"Williams Karen (RPA) Medway Trust" ---2017-01-11 11:53:24---Hi

De : "Williams Karen (RPA) Medway Trust" <[log in to unmask]>
A : [log in to unmask]
Date : 2017-01-11 11:53
Objet : Intereference with total protein - any ideas?
Envoyé par : Clinical biochemistry discussion list <[log in to unmask]>

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Hi
 
We have a myeloma patient (IgG Kappa) who recently has TP results >100g/L which we expected would be due to rising paraprotein.
 

	23/11/16	20/9/16	21/6/16	9/2/16
TP g/L	117	109	100	91
Albumin g/L	37	37	36	36
Paraprotein g/L	17.9	30.0	37.4	29.7
Paraprotein %	15.3	27.5	37.4	32.6
Scan albumin g/L	66.1!	49.8	40.1	39.5
Scan albumin %	56.5	45.7	40.1	43.4

 
Visually the electrophoresis scans look as you would expect, the sample from 23/11/16 the paraprotein band looks narrower than the previous sample and the peak is much lower compared to albumin than on the previous scan.
 
Normally our scanned albumin results are close to the measured albumin results.
 
All of which leads us to believe the problem is with the TP result not the electrophoresis.  We don’t usually see interference from the paraprotein itself on the TP assay and have other patients with TP of this order which don’t look like this.
 
We have had a sample today, TP is 119g/L, on dilution results are linear.  We haven’t run electrophoresis on it yet.
 
Patient is on Bisoprolol, Oxazepam, Aspirin, Solifenacin, Lansaprazole, Bendroflumethiazide.
 
I have now found a second patient which looks suspiciously similar, TP yesterday 102g/L  PP 24g/L previous TP 86g/L PP also 24g/L visually on the scan the paraprotein has gone down on the most recent sample with the high TP.
 
Any ideas?
 
Thanks
 
 
Karen
Karen Williams
Clinical Biochemist
Biochemistry, Pathology
Diagnostics
Medway NHS Foundation Trust
 
01634 830000 Ext 5419/5244
 
Please note I work part time, my normal working days are Monday, Tuesday and Wednesday
 
Website: www.medway.nhs.uk 

       
 
 

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