Deceiving proteins! A case of lymphoma and high creatinine

El Hakem Abdelkarim Metraiah; Helen Regan; Johanna Louw; Dana Kidder

doi:10.1136/bcr-2016-217946

Deceiving proteins! A case of lymphoma and high creatinine

El Hakem Abdelkarim Metraiah (Corresponding Author), Helen Regan, Johanna Louw, Dana Kidder

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Abstract

Estimation of kidney function by measuring serum creatinine is one the commonest laboratory tests conducted in clinical practice. Enzymatic methods are often used to measure serum creatinine. Clinicians should be aware of the limitations of these methods, such as test interference with paraproteins.We present a case of falsely elevated serum creatinine in a patient referred for renal biopsy. The combination of fluctuating creatinine and normal blood urea level was unusual. Serum protein electrophoresis revealed the presence of an IgM paraprotein. Further investigations confirmed an underlying diagnosis of lymphoplasmacytoid lymphoma. This case highlights how IgM paraprotein can interfere with creatinine estimation by enzymatic assay and the utility of alternative methods of estimating serum creatinine.

Original language	English
Pages (from-to)	1-3
Number of pages	3
Journal	BMJ Case Reports
Volume	2017
DOIs	https://doi.org/10.1136/bcr-2016-217946
Publication status	Published - 23 Jan 2017

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10.1136/bcr-2016-217946Licence: CC BY-NC

Deceiving proteins! A case of lymphoma and high creatinine
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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AB - Estimation of kidney function by measuring serum creatinine is one the commonest laboratory tests conducted in clinical practice. Enzymatic methods are often used to measure serum creatinine. Clinicians should be aware of the limitations of these methods, such as test interference with paraproteins.We present a case of falsely elevated serum creatinine in a patient referred for renal biopsy. The combination of fluctuating creatinine and normal blood urea level was unusual. Serum protein electrophoresis revealed the presence of an IgM paraprotein. Further investigations confirmed an underlying diagnosis of lymphoplasmacytoid lymphoma. This case highlights how IgM paraprotein can interfere with creatinine estimation by enzymatic assay and the utility of alternative methods of estimating serum creatinine.

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Deceiving proteins! A case of lymphoma and high creatinine

Abstract

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