Hi Graham,
I know the Roche D-HDL Cholesterol is affected by monoclonal proteins, both falsely low and high results have been reported. Don't know whether this also applies to the total cholesterol. Have you ruled out M-proteins in this patient? Any history of MM?
Regards,
Godfrey
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Graham Bishell
Sent: Wednesday, May 10, 2006 7:02 AM
To: [log in to unmask]
Subject: HDL CHOLESTEROL
I would be grateful for opinions on the HDL cholesterol results on a
renal patient.
The last 3 results on this patient are:
total cholesterol HDL cholesterol
8.5 6.0
6.7 4.5
7.5 5.5
all mmol/L. The patient is a middle aged woman with renal failure (eGFR
20). She is on no unusual drugs, her triglycerides are normal and there
is no unusual appearance to the serum.
We use the Roche Modular method which uses magnesium sulphate and
dextran sulphate to form water soluble complexes with LDL, VLDL and
chylomicrons that are resistent to PEG modified enzymes. Unless these
results are genuine (which is possible) something is presumably
interfering with the formation of the complexes.
On this subject in general, we have noticed that the HDL cholesterol
results that we get with the Roche method are generally high when
compared with their quoted reference range. Our local reference range
study confirmed this. It is not at all unusual to find results of
greater than 3 mmol/L. Do other users also find this? We perform well on
EQAS.
Graham Bishell
Chief BMS
Chemical Pathology
Swansea NHS Trust.
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