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[False positive FDP test associated with malignant lymphoma]

K Kitazume¹, K Usuki, M Endo

¹Division of Hematology, Kanto Teishin Hospital.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology

|January 1, 1997

Summary

False positive fibrin degradation product (FDP) test results in a lymphoma patient were caused by monoclonal IgM, not actual clotting issues. This highlights the need to consider autoantibodies in interpreting laboratory diagnostics.

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Area of Science:

Hematology
Clinical Chemistry
Immunology

Background:

Fibrin degradation product (FDP) testing is crucial for diagnosing disseminated intravascular coagulation.
Monoclonal gammopathies can interfere with various laboratory assays.
This case involves a patient with non-Hodgkin's lymphoma and abnormal coagulation parameters.

Observation:

The patient presented with elevated FDP, prolonged prothrombin time (PT), and activated partial thromboplastin time (APTT).
Standard anticoagulation therapy did not resolve the abnormal coagulation parameters.
Steroid pulse therapy normalized coagulation markers but paradoxically increased FDP levels.

Findings:

Dilution analyses and a positive pregnancy test indicated false positive FDP results due to serum latex agglutinin.

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Addition of anti-immunoglobulin antibody inhibited latex agglutination.

FDP levels showed a positive correlation with serum IgM concentrations, suggesting monoclonal IgM as the cause.

Implications:

Monoclonal immunoglobulins, particularly IgM, can cause false positive FDP test results.
This interference can complicate the diagnosis and management of coagulation disorders.
Clinicians should be aware of potential laboratory interferences in patients with monoclonal gammopathies.