Detecting paraprotein interference on a direct bilirubin assay by reviewing the photometric reaction data
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Elena García-González
Abstract
Background:
The direct bilirubin (D-Bil) assay on the AU Beckman Coulter instrumentation can be interfered by paraproteins, which may result in spurious D-Bil results. In a previous work, we took advantage of this fact to detect this interference, thus helping with the identification of patients with unsuspected monoclonal gammopathies. In this work, we investigate the possibility to detect interference based on the review of the photometric reactions, regardless of the D-Bil result.
Methods:
The D-Bil assay was carried out in a set of 2164 samples. It included a group of 164 samples with paraproteins (67 of which caused interference on the assay), as well as different groups of samples for which high absorbance background readings could also be expected (i.e. hemolyzed, lipemic, or icteric samples). Photometric reaction data were reviewed and receiver operating characteristics (ROC) curves were used to establish a cut-off for absorbance that best discriminates interference.
Results:
The best cut-off was 0.0100 for the absorbance at the first photometric point of the complementary wavelength in the blank cuvette. Once the optimal cut-off for probable interference was selected, all samples analyzed in our laboratory that provided absorbance values above this cut-off were further investigated to try to discover paraproteins. During a period of 6 months, we detected 44 samples containing paraproteins, five of which belonged to patients with non-diagnosed monoclonal gammopathies.
Conclusions:
Review of the photometric reaction data permits the systematic detection of paraprotein interference on the D-Bil AU assay, even for samples for which reasonable results are obtained.
Acknowledgments
The authors acknowledge the funding from CTQ2015-64684-P (MINECO/FEDER) and from the Aragón Government (Fondo Europeo de Desarrollo Regional).
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: CTQ2015-64684-P (MINECO/FEDER), Aragón Government (Fondo Europeo de Desarrollo Regional).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Biomarkers of acute kidney injury: a step forward
- Reviews
- Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption
- Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis
- Opinion Paper
- Traceability in laboratory medicine: a global driver for accurate results for patient care
- Point
- To report or not to report: a proposal on how to deal with altered test results in hemolytic samples
- Counterpoint
- Reporting altered test results in hemolyzed samples: is the cure worse than the disease?
- Genetics and Molecular Diagnostics
- Early mixed hematopoietic chimerism detection by digital droplet PCR in patients undergoing gender-mismatched hematopoietic stem cell transplantation
- Comparison of Abbott RealTime genotype II, GeneMatrix restriction fragment mass polymorphism and Sysmex HISCL HCV Gr assays for hepatitis C virus genotyping
- General Clinical Chemistry and Laboratory Medicine
- The relationship between vacuum and hemolysis during catheter blood collection: a retrospective analysis of six large cohorts
- Evaluation of the Greiner Bio-One serum separator BCA Fast Clot tube
- Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays
- Parathormone stability in hemodialyzed patients and healthy subjects: comparison on non-centrifuged EDTA and serum samples with second- and third-generation assays
- Association between plasma proANP and hyperuricemia in Chinese Han women: a cross-sectional study
- Activity of the liver enzyme ornithine carbamoyltransferase (OTC) in blood: LC-MS/MS assay for non-invasive diagnosis of ornithine carbamoyltransferase deficiency
- Detecting paraprotein interference on a direct bilirubin assay by reviewing the photometric reaction data
- Prediction of human iron bioavailability using rapid c-ELISAs for human plasma hepcidin
- Reference Values and Biological Variations
- Determination of glucose-6-phosphate dehydrogenase cut-off values in a Tunisian population
- Plasma levels of endothelin-1 and renal function among young and healthy adults
- Cancer Diagnostics
- A new strategy for calculating the risk of ovarian malignancy algorithm (ROMA)
- Laboratory characterization of leukemic cell procoagulants
- Diabetes
- Preparation, calibration and evaluation of the First International Standard for human C-peptide
- Hb variants in Korea: effect on HbA1c using five routine methods
- Letters to the Editor
- Pseudohyperkalemia in capillary whole-blood samples – an occasional error or a significant problem in a pediatric hospital?
- Elevation of creatine kinase is linked to disease severity and predicts fatal outcomes in H7N9 infection
- Analytical evaluation of point-of-care procalcitonin (PCT) and clinical performances in an unselected population as compared with central lab PCT assay
- Evaluation of an automated commercial ELISA method for calprotectin determination in pleural fluid
- The unfinished story of interference in thyroid hormones with Roche immunoassays: when prewashing procedures matter
- Effects of apixaban on prothrombin time, activated partial thromboplastin time and anti-Xa assays: a European survey
- Evaluation of a chemiluminescent immunoassay for urinary aldosterone on the DiaSorin LIAISON automated platform against RIA and LC-MS/MS
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