RT Journal Article
SR Electronic
T1 Pseudohypoproteinemia and multiple myeloma
JF Cleveland Clinic Journal of Medicine
JO Cleve Clin J Med
FD Cleveland Clinic
SP 298
OP 300
VO 57
IS 3
A1 Avashia, Jay H.
A1 Walsh, T. Declan
A1 Valenzuela, Rafael
A1 Quevedo, J. Fernando
A1 Clough, John
YR 1990
UL http://www.ccjm.org/content/57/3/298.abstract
AB Paraproteinemia is an important diagnostic feature of multiple myeloma. The M-protein level reflects tumor burden and helps to determine the response to chemotherapy. A case is described that illustrates the phenomenon of reversible in vitro gelification of an M-protein. Paraprotein IgG,-kappa formed a concentration- and temperature-dependent gel, which was reversed by agitation. Measurement of paraprotein without previous vortexing of the specimen can erroneously lower the apparent M-protein level as well as reduce serum viscosity levels. This phenomenon can downstage the disease at diagnosis, produce inappropriate assessment of treatment response, or lead to premature withdrawal of chemotherapy. In addition, misdiagnosis of hyperviscosity syndrome can occur with serious clinical consequences.