Keywords
monoclonal gammopathy
analytical interference
How to Cite
Abstract
Introduction: Scientific articles have reported positive interference from paraproteins in the determination of total bilirubin. This interference, reported as a problem, could potentially be used as an early indicator of an unsuspected pathology. In 2024, our research group published an article on the first cases of monoclonal gammopathies, clinically undiagnosed, based on the detection of spurious hyperbilirubinemia (pseudohyperbilirubinemia). Aim: The aim of this article is to report new cases based of spurious hyperbilirubinemia and describe aspects of its clinical-biochemical presentation. Materials and Methods: In a public hospital in the Province of Buenos Aires, Argentina, seven new cases of pseudohyperbilirubinemia were studied. Combined with the previously reported cases, this brings the total to thirteen. The determinations and studies recommended in the prior publication were implemented: seric total protein, immunoglobulin assay, and electrophoretic proteinogram. Results: Five cases exhibited the presence of a homogeneous band; one case exhibited a polyclonal increase, suggesting follow-up; and the remaining case could not be evaluated. Results showed that interference in total bilirubin by the monoclonal component could precede serum hyperproteinemia. Conclusions: It is crucial to train and educate laboratory professionals in detecting this interference, implementing alert systems, patient follow-up, and improving communication with the medical team. It is considered relevant to manage the creation of a laboratory platform to report cases of positive interference from paraproteins in bilirubin assays, contributing to national case report and early detection of monoclonal gammopathies.
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