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A Case of Falsely Low Serum Creatinine by Enzymatic Method due to Immunoglobulin M Paraprotein Interference
Background:
We report a case of negative serum creatinine (SCr) value due to the interference of immunoglobulin M (IgM) paraprotein.
Methods:
We measured SCr using dilution patterns of 1:10, 1:20, 1:50 on Roche Cobas®c702 analyzer. Then the patient's serum was precipitated 1:1 with polyethylene glycol (PEG) 6000 and was measured for SCr. Additionally, we used the VITROS® 350 Dry Chemistry platform to measure SCr.
Results:
The correct SCr results could not be obtained by normal and dilution patterns, and there were abnormal reaction curves. Reliable SCr results were obtained by PEG precipitation or dry chemical determination.
Conclusions:
The negative Scr value by enzymatic method was caused by the IgM paraprotein. Looking at the SCr reaction curve was an easy way to observe the presence of IgM paraprotein interference.
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