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Related Experiment Videos

Interference by IgG paraproteins in the Jaffe method for creatinine determination.

P Datta, G A Graham, I Schoen

    American Journal of Clinical Pathology
    |April 1, 1986
    PubMed
    Summary

    Monoclonal gammopathies, specifically IgG type, can interfere with serum creatinine tests using the Jaffe reaction, causing falsely low results. An enzymatic method is unaffected by this interference.

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    Area of Science:

    • Clinical chemistry
    • Immunology
    • Biochemistry

    Background:

    • Serum creatinine is a key biomarker for kidney function.
    • The Jaffe reaction is a common method for creatinine determination.
    • Monoclonal gammopathies can sometimes interfere with laboratory assays.

    Purpose of the Study:

    • To investigate a significant negative interference in serum creatinine measurements observed in myeloma patients.
    • To identify the cause of interference and compare different analytical methods.

    Main Methods:

    • Serum samples from myeloma patients were analyzed for creatinine using the Jaffe reaction and an enzymatic method.
    • Serum electrophoresis was performed to detect monoclonal proteins.
    • Interference removal techniques (acid precipitation, dithiothreitol) and dialysis were employed.

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  • Kinetic analysis of the Jaffe reaction was conducted.

    • Main Results:

    • A 60-100% negative interference in serum creatinine was observed in 3 of 18 myeloma patients with IgG monoclonal gammopathy using the Jaffe reaction.
    • No interference was detected with an enzymatic creatinine method.
    • The interferent was removable by acid precipitation or dithiothreitol and present in high molecular weight fractions.
    • The interferent was identified as likely being a specific monoclonal IgG, not albumin or normal gammaglobulin.

    Conclusions:

    • Certain monoclonal Immunoglobulins G (IgGs) can interfere with the Jaffe reaction, leading to falsely decreased serum creatinine levels.
    • The interference is specific to the Jaffe reaction and not observed with enzymatic methods.
    • This finding highlights the importance of considering monoclonal gammopathies when interpreting creatinine results, especially when using the Jaffe method.