A patient with elevated monoclonal proteins may have a falsely elevated serum vitamin D concentration.
Presentation: high serum 25-hydroxyvitamin D measured by a competitive immunoassay
Laboratory findings:
(1) presence of a monoclonal gammopathy
(2) dilutions of the serum sample do not show a comparable change in vitamin D levels
(3) measuring vitamin D by liquid chromatography tandem mass spectrometry gives a lower level
(4) therapy to reduce the concentration of the monoclonal protein is associated with a reduction in the serum vitamin D concentration comparable to the LC-MS/MS result.
(5) there is no evidence of other interference with the immunoassay
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