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It may depend on your assay. When we had a Beckman analyser, the multi-wavelength TP assay they used was affected by some drugs. Gor example sulphasalazine could result in a negative total protein result. ************************************************************************************** Prof. Tim Reynolds Consultant Chemical Pathologist, Burton Hospitals NHS Foundation Trust work tel: 01283 511511 ext 4035 work fax: 01283 593064 work email: [log in to unmask]<mailto:[log in to unmask]> work URL: www.burtonhospitals.nhs.uk<http://www.burtonhospitals.nhs.uk/> This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. If you have received this e-mail in error, please notify me on 01283 511511 Ext 4035 [Picture of tree not available] Please consider the environment before printing this e-mail From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Williams Karen (RPA) Medway Trust Sent: 11 January 2017 16:51 To: [log in to unmask] Subject: Intereference with total protein - any ideas? 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/> [cid:image001.jpg@01D1C64F.FB8B9540] [https://loebig.files.wordpress.com/2013/10/twitter1.png]<https://twitter.com/Medway_NHS_FT> [facebook] <https://www.facebook.com/Medway-NHS-Foundation-Trust-334375793239893/> [linkedin] <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/ ------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/