Hello Richard
While the urine electrophoresis suggests some protein degradation
(consistent with the UTI you mentioned), and your patient seems to be a bit
young to be producing monoclonal immunoglobulins, I can't see any gamma
globulin on your serum protein electrophoresis image. An assay of serum free
kappa and free lambda light chains might be interesting, even if the
gelofusin has been established as an interferent.
Regards
Richard Scarff
Biochemistry Dept
Royal Perth Hospital
<<pyrogallol interf.doc>> Problem solved (mostly)
Dear All
Alas the excitement is no longer as intense.
Thanks for all those who responded.
Suspects offered were gelofusine and aminoglycoside antibiotics. Patient
had been on cefradine, but not aminoglycosides, and gelofusin was mentioned
but nobody could remember how much or when. Examination of notes revealed 1
litre of gelofusin administered midway through the 24 hour collection.
Summary of results :
"total protein"
pyrogallol red (Olympus AU640) 5184 mg/L
benzethonium chloride (Roche 917) 357 mg/L
pyrocatechol violet-molyb/ox (Vitros) 330 mg/l
turbidimetric albumin (Olympus AU640) 69.6 mg/l
urine dipstick (Bayer) trace
shake the bottle vigorously unstable foaming
urine electrophoresis see attached
I am not convinced that the other methods don't also have interference,
since the albumin and "protein" concentrations are so discrepant. I have
aliquots of the urine in the freezer if anyone would like to play.
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
DA14 6LT
020-8308-3084
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