篇名 | Waldenström macroglobulinemia導致Pseudohypoglycemia之案例報告 |
---|---|
卷期 | 27:2 |
並列篇名 | A Waldenström macroglobulinemia Case of Pseudohypoglycemia Caused by Interference of IgM in Glucose Assay |
作者 | 張智凱 、 楊弘翊 、 張錦標 、 湯勝輝 |
頁次 | 121-132 |
關鍵字 | Waldenström Macroglobulinemia 、 Pseudohypoglycemia 、 Hexokinase 、 Glucose 、 TSCI |
出刊日期 | 202004 |
Waldenström macroglobulinemia (WM)為臨床罕見的Immunoglobulin M單株免疫球蛋白增高血症(IgM Monoclonal Gammopathy);主要為淋巴漿細胞異常大量製造IgM paraprotein。IgM Paraprotein 在Olympus AU 680 生化分析儀 (Beckman-Coulter, USA)會干擾血糖的酵素法Hexokinase G-6-PDH分析,導致假性低血糖值(Pseudohypoglycemia)之結果。至目前,檢驗室很少有簡易去除IgM干擾的方法。本研究主要探討IgM干擾造成假性低血糖之個案,檢驗室常見使用去離子水及生理食鹽水稀釋檢體,評估降低干擾前後結果之差異,與本院的ACCU CHEK Inform II血糖機分析結果做比較,提供檢驗室快速降低IgM干擾之流程,且能發出準確的血糖報告,以提升醫療品質及病人安全。
Waldenström macroglobulinemia (WM), a rare IgM monoclonal gammopathy, is characterized by lymphoplasmacytic cells abnormally producing large amount of IgM paraprotein. On Olympus AU680 analyzer (Beckman-Coulter, USA), glucose level determined by Hexokinase G-6-PDH was interfered with IgM Paraprotein and caused pseudohypoglycemia. As of now, there is not a simple approach to eliminate IgM Paraprotein. The aim of this study is to investigate a pseudohypoglycemia case caused by interference of IgM paraprotein. In the laboratory, plasma samples were diluted with deionized water and normal saline and compared differences between pre-treated and treated samples and utilized ACCU CHEK Inform II glucose meter to analyze results. For health care quality and patient safety, we established a procedure for rapidly eliminating IgM and quickly accurate glucose report.