PDF(Pubmed)
Abstract：
UNASSIGNED: Paraproteins can interfere with several substances, producing erroneous laboratory measurements. The diagnosis of kidney disease in patients with hematological disorders has important prognosis implications. An elevated creatinine with no other signs of kidney disease should prompt the idea of a spurious creatinine. Communication between the clinical team and the laboratory is key.
UNASSIGNED: In this case, we present a 68-year-old woman with an elevated creatinine and an IgM lambda paraprotein. Interestingly, there were no other signs of chronic kidney disease besides the creatinine value, with no albuminuria or microhematuria. A kidney biopsy showed normal parenchyma and ruled out the possibility of paraprotein-related damage. The monoclonal component and creatinine levels raised parallelly during follow-up while maintaining normal urea levels. This prompted the hypothesis of a falsely elevated creatinine. It was confirmed with a normal glomerular filtration rate determined by a radioisotope, a cystatin C measurement and a reduction in creatinine when diluting the sample.
UNASSIGNED: It is important to consider the possibility of a falsely elevated creatinine in patients with paraproteinemia and no other signs of kidney disease to avoid unnecessary diagnostic tests and for the prognostic implications.
UNASSIGNED: In this case, we present a 68-year-old woman with an elevated creatinine and an IgM lambda paraprotein. Interestingly, there were no other signs of chronic kidney disease besides the creatinine value, with no albuminuria or microhematuria. A kidney biopsy showed normal parenchyma and ruled out the possibility of paraprotein-related damage. The monoclonal component and creatinine levels raised parallelly during follow-up while maintaining normal urea levels. This prompted the hypothesis of a falsely elevated creatinine. It was confirmed with a normal glomerular filtration rate determined by a radioisotope, a cystatin C measurement and a reduction in creatinine when diluting the sample.
UNASSIGNED: It is important to consider the possibility of a falsely elevated creatinine in patients with paraproteinemia and no other signs of kidney disease to avoid unnecessary diagnostic tests and for the prognostic implications.
摘要：
■副蛋白可以干扰几种物质，产生错误的实验室测量。血液病患者肾脏疾病的诊断具有重要的预后意义。肌酐升高，没有其他肾脏疾病的迹象，应该提示虚假肌酐的想法。临床团队和实验室之间的沟通是关键。
■在这种情况下，我们介绍了一名68岁女性,其肌酐和IgMλ副蛋白升高.有趣的是,除了肌酐值，没有其他慢性肾病的迹象，无蛋白尿或微血尿。肾脏活检显示实质正常，并排除了副蛋白相关损害的可能性。在随访期间，单克隆成分和肌酐水平平行升高，同时维持正常的尿素水平。这提示了肌酐错误升高的假设。通过放射性同位素确定的正常肾小球滤过率证实了这一点，测量胱抑素C和稀释样品时肌酐的减少。
■重要的是要考虑副蛋白血症患者中肌酐虚高的可能性，并且没有其他肾脏疾病的征象，以避免不必要的诊断测试和对预后的影响。
■在这种情况下，我们介绍了一名68岁女性,其肌酐和IgMλ副蛋白升高.有趣的是,除了肌酐值，没有其他慢性肾病的迹象，无蛋白尿或微血尿。肾脏活检显示实质正常，并排除了副蛋白相关损害的可能性。在随访期间，单克隆成分和肌酐水平平行升高，同时维持正常的尿素水平。这提示了肌酐错误升高的假设。通过放射性同位素确定的正常肾小球滤过率证实了这一点，测量胱抑素C和稀释样品时肌酐的减少。
■重要的是要考虑副蛋白血症患者中肌酐虚高的可能性，并且没有其他肾脏疾病的征象，以避免不必要的诊断测试和对预后的影响。
