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Multiple myeloma uncovered by investigating a negative serum iron level
  1. L C Wu1,
  2. S S Chuang1,
  3. C N Lin1,
  4. C C Su2,
  5. M P Lin3
  1. 1Department of Pathology, Chi-Mei Foundation Medical Center, Taipei, Taiwan
  2. 2Departments of Pathology and Anatomic Pathology Clinical, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Department of Pathology, Tzu Chi University, Tainan, Taiwan
  3. 3Department of Radiology, Chi-Mei Foundation Medical Center, Tainan, Taiwan
  1. Correspondence to:
    Dr C C Su
    Department of Clinical Pathology, Buddhist Dalin Tzu Chi General Hospital, 2, Minsheng Road, Dalin Town, Chiayi County 622, Taiwan; sucpo{at}

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A 67-year-old woman had left nostril obstruction for several weeks, which was thought to be due to a simple nasal polyp. Routine laboratory tests showed anaemia (haemoglobin 7.2 g/l (reference range 11.6–14.0)) and a negative serum iron level (−68.2 μmol/l (7.2–26.9)) was detected with an automatic analyser (Hitachi 7600, Hitachi, Tokyo, Japan). Interference in the direct method of iron measurement was suspected and an investigation of the abnormal absorbance pattern (fig 1) was conducted. We combined the patient’s serum with pooled serum at dilution factors 2, 3, 5 and 10, and measured the iron levels. The iron levels were −1.8, 3.4, 5.4 and 5.4 μmol/l, respectively, confirming …

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  • Funding: This study was supported by grant DTCRD94(2)-08 from the Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.

  • Competing interests: None.

  • This study was approved by the institutional review board of our hospital.