Clinical Pharmacology, Kyoto Pharmaceutical University, Kyoto, Japan
Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
BMJ Case Rep. 2024 Apr 25;17(4):e256242. doi: 10.1136/bcr-2023-256242.
We report a man in his 70s who presented with discrepant serum creatinine concentrations in different hospitals at the same time. Further examinations of these discrepancies revealed turbidity of the serum sample and, thus, a reagent reaction and false hypercreatinine caused by paraprotein interference were suspected. Serum protein electrophoresis revealed a small amount of monoclonal γ globulin (2.9 g/L), which may have been involved in paraprotein interference. Monoclonal λ-type IgG was detected in the serum, resulting in a diagnosis of monoclonal gammopathy of undetermined significance. Previous studies indicated paraprotein interference in serum containing monoclonal IgM or a large amount of IgG (> 25 g/L). Although this case of paraprotein interference induced by a small amount of IgG is rare, a discrepancy in creatinine results may be an indicator leading to the diagnosis of plasma cell proliferative diseases.
我们报告了一位 70 多岁的男性患者，他在同一时间于不同医院的血清肌酐浓度存在差异。进一步检查这些差异发现血清样本混浊，因此怀疑存在由副蛋白干扰引起的试剂反应和假性高肌酐。血清蛋白电泳显示少量单克隆γ球蛋白（2.9 g/L），可能参与了副蛋白干扰。血清中检测到单克隆 λ 型 IgG，诊断为意义未明的单克隆丙种球蛋白病。先前的研究表明，血清中单克隆 IgM 或大量 IgG（> 25 g/L）存在副蛋白干扰。虽然这种由少量 IgG 引起的副蛋白干扰的情况很少见，但肌酐结果的差异可能是导致浆细胞增生性疾病诊断的一个指标。
