Journal of Turkish Clinical Biochemistry

The official publication of Turkish Clinical Biochemistry Association

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December 01, 2025
JTCB. 2025 Dec 1; 23 (3) : 143-147

From Laboratory Clue to Diagnosis: Multiple Myeloma

1 Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya, Zonguldak, Türkiye
2 Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi, Hematoloji, Zonguldak, Türkiye

Abstract

Preanalytical irregularities in serum separator tubes are frequently regarded as technical artifacts. In this case, repeated failure of serum separation led to the diagnosis of multiple myeloma. A 77-year-old woman presented with chest pain and fatigue, and successive serum samples failed to form an adequate gel barrier, yielding only minimal serum despite prolonged centrifugation. Biochemical analyses revealed hypoalbuminemia, elevated total protein, increased IgA with suppressed IgM and IgG levels, and a markedly decreased kappa/lambda ratio. Serum and urine immunofixation identified an IgAlambda monoclonal band. PET-CT demonstrated multiple lytic bone lesions. Bone marrow biopsy revealed a hypercellular marrow with 80% plasma cell infiltration, confirming the diagnosis of multiple myeloma. These findings underscore that abnormal serum separation, often dismissed as a technical issue, may serve as an early indicator of underlying hematologic malignancy.

Citation

Can, Murat, Berrak Güven, Şehmus Ertop, and Havva Aksel. 2025. “From Laboratory Clue to Diagnosis: Multiple Myeloma”. Journal of Turkish Clinical Biochemistry 23 (3):143-47. https://turkclinbiochem.org/index.php/pub/article/view/522.

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