{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:28:29Z","timestamp":1792268909863,"version":"4.4.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"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":["Nephrology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pseudohypobicarbonataemia is a rare but important diagnostic pitfall that can lead to unnecessary investigations and inappropriate treatments if unrecognised. We present a case of a 92\u2010year\u2010old woman with chronic severe hypobicarbonataemia on enzymatic assay, despite normal acid\u2013base parameters on blood gas analysis. Extensive evaluation excluded common causes of metabolic acidosis. Analytical studies identified interference by an IgG lambda paraprotein. Serial dilution showed a non\u2010linear increase in bicarbonate concentration and polyethylene glycol precipitation improved bicarbonate recovery, implicating a protein\u2010mediated effect. No turbidity or heterophile antibody interference was observed. This case highlights the importance of considering assay interference in patients with unexplained biochemical abnormalities to prevent misdiagnosis and unnecessary treatment. Additionally, it aims to encourage clinicians to utilise blood gas analysis as a reliable method to confirm bicarbonate levels when enzymatic assays are suspected to be inaccurate.<\/jats:p>","DOI":"10.1111\/nep.70188","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T04:25:29Z","timestamp":1773635129000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pseudohypobicarbonataemia: A Rare Case of Enzymatic Assay Interference From Monoclonal Paraproteinaemia"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4186-2712","authenticated-orcid":false,"given":"Mikaela","family":"Mandato","sequence":"first","affiliation":[{"name":"Lismore Base Hospital  Lismore Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"James","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  Lismore Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations","author":"Centor R. M.","year":"1990"},{"key":"e_1_2_9_3_1","volume-title":"National Health and Nutrition Examination Survey (NHANES) 2017\u20102018: Bicarbonate (CO2) in Serum Laboratory Methodology [Internet]","author":"Centers for Disease Control and Prevention (CDC)","year":"2017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55787"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP171855.CR"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2014.917945"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5414\/CN109627"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2018.04.016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.06.003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfac088"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2021.05.025"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaa074"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1684\/abc.2014.0995"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:08:57Z","timestamp":1776046137000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/nep.70188"],"URL":"https:\/\/doi.org\/10.1111\/nep.70188","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70188"}}