Disturbed latex immunoassays for C-reactive protein and ferritin in a renal transplant patient due to polyclonal IgM hypergammaglobulinaemia
| Autor: | Manuela Födinger, T C Vukovich, W H Hörl, A. Hamwi, Gere Sunder-Plassmann |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
Latex Nephelometry and Turbidimetry Hypergammaglobulinemia medicine Humans False Positive Reactions Immunoassay Transplantation medicine.diagnostic_test biology business.industry Middle Aged Kidney Transplantation Blood proteins Ferritin C-Reactive Protein Immunoglobulin M Nephrology Ferritins Immunology Monoclonal biology.protein Antibody business Nephelometry |
| Zdroj: | Nephrology Dialysis Transplantation. 12:1229-1233 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/12.6.1229 |
| Popis: | interest for the management of allograft recipients in whom monoclonal and polyclonal gammaglobulinaeBackground. C-reactive protein (CRP) and ferritin serum levels represent routine laboratory parameters mia are frequently observed. We therefore recommend reanalysis of the respective plasma proteins by latexin the monitoring of renal failure patients. Analysis of CRP, ferritin and other serum proteins can be per- free assays in patients with hypergammaglobinaemia showing no clinical signs of an acute infectious disease formed using latex-enhanced or non-latex-enhanced immunoassays. We report on a renal transplant patient or malignant disorder. with polyclonal IgM hypergammaglobulinaemia having markedly elevated serum CRP and ferritin Key words: latex immunoassays; hypergammagloblevels (as detected by latex-enhanced immunoassays) ulinaemia; C-reactive protein; ferritin in the absence of clinical signs of an infectious or malignant disorder. Methods. CRP and ferritin serum levels were determined with various immunoassays with and without Introduction latex enhancement. To characterize the causative agent for the elevated CRP and ferritin values, the patient’s C-reactive protein (CRP) and ferritin are routine laborand a control serum were fractionated by gel filtration atory parameters in the monitoring of renal failure on a Sephacryl S-300 column. Serum fractions were patients. For quantification of CRP and ferritin a subjected to further analysis for reactivity in CRP and variety of methods such as turbidimetry or nepheloferritin assays. In addition, patient’s serum samples metry have been developed. In principle all these were investigated for reactivity with various other methods use a heterologous antibody directed against latex-based immunoassays (rheumatoid factor, antis- the target protein. In order to improve sensitivity of treptolysin O, antistreptococcal DNase B). immunoassays, enhancement using latex particles is Results. Using latex-enhanced CRP and ferritin frequently applied [1 ]. Falsely high levels of CRP have immunoassays, markedly elevated serum levels were been reported in patients with high titres of rheumatoid obtained (CRP 726 mg/l determined by turbidimetry, factor [2‐4] or monoclonal gammopathies, predomi398 mg/l determined by nephelometry; ferritin, nantly of the IgM type [5‐8]. In the latter case, the 20 000 mg/l determined by turbidimetry). In contrast, mechanism resulting in the falsely high CRP determinaassays without latex enhancement revealed levels tion has been shown to be due to a non-specific within the normal range for both serum proteins (CRP reaction between the patient’s monoclonal immuno |
| Databáze: | OpenAIRE |
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