Detecting paraprotein interference on a direct bilirubin assay by reviewing the photometric reaction data

Abstract

Review of the photometric reaction data permits the systematic detection of paraprotein interference on the D-Bil AU assay, even for samples for which reasonable results are obtained.

A component could not be larger than the whole, polyclonal immunoglobulin interference in conjugated/direct bilirubin assay and elimination: A case report

“…These analytical interferences may result from sample turbidity, chemical or immunological reaction with assay constituent, hook effect, and hyperviscosity. Some chemical analytes, including conjugated bilirubin, are sensitive to proteins' interference 4,5 6 .…”

“…Some chemical analytes, including conjugated bilirubin, are sensitive to proteins' interference. 4,5 While there are many reports on monoclonal paraproteins' interference in biochemistry autoanalyzers' results, the interference by polyclonal immunoglobulin is not yet well known. 6 Individual proteins have unique amino acid sequences and different set points for conformational changes in response to changes in pH and ionic strength.…”

A case of atypical IgA paraprotein interference on multiple chemistry assays: How to deal with it

“…Can such erroneous results be prevented from being released in the first place? Attempts have been made to develop algorithms to detect abnormalities in reaction curves and raise flags in the system (7). On the flip side of such measures are two issues: preponderance of false flags, i.e., genuine results being blocked by the system from being released, and compromise on the system's throughput.…”