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CASE REPORT
Deceiving proteins! A case of lymphoma and high creatinine
  1. El Hakem Abdelkarim Metraiah1,
  2. Helen Regan2,
  3. Johanna Louw1,
  4. Dana Kidder1
  1. 1Renal Unit, Aberdeen Royal Infirmary, Aberdeen, UK
  2. 2NHS Grampian, Aberdeen, Aberdeen, UK
  1. Correspondence to Dr El Hakem Abdelkarim Metraiah, metraiah{at}gmail.com

Summary

Estimation of kidney function by measuring serum creatinine is one the commonest laboratory tests conducted in clinical practice. Enzymatic methods are often used to measure serum creatinine. Clinicians should be aware of the limitations of these methods, such as test interference with paraproteins.We present a case of falsely elevated serum creatinine in a patient referred for renal biopsy. The combination of fluctuating creatinine and normal blood urea level was unusual. Serum protein electrophoresis revealed the presence of an IgM paraprotein. Further investigations confirmed an underlying diagnosis of lymphoplasmacytoid lymphoma. This case highlights how IgM paraprotein can interfere with creatinine estimation by enzymatic assay and the utility of alternative methods of estimating serum creatinine.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2016-217946

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    Footnotes

    • Contributors E-HM is primary author and performed writing, editing and literature search. DK is senior author involved in writing, editing and supervising manuscript. HR helped in editing and case discussion. JL helped in editing.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.