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Dr. Bertholf Have you checked for paraprotein interference? I have seen rare cases in which this led to an artificially low hdl. Paraprotiens tend to cause precipitates while the reaction is running. Joe From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ian Young Sent: Wednesday, October 14, 2009 3:54 PM To: [log in to unmask] Subject: Re: Unusual lipid results Roger This is a very unusual set of results, as you are fully aware. I would be very suspicious that there is something causing negative interference with the cholesterol measurement. Do you know if the cholesterol methods used in the two labs relied on the same principle? I would proceed to ultracentrifugation (if available), plus measurement of apoA1 and apoB. Best wishes Ian Ian S.Young Professor of Medicine, Queen's University Belfast Wellcome Research Laboratories Top Floor ICS A Block Royal Victoria Hospital Grosvenor Road Belfast BT12 6BJ Northern Ireland tel: +44 2890 632743 fax: +44 2890 235900 email: [log in to unmask] From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Bertholf, Roger Sent: 14 October 2009 20:35 To: [log in to unmask] Subject: Unusual lipid results Total cholesterol = 210 mg/dL HDL cholesterol = 7 mg/dL LDL cholesterol = 2 mg/dL Triglyceride = 610 mg/dL LPE results: Appearance: Clear (?) Chylomicrons: negative Beta: normal Pre-beta: elevated Alpha: normal All of the tests (except the LPE) have been duplicated in two labs (and in one lab with two specimens). We do not perform LPE, but the results came back with the interpretation "Type IV," even though texts say that serum in Type IV hyperlipidemia is cloudy. Shouldn't a specimen with triglycerides >600 mg/dL be turbid? Can VLDL account for >95% of total cholesterol? Would serum with HDL 7 mg/dL and LDL 2 mg/dL give "normal" alpha and beta bands on LPE? The chair of our department of medicine has told me that an LDL of 2 mg/dL is incompatible with life. This is an (alive) 58 y/o female. I would appreciate any thoughts. Roger Roger L. Bertholf, PhD Professor of Pathology Director of Clinical Chemistry, Toxicology, and Point of Care Testing University of Florida Health Science Center/Jacksonville ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/