A patient with a paraproteinemia may have an artifactual hyperbilirubinemia.


Method: Roche Hitachi serum total bilirubin


Cause of interference: protein precipitation with turbidity


Clues that there may be a problem with the assay:

(1) The patient is not jaundiced.

(2) The specimen is not icteric.

(3) A much lower value for the total bilirubin is given by an alternative method.

(4) The direct bilirubin assay is unaffected.


If the patient is jaundiced or the specimen icteric then the problem might go unnoticed.


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