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Case Reports
. 2019 Dec 7;5(3):377-381.
doi: 10.1016/j.ekir.2019.11.017. eCollection 2020 Mar.

Falsely Elevated Serum Creatinine Associated With IgM Paraproteinemia

Hiroyasu Mase  1 , Naoto Hamano  2 , Ryoko Mizuhara  2 , Tsukasa Nozaki  3 , Takayuki Saso  3 , Takehiko Wada  2 , Satomi Asai  1 , Hayato Miyachi  1 , Masafumi Fukagawa  2
Affiliations
Case Reports

Falsely Elevated Serum Creatinine Associated With IgM Paraproteinemia

Hiroyasu Mase et al. Kidney Int Rep. .
No abstract available

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Figures

Figure 1
Figure 1
Emergence of turbidity, due to mixture of the patient’s serum and the reagents in the kit of our laboratory, and its disappearance following the addition of salt solution. (a) Serum and first reagent; (b) panel (a) and second reagent; (c) panel (b) and 5 mol/l sodium chloride solution.
Figure 2
Figure 2
Reaction curves in creatinine measurement. The curve is distorted in this case (black line), but not in control serum without paraproteinemia with creatinine levels of 5.5 mg/dl (blue line).
Figure 3
Figure 3
Differences in reaction curves depending on sample pretreatment. A sharp elevation due to addition of the second reagent is observed in the serum of this case without pretreatment (black line), which is ablated by elimination of total protein (red line). This distortion is partially attenuated but present after removal of non-IgM protein with 2 agarose-embedded proteins (blue line).
Figure 4
Figure 4
Summary of creatinine measuring methods and mechanisms of interference. Mechanisms involved in this case are highlighted in red. *Adequate pretreatments eliminate interfering substances, including proteins. ID-LC/MS, isotope dilution liquid chromatography/tandem mass spectrometry.
See this image and copyright information in PMC

References

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