An elderly patient with BPH came to A&E, I think because his urinary
catheter had become blocked. PSA on this sample was 1.8ug/L (Bayer Centaur
method), creatinine 97umol/L. He has mild hypercalcaemia and a serum
paraprotein band of 8g/L (being typed at the moment).
He was admitted and the catheter was unblocked. He is thought to have a UTI
but no significant urinary retention. 3 days later, we received 2 more serum
samples from him (not for any good reason - the usual administrative and
communication problems!). The PSA on these samples is 103 and 95ug/L,
creatinine now 139umol/L.
These results all checked out fine by repeat analysis. My first guess that
the original sample was from a different patient now seems unlikely as the
electrophoretic pattern is exactly the same in the later samples. The
original sample was unfortunately rather small, and little remains for
further testing.
I have previously seen a PSA of 21ug/L in a very severe case of chronic
retention, which gradually declined to 5ug/L after relief of the
obstruction, but have no idea of the time-scale over which it would have
increased. The magnitude and rate of this increase seems too high for such
an explanation anyway.
Can anyone shed any light on this for me please? Thanks very much.
Angela Woods
West Herts Hospitals Trust
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