{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:26:05Z","timestamp":1788906365244,"version":"build-2803163510"},"reference-count":10,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>An 81-year-old man was admitted to hospital with symptomatic coronavirus disease (COVID-19) infection. He had a background of progressive chronic inflammatory demyelinating polyneuropathy associated with Waldenstrom\u2019s macroglobulinaemia. His plasma creatinine on four separate samples was inconceivably low (all \u226413\u00a0\u03bcmol\/L), as measured by a Beckman Coulter enzymatic assay) after being 72\u00a0\u03bcmol\/L 3\u00a0months earlier. On further investigation, his serum immunoglobulin M (IgM) was 15.4\u00a0g\/L and his plasma creatinine measured by Roche enzymatic and Roche Jaffe methods was 62\u00a0\u03bcmol\/L and 64\u00a0\u03bcmol\/L, respectively. This was consistent with results post dilution studies and polyethylene glycol (PEG) precipitation on the Beckman Coulter assay. There was no evidence of similar interference when reviewing creatinine results from 10 other patients with IgM paraproteinaemia who had been tested in our laboratory. Clinicians and laboratorians are reminded that enzymatic creatinine is not free from interferences. IgM paraprotein negative interference of enzymatic creatinine is rare and specific to a patient\u2019s IgM and assay combination, but should be considered in patients with an unexplained low enzymatic creatinine result. Useful investigations to identify an interference include dilution studies, PEG precipitation and measuring creatinine on an alternative method such as Jaffe, mass spectrometry or an enzymatic method from a different platform.<\/jats:p>","DOI":"10.1177\/00045632231190507","type":"journal-article","created":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T23:51:57Z","timestamp":1690156317000},"page":"423-427","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Artefactually low creatinine by Beckman Coulter enzymatic method due to immunoglobulin M paraprotein interference"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-6129","authenticated-orcid":false,"given":"Bobby","family":"Li","sequence":"first","affiliation":[{"name":"Te Whatu Ora \u2013 Health New Zealand Waitaha Canterbury, Christchurch, New Zealand"},{"name":"Biochemistry, Canterbury Health Laboratories, 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Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,23]]},"reference":[{"key":"bibr1-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1515\/cclm.2008.113"},{"key":"bibr2-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2011.172288"},{"key":"bibr3-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2015-203064"},{"key":"bibr4-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.05.014"},{"key":"bibr5-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.09.027"},{"key":"bibr6-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.11.017"},{"key":"bibr7-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2022.01.012"},{"key":"bibr8-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1177\/00045632221074867"},{"key":"bibr9-00045632231190507","doi-asserted-by":"publisher","DOI":"10.3109\/00313025.2010.493868"},{"key":"bibr10-00045632231190507","doi-asserted-by":"publisher","DOI":"10.1016\/j.plabm.2015.09.001"}],"container-title":["Annals 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