Falsely low LDL-cholesterol concentrations and artifactual undetectable HDL-cholesterol measured by direct methods in a patient with monoclonal paraprotein

Clin Chim Acta. 2005 Aug;358(1-2):192-5. doi: 10.1016/j.cccn.2005.02.008.

Abstract

Introduction: Multiple myeloma is a malignant immunoproliferative disorder with lipoprotein abnormalities. We report a case of falsely low concentrations of LDL-cholesterol (LDL-C) and artifactural undetectable HDL-cholesterol (HDL-C) as measured with direct methods in a patient of multiple myeloma with IgGkappa monoclonal gammapathy and significant hyperlipidemia.

Case report: The patient had HDL-C and LDL-C concentrations in the 0.63-0.71 mmol/l and 2.22-2.36 mmol/l ranges, respectively, as measured by a traditional semi-quantitative electrophoresis method. The observation of falsely low concentrations of LDL-C and artifactural undetectable HDL-C might result in the mismanagement of patients of multiple myeloma with monoclonal gammapathy, because the LDL-C and HDL-C concentrations are positive and negative risk factors of cardiovascular diseases.

Conclusions: Care must be taken when using the homogenous method for direct measurement of LDL-cholesterol and HDL-cholesterol in patients of multiple myeloma with monoclonal paraprotein.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal / blood*
  • Artifacts*
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Electrophoresis / methods*
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications
  • Hyperlipidemias / diagnosis
  • Immunoglobulin G / analysis
  • Multiple Myeloma / blood*
  • Multiple Myeloma / complications
  • Multiple Myeloma / diagnosis
  • Paraproteinemias / blood*
  • Paraproteinemias / complications
  • Paraproteinemias / diagnosis
  • Paraproteins / analysis

Substances

  • Antibodies, Monoclonal
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Immunoglobulin G
  • Paraproteins