May I ask a further question on the inferences seen with some myeloma patients?
We have a myeloma patient with the following results:
Tot. Protein 112 g/L
IgG 78,7 g/L
Na 127 mmol/L K 3,6 mmol/L (indirect ISE)
Cl 98 mmol/L
Ca 2.05 mmol/L
Phosph 0.85 mmol/L
Osmolality 280 mOsm/kg
Here, we probably have a pseudohyponatremia due to hyperviscosity. How are others dealing with this low sodium result? Do you advise to measure via direct ISE? Prior to centrifugation, we analysed this sample on our bloodgas meter, with 134 mmol/L as a result.
Kind regards,
Veronique
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Universitair Ziekenhuis Gent
Klinisch Ondersteunende Sector
Veronique Stove
PharmD PhD - Klinisch bioloog 24u lab
Klinische Biologie - Gebouw 2P8
Interne brievenbus: 2P8-klinische biologie
De Pintelaan 185 - B-9000 Gent
tel.: +32 (0)9 332 5871
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www.uzgent.be
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-----Oorspronkelijk bericht-----
Van: Clinical biochemistry discussion list [mailto:[log in to unmask]] Namens Fiona Davidson
Verzonden: woensdag 31 juli 2013 10:42
Aan: [log in to unmask]
Onderwerp: Re: Spurious hypocalcaemia and hyperphosphataemia
Thanks for all your responses.
I think the consensus is delayed separation. On closer inspection this sample seems to have been taken on a Friday and received in the lab on Monday. I have no idea why we analysed the sample as our policy is to take out all affected tests if a sample has been left unseparated overnight.
We have recently picked up a case of undiagnosed myeloma causing a spuriously raised phosphate, however, as this is a young, asymptomatic patient whose phosphate and calcium were back to normal on the next sample I think this would be an unlikely explanation.
Thanks
Fiona
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