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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 45, Issue 9


Gammopathy interference in clinical chemistry assays: mechanisms, detection and prevention

Andries J. Bakker
  • 1Stichting Klinisch Chemisch Laboratorium, Medical Centre Leeuwarden, Leeuwarden, Netherlands
  • Other articles by this author:
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/ Matthias Mücke
Published Online: 2007-09-11 | DOI: https://doi.org/10.1515/CCLM.2007.254


Monoclonal gammopathy is characterized by the presence of an M-protein in serum or urine that has homogeneous structural and functional properties. It can occur in very high concentrations and may cause significant interference in clinical chemistry assays. Examples of gammopathy interference for the analytes glucose, bilirubin, γ-glutamyltransferase, urea and ferritin are presented. Various mechanisms of interference are described, such as the production of turbidity by the M-protein and the binding of the M-protein to a component of the test system or analyte. In immunoglobulin tests, the M-protein is the analyte itself and may not be completely bound by the test antibody owing to its structural properties. Modern analyzers can detect unusual changes in absorption during the course of a reaction, and thus the formation of turbidity due to M-proteins. This interference may be prevented by optimizing the buffering conditions of the reagents to avoid the formation of turbidity or by removal of the M-protein prior to analysis of the sample. Owing to the unique properties of each M-protein, it is impossible to protect common clinical chemistry test systems completely from gammopathy interference. Therefore, efficient ways for the detection of such interference are needed.

Clin Chem Lab Med 2007;45:1240–3.

Keywords: gammopathy; interference; paraprotein; M-protein

About the article

Corresponding author: Dr. Matthias Mücke, Roche Diagnostics GmbH, LR-HA, Nonnenwald 2, 82377 Penzberg, Germany Phone: +49-8856-605559, Fax: +49-8856-605594,

Received: 2007-03-06

Accepted: 2007-05-04

Published Online: 2007-09-11

Published in Print: 2007-09-01

Citation Information: Clinical Chemical Laboratory Medicine, Volume 45, Issue 9, Pages 1240–1243, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: https://doi.org/10.1515/CCLM.2007.254.

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