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Serum separation abnormality in a multiple myeloma patient
M R Zaharudin1, S C Thambiah2, I N Samsudin1
1Universiti Putra Malaysia, Faculty of Medicine & Health Sciences, Department of Pathology, 43400 Serdang, Malaysia.
The Malaysian Journal of Pathology
|April 29, 2023
Summary
M-protein from multiple myeloma can interfere with laboratory tests, causing issues like improper serum separation in blood samples. This case highlights a significant pre-analytical interference that can affect diagnostic accuracy.
Area of Science:
- Clinical Chemistry
- Hematology
- Diagnostic Laboratory Science
Background:
- Monoclonal proteins (M-proteins) secreted by myeloma cells are associated with disease complications.
- M-proteins are known to cause interference in various laboratory assays.
- This interference can lead to pre-analytical issues affecting sample integrity.
Observation:
- A 62-year-old woman presented with a blood sample exhibiting improper serum separation despite repeat centrifugation.
- Subsequent sampling yielded minimal serum with highly elevated total protein levels.
- The patient had a confirmed diagnosis of multiple myeloma.
Findings:
- The M-protein in the patient's serum interfered with the serum separation process in standard laboratory tubes.
- This interference led to a significant pre-analytical error, complicating sample processing.
- Elevated total protein levels were a direct consequence of the M-protein presence.
Implications:
- M-protein interference represents a rare but critical challenge in clinical laboratory diagnostics.
- Awareness of M-protein-related pre-analytical issues is crucial for accurate patient diagnosis and management.
- Laboratory protocols may need to be adapted to mitigate M-protein interference in specific patient populations.
