{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T14:07:47Z","timestamp":1779026867711,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>IgM paraproteins frequently cause spurious results in biochemical assays; however, standardized strategies to eliminate such interference remain limited. This study systematically compares four dilution matrices to identify effective methods for correcting IgM\u2010mediated interference in prealbumin (PA) and uric acid (UA) measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two cases of IgM\u2010type monoclonal gammopathy (IgM\u2010\u03ba: 5.37\u2009g\/L; IgM\u2010\u03bb: 25.8\u2009g\/L) presenting with spurious PA and UA results were investigated. Four interference\u2010mitigation strategies were evaluated: dilution with deionized water, 0.9% saline, 18% hypertonic saline, and prealbumin reagent 1 containing polyethylene glycol (PEG). Analytical performance was assessed using recovery rates, result stability across dilution factors, and reaction curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For PA measurement, dilution with prealbumin reagent 1 (2\u2010fold) or deionized water (3\u2010fold) effectively eliminated IgM interference, restoring results to clinically plausible concentrations with recovery rates of 101.4% and 99.5% in control samples. For UA measurement, optimal correction was achieved using 18% hypertonic saline (2\u2010fold) or deionized water (3\u2010fold), yielding recovery rates of 101.6% and 102.8%, respectively. Higher dilution factors resulted in reduced analytical reliability in IgM\u2010positive samples but not in controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Effective elimination of IgM paraprotein interference requires assay\u2010specific pretreatment strategies. PEG\u2010based dilution is optimal for PA immunoturbidimetric assays, while osmotic modulation with hypertonic saline is most effective for UA measurement. Deionized water dilution provides a practical, broadly applicable alternative. These simple protocols are suitable for routine clinical laboratory implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70209","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:57:34Z","timestamp":1774612654000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Four Matrix Dilution Methods for Eliminating\n                    <scp>IgM<\/scp>\n                    Paraprotein Interference in Prealbumin and Uric Acid Assays: Based on Two Case Reports"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1195-805X","authenticated-orcid":false,"given":"Xiaowei","family":"Chi","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan Shandong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihan","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Washington at Seattle  Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weifang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan Shandong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan Shandong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denglu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Experimental Center Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan Shandong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12061688"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.905484"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2018.04.007"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2023.230508"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672\u20109455.2019.01.021"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672\u20109455.2022.08.038"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.13602\/j.cnki.jcls.2024.10.02"},{"key":"e_1_2_13_9_1","volume-title":"Analytical Performance Standard for Routine Analytes in Clinical Chemistry: WS\/T 403\u20132024","author":"National Health Commission of the People's Republic of China","year":"2024"},{"key":"e_1_2_13_10_1","volume-title":"Interference Testing in Clinical Chemistry; Approved Guideline\u2014Third Edition. 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