Journal of clinical laboratory analysis · 2026
Comparative Analysis of Four Matrix Dilution Methods for Eliminating IgM Paraprotein Interference in Prealbumin and Uric Acid Assays: Based on Two Case Reports.
СтатьяКлинический случайСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chi Xiaowei, Liu Zihan, Liu Weifang, Jiang Huihui, Zhang Denglu
Аннотация
BACKGROUND: IgM paraproteins frequently cause spurious results in biochemical assays; however, standardized strategies to eliminate such interference remain limited. This study systematically compares four dilution matrices to identify effective methods for correcting IgM-mediated interference in prealbumin (PA) and uric acid (UA) measurements.
METHODS: Two cases of IgM-type monoclonal gammopathy (IgM-κ: 5.37 g/L; IgM-λ: 25.8 g/L) presenting with spurious PA and UA results were investigated. Four interference-mitigation strategies were evaluated: dilution with deionized water, 0.9% saline, 18% hypertonic saline, and prealbumin reagent 1 containing polyethylene glycol (PEG). Analytical performance was assessed using recovery rates, result stability across dilution factors, and reaction curve analysis.
RESULTS: For PA measurement, dilution with prealbumin reagent 1 (2-fold) or deionized water (3-fold) effectively eliminated IgM interference, restoring results to clinically plausible concentrations with recovery rates of 101.4% and 99.5% in control samples. For UA measurement, optimal correction was achieved using 18% hypertonic saline (2-fold) or deionized water (3-fold), yielding recovery rates of 101.6% and 102.8%, respectively. Higher dilution factors resulted in reduced analytical reliability in IgM-positive samples but not in controls.
CONCLUSIONS: Effective elimination of IgM paraprotein interference requires assay-specific pretreatment strategies. PEG-based dilution is optimal for PA immunoturbidimetric assays, while osmotic modulation with hypertonic saline is most effective for UA measurement. Deionized water dilution provides a practical, broadly applicable alternative. These simple protocols are suitable for routine clinical laboratory implementation.
METHODS: Two cases of IgM-type monoclonal gammopathy (IgM-κ: 5.37 g/L; IgM-λ: 25.8 g/L) presenting with spurious PA and UA results were investigated. Four interference-mitigation strategies were evaluated: dilution with deionized water, 0.9% saline, 18% hypertonic saline, and prealbumin reagent 1 containing polyethylene glycol (PEG). Analytical performance was assessed using recovery rates, result stability across dilution factors, and reaction curve analysis.
RESULTS: For PA measurement, dilution with prealbumin reagent 1 (2-fold) or deionized water (3-fold) effectively eliminated IgM interference, restoring results to clinically plausible concentrations with recovery rates of 101.4% and 99.5% in control samples. For UA measurement, optimal correction was achieved using 18% hypertonic saline (2-fold) or deionized water (3-fold), yielding recovery rates of 101.6% and 102.8%, respectively. Higher dilution factors resulted in reduced analytical reliability in IgM-positive samples but not in controls.
CONCLUSIONS: Effective elimination of IgM paraprotein interference requires assay-specific pretreatment strategies. PEG-based dilution is optimal for PA immunoturbidimetric assays, while osmotic modulation with hypertonic saline is most effective for UA measurement. Deionized water dilution provides a practical, broadly applicable alternative. These simple protocols are suitable for routine clinical laboratory implementation.