目的:一例39岁男性白种人凝血酶时间(TT)试验中单克隆蛋白(M蛋白)干扰的病例。
方法:进行凝血筛选试验,其中仅测量TT结果(>150秒)和活化部分凝血活酶时间(aPTT)结果(36秒)的改变结果。进一步的特定凝血测试包括测量单个凝血因子FII,FV,FVII,FVIII,FIX,FX,FXI,和FXII。检测和鉴定单克隆蛋白的诊断步骤包括血清蛋白电泳和免疫固定(血清和尿液标本)。
结果:单克隆蛋白免疫球蛋白Gκ在血清和尿液中的检测和鉴定情况得到澄清。
结论:在没有任何抗凝治疗的患者中,在没有任何适当的临床体征和症状的情况下,需要在延长的后续诊断步骤中严格考虑筛查凝血测试结果的意外改变,以澄清病理测试结果的原因。
OBJECTIVE: A case of interference of monoclonal protein (M-protein) on thrombin time (TT) test in a 39-year-old Caucasian male patient is presented.
METHODS: Coagulation screening tests were performed where altered results only for TT result (>150 seconds) and activated partial thromboplastin time (aPTT) result (36 seconds) were measured. Further specific coagulation testing included measurement of individual coagulation factors FII, FV, FVII, FVIII, FIX, FX, FXI, and FXII. Diagnostic steps in detection and identification of monoclonal protein included serum protein electrophoresis and immunofixation (both serum and urine specimen).
RESULTS: Monoclonal protein immunoglobulin G kappa detection and identification in serum and urine clarified the situation.
CONCLUSIONS: Unexpectedly altered results of screening coagulation tests without any appropriate clinical signs and symptoms in a patient without any anticoagulant therapy needs to be critically considered in the context of extended next diagnostic steps in order to clarify the cause of pathological test results.