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False Increase in Serum C-Reactive Protein Caused by Monoclonal IgM-λ: a Case Report

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Published/Copyright: June 1, 2005
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Volume 39 Issue 10

Abstract

Interference caused by human anti-animal antibodies has been described in many laboratory assays. Usually the antigen giving rise to these antibodies is not known. When present in sufficiently high titer, these antibodies may have a significant effect on laboratory assays, causing falsely increased or decreased values, to the detriment of patient care and laboratory diagnosis. We report a case of an 86-year old man who had greatly increased C-reactive protein (CRP) levels in serum (>500 mg/l), suggestive of an unusually strong inflammatory response such as seen in septicemia. Because this diagnosis was not consistent with his symptoms, CRP measurements were repeated using alternative methods, none of which gave CRP results higher than 12 mg/l. Protein electrophoresis followed by immunofixation showed a monoclonal IgM-λ paraprotein (7 g/l), which bound the goat anti-CRP antibodies used in the first CRP assay. Precipitation of the IgM-λ paraprotein eliminated the interference. Subsequent bone marrow tests did not reveal any blood malignancy, and the monoclonal IgM component was attributed to monoclonal gammopathy of unknown significance. In conclusion, an IgM-λ paraprotein was shown to cause falsely elevated CRP values in an automated immunometric assay using goat anti-CRP antibodies.

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Published Online: 2005-06-01
Published in Print: 2001-10-23

Copyright © 2001 by Walter de Gruyter GmbH & Co. KG

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https://doi.org/10.1515/CCLM.2001.160

Articles in the same Issue

  1. Identifying Bacteria in Human Urine: Current Practice and the Potential for Rapid, Near-Patient Diagnosis by Sensing Volatile Organic Compounds
  2. Risk Factors for Coronary Disease: the Time for a Paradigm Shift?
  3. Description of a Generally Applicable Model for the Evaluation of Uncertainty of Measurement in Clinical Chemistry
  4. Nitric Oxide in Liver Transplantation
  5. Carbohydrate-Deficient Transferrin and Chronic Alcohol Ingestion in Subjects with Transferrin CD-Variants
  6. Determination of Serum Cortisol by Isotope-Dilution Liquid-Chromatography Electrospray Ionization Tandem Mass Spectrometry with On-line Extraction
  7. Analysis of 5' Non-Coding Region in Hepatitis C Virus by Single-Strand Conformation Polymorphism and Low-Stringency Single Specific Primer PCR
  8. Rapid Detection of the Wilson's Disease H1069Q Mutation by Melting Curve Analysis with the LightCycler
  9. Persistent Hepatitis G Virus (HGV) Infection in Chronic Hemodialysis Patients and Non-B, Non-C Chronic Hepatitis
  10. Serum 90K/MAC-2BP Glycoprotein in Patients with Liver Cirrhosis and Hepatocellular Carcinoma: a Comparison with α-Fetoprotein
  11. Testing the Predictability of the Relative Urinary Supersaturation from the Bonn-Risk-Index for Calcium Oxalate Stone Formation
  12. Reference Values for the Five Electrophoretic Serum Protein Fractions in Caucasian Children by Capillary Zone Electrophoresis
  13. Reference Intervals from Birth to Adulthood for Serum Thyroxine (T4), Triiodothyronine (T3), free T3, free T4, Thyroxine Binding Globulin (TBG) and Thyrotropin (TSH)
  14. Pediatric Reference Ranges for Osteocalcin Measured by the Immulite Analyzer
  15. False Increase in Serum C-Reactive Protein Caused by Monoclonal IgM-λ: a Case Report
  16. Key Elements of the Implementation of a Quality System in Three Finnish Clinical Laboratories
  17. The Temple and the Plane Tree: Rationality and Cult at the Beginnings of Western Medicine
  18. EDTA Samples for the Measurement of Erythrocyte Sedimentation Rate Using Sedimatic 100 Analyser
  19. Gc-Globulin in Acute Coronary Syndrome
  20. Handbook of Diagnostic Endocrinology. Edited by I. Jiala, W. E. Winter and D. W. Chan
  21. EUROMEDLAB 2001 – 14th IFCC-FESCC European Congress of Clinical Chemistry and Laboratory Medicine
  22. International Society on Thrombosis and Haemostasis, Paris, 612 July 2001. Symposium, Coagulation Monitoring: Bringing the Lab to the Patient
  23. Meetings and Awards
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