A paraprotein interference and its management in clinical laboratory / Bir paraprotein interferansı vakasının klinik laboratuvarda yönetimi

In the present study we describe a patient who has interference due to paraproteinemia in her labaratory results. In a patient with a total protein concentration of 10.8 g/dL, a direct bilirubin result higher than total was detected. She also had discordant results in her whole blood count parameters. Further investigation was performed on this patient. Presence of any cold agglutinin and cryoglobulin was tested and excluded first. After 2-mercaptoethanol (2-ME) treatment, patient was idendified as Ig-M Kappa monoclonal gammapathy on immunofixation electrophoresis (IFE). Direct bilirubin interference disappeared after removal of the paraprotein by polyethylene glycol (PEG) precipitation. Laboratory specialist should know paraprotein interference and be able to manage it.