Rafael José García Martínez, José Carlos Garrido Gomez, Enrique María Ocio San Miguel, María Josefa Muruzábal Sitges
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引用次数: 0
摘要
目的：由抗体引起的分析干扰往往不被注意，需要在正确的临床背景下深入了解分析仪原理：由抗体引起的分析干扰常常被忽视，需要在正确的临床背景下深入了解分析仪的原理：本病例报告详细描述了一名因多发性骨髓瘤而出现高粘度综合征（HVS）症状的 56 岁男性：结果：DxH 900 分析仪显示有核红细胞（nRBC）图异常，原因是高浓度的 IgA kappa。立即进行血浆置换成功治疗了 HVS，减少了单克隆成分，消除了异常绿色信号：在适当的临床环境中，只有了解仪器的分析原理，才能识别分析干扰，进行准确的临床解释。在本病例中，高浓度的 IgA kappa 在 VCSm 中产生了异常绿色信号。
Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome.
Objectives: Analytical interferences, caused by antibodies, often go unnoticed and require a deep understanding of analyzer principles in the correct clinical context.
Methods: A case report details a 56-year-old man with symptoms of hyperviscosity syndrome (HVS) due to multiple myeloma.
Results: The DxH 900 analyzer revealed abnormalities in the nucleated red blood cell (nRBC) graph, attributed to a high concentration of IgA kappa. Immediate plasmapheresis successfully treated HVS, reducing the monoclonal component and eliminating the aberrant green signal.
Conclusions: In the appropriate clinical context, the recognition of analytical interferences is necessary for accurate clinical interpretation, and it is only possible with knowledge of the analytical principles of the instruments. In this case, the high concentration of IgA kappa generated an aberrant green signal in the VCSm.
期刊介绍：
Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality. Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error
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