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Clinical Chemistry 50: 255-256, 2004; 10.1373/clinchem.2003.027813
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(Clinical Chemistry. 2004;50:255-256.)
© 2004 American Association for Clinical Chemistry, Inc.

Letters

Artifactual Undetectable HDL-Cholesterol with the Beckman Synchron LX and Vitros 950 Assays Temporally Associated with a Paraprotein

Arthur Baca1, Richard J. Haber2, Kirk Sujishi3, Philip H. Frost2 and Valerie L. Ng1,a

Departments of1 Laboratory Medicine and2 Medicine University of California San Francisco San Francisco, CA 94110
3 Clinical Laboratory University of California San Francisco Medical Center San Francisco, CA 94110

aAuthor for correspondence.

The first 20% of the full text of this article appears below.


To the Editor:

We report here the failure of the Synchron LX (Beckman) and Vitros 950 (Johnson & Johnson) assays to detect HDL-cholesterol (HDL-C) in the presence of a paraprotein.

HDL-C was repeatedly undetectable (<50 mg/L) in a male who historically had HDL-C values in the 600–800 mg/L range, as determined by manual dextran sulfate precipitation followed by measurement of HDL-C on a BMC (Roche) Hitachi 747, during a time period that coincided with a change in laboratory HDL-C test methodology to the Synchron LX HDL-C (Beckman). The specimens with undetectable HDL-C values in the Synchron LX assay were not hemolyzed or icteric, two conditions known to decrease HDL-C values in the Synchron LX assay. A review of laboratory test results for this patient at the most recent visit for which his HDL-C was undetectable revealed a newly identified paraprotein (IgG{kappa}; Table 1 , specimen 1a) and a new diagnosis of multiple myeloma.


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  		Table 1. Panel of paraprotein-containing specimens tested for HDL-C by the Synchron LX (Beckman) and Vitros 950 (Johnson & Johnson) assays1.

HDL-C values (heparin–manganese . . . [Full Text of this Article]




The following articles in journals at HighWire Press have cited this article:


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J. A. Schifferli, R. B. Goldberg, A. J. Mendez, and M. R. Murali
Case 40-2006: Anemia and Low HDL Cholesterol
N. Engl. J. Med., May 3, 2007; 356(18): 1893 - 1895.
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 NEJMHome page
M. R. Murali, A. Kratz, and K. E. Finberg
Case 40-2006 -- A 64-Year-Old Man with Anemia and a Low Level of HDL Cholesterol
N. Engl. J. Med., December 28, 2006; 355(26): 2772 - 2779.
[Full Text] [PDF]

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 Clin. Chem.Home page
C. Garcia-Hejl, P. Vest, C. Renard, A. Merens-Gonthier, A. Boukhira, and H. Thefenne-Astier
Falsely Low LDL Cholesterol Results and Cholestasis.
Clin. Chem., November 1, 2006; 52(11): 2125 - 2127.
[Full Text] [PDF]


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