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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 <http://www.medway.nhs.uk/> <https://twitter.com/Medway_NHS_FT> <https://www.facebook.com/Medway-NHS-Foundation-Trust-334375793239893/> <https://www.linkedin.com/company/medway> ------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 Green Laboratories Work http://www.laboratorymedicine.nhs.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/