi-quantitative electrophoresis method. The observation of falsely low concentrations of LDL-C and artifactural undetectable HDL-C might result in the mismanagement of patients of multiple myeloma with monoclonal gammapathy, because the LDL-C and HDL-C concentrations are positive and negative risk factors of cardiovascular diseases.

CONCLUSIONS

Care must be taken when using the homogenous method for direct measurement of LDL-cholesterol and HDL-cholesterol in patients of multiple myeloma with monoclonal paraprotein.

摘要

引言

多发性骨髓瘤是一种伴有脂蛋白异常的恶性免疫增殖性疾病。我们报告了一例多发性骨髓瘤患者，其伴有IgGκ单克隆丙种球蛋白病和显著高脂血症，采用直接法测量时出现低密度脂蛋白胆固醇（LDL-C）浓度假性降低以及假性无法检测到高密度脂蛋白胆固醇（HDL-C）的情况。

病例报告

采用传统半定量电泳法测量，该患者的HDL-C和LDL-C浓度分别在0.63 - 0.71 mmol/l和2.22 - 2.36 mmol/l范围内。LDL-C浓度假性降低以及假性无法检测到HDL-C的情况可能会导致对伴有单克隆丙种球蛋白病的多发性骨髓瘤患者管理不当，因为LDL-C和HDL-C浓度分别是心血管疾病的正性和负性危险因素。