Pseudohyponatremia and falsely increased serum osmolal gap caused by paraprotein in a patient with severe metabolic acidosis - a case study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F21%3AA2202B7V" target="_blank" >RIV/61988987:17110/21:A2202B7V - isvavai.cz</a>

Result on the web

<a href="http://www.rrml.ro/articole/articol.php?year=2021&vol=2&poz=9" target="_blank" >http://www.rrml.ro/articole/articol.php?year=2021&vol=2&poz=9</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.2478/rrlm-2021-0017" target="_blank" >10.2478/rrlm-2021-0017</a>

Result language

angličtina

Original language name

Pseudohyponatremia and falsely increased serum osmolal gap caused by paraprotein in a patient with severe metabolic acidosis - a case study

Original language description

Introduction: The aim of the study is to present a case study of a 63-year-old male with pseudohyponatremia, falsely increased serum osmolal gap and severe metabolic acidosis. Material and Methods: Venous whole blood (direct sodium selective electrode measurement) and serum (indirect sodium selective electrode measurement) were used to measure sodium concentration. Serum cholesterol, triacylglycerides and total protein were measured to confirm pseudohyponatremia. Base excess in extracellular fluid and serum bicarbonate concentrations were employed as markers of metabolic acidosis. Serum protein electrophoresis and free light chain analysis were used for the detection of paraproteins. Results: Venous whole blood acid base analysis showed a pH of 7.171, negative base excess in extracellular fluid of – 18.6 mmol/L and sodium concentration of 140 mmol/L. Serum test measurement revealed serum sodium concentration of 130 mmol/L, osmolal gap of 24 mmol/kg, creatinine concentration of 702 µmol/L, HCO3- concentration of 6.1 mmol/L and total protein concentration of 134.9 g/L. Serum paraprotein IgG kappa with a concentration of 86 g/L and a serum free light chains kappa/lambda ratio of 223.5, along with the final diagnosis of multiple myeloma were detected. Toxic alcohol ingestion was considered, both methanol and ethylene glycol tests were negative. Conclusions: High paraprotein concentrations in serum may lead to pseudohyponatremia when measured by indirect ion selective electrodes. Multiple myeloma frequently leads to renal failure with metabolic acidosis.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30107 - Medicinal chemistry

Project

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Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Revista Romana de Medicina de Laborator

ISSN

1841-6624

e-ISSN

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Volume of the periodical

29

Issue of the periodical within the volume

2

Country of publishing house

RO - ROMANIA

Number of pages

5

Pages from-to

229-233

UT code for WoS article

000657769600009

EID of the result in the Scopus database

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