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[Effects on M-protein on laboratory data].

K Fujita¹, I Sakurabayashi

¹Department of Medical Technology, School of Allied Medical Sciences, Shinshu University, Matsumoto 390-8621.

Rinsho Byori. the Japanese Journal of Clinical Pathology

|August 25, 2001

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Two patients presented with abnormal immunoglobulins. One had elevated serum fructosamine due to IgA-kappa M-protein, while the other experienced pseudo-leukocytosis from EDTA interaction with IgG-kappa M-protein.

Area of Science:

Clinical chemistry
Immunology
Hematology

Background:

Monoclonal gammopathies, such as M-protein production, can lead to various clinical manifestations.
Serum fructosamine (FRA) is a marker of glycemic control, but its elevation can be influenced by non-glycemic factors.
Ethylenediaminetetraacetic acid (EDTA) is commonly used as an anticoagulant, but can sometimes interfere with laboratory testing.

Observation:

Case 1: A non-diabetic patient with IgA-kappa M-protein exhibited markedly elevated serum fructosamine (FRA).
The elevated FRA in Case 1 was associated with high molecular weight fractions and demonstrated glycation of the IgA-kappa M-protein.
Case 2: A patient developed pseudo-leukocytosis upon EDTA anticoagulation, with white precipitates identified as IgG2-kappa M-protein.

Findings:

Related Experiment Videos

Serum FRA levels were elevated in non-diabetic patients with IgA M-protein but not with IgG or IgM M-protein.
The M-protein in Case 1 was conjugated to serum albumin.
EDTA-induced white precipitates in Case 2 were confirmed to be IgG2-kappa M-protein.

Implications:

Elevated serum FRA in non-diabetic individuals may indicate the presence of IgA-kappa M-protein.
The interaction between specific M-proteins and EDTA can cause artifactual laboratory results, necessitating careful interpretation.
These cases highlight the importance of considering M-protein characteristics when interpreting laboratory findings like FRA levels and white blood cell counts.