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Clin Chem Clinical Case Studies
Clinical Case Studies
These case studies are meant to be educational in nature and the questions provided are intended to stimulate discussion and develop problem-solving skills. Each month, a case and a series of questions can be emailed to interested individuals 2-3 weeks in advance of publication in Clinical Chemistry. The published version will include a discussion of the case, important points to remember, and comments from 1-2 experts in the field. We urge you to share and discuss these with your trainees each month.
Clinical Chemistry also welcomes the submission of interesting case studies. Please go to Submission Instructions.
All previous Clinical Cases Studies can be accessed and downloaded online at http://www.aacc.org/resourcecenters/casestudies/.
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January 2010
Sharply Increased Serum Free Light-Chain Concentrations after Treatment for Multiple Myeloma
Kazunori Murata, Raynell J Clark, K Lockington, Linda J Tostrud, Philip R Greipp and Jerry A Katzmann
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for January 2010. This published version includes a discussion of the case, important points to remember, and comments from experts in the field.
Kazunori Murata, Raynell J. Clark, Karen S. Lockington, Linda J. Tostrud, Philip R. Greipp, and Jerry A. Katzmann
Sharply Increased Serum Free Light-Chain Concentrations after Treatment for Multiple Myeloma
Clin Chem 2010 56: 16-18.
http://www.clinchem.org/cgi/content/full/56/1/16
Commentaries
Jim D. Faix
Clin Chem 2010 56: 19
http://www.clinchem.org/cgi/reprint/56/1/19
Morey A. Blinder
Clin Chem 2010 56: 19-20
http://www.clinchem.org/cgi/reprint/56/1/19
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete January 2010 issue at http://www.clinchem.org/content/vol56/issue1/
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December 2009
Too Much of a Good Thing: A Woman with Hypertension and Hypokalemia
Sean C Murphy, Sean Agger and Petrie M Rainey
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November 2009
Severe Hyponatremia with High Urine Sodium and Osmolality
Joost van der Hoek, Ewout J Hoorn, Gijs M T de Jong, Emile N W Janssens and Wouter W de Herder
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for November 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
Joost van der Hoek, Ewout J. Hoorn, Gijs M.T. de Jong, Emile N.W. Janssens, and Wouter W. de Herder
Severe Hyponatremia with High Urine Sodium and Osmolality
Clin Chem 2009 55: 1905-1908.
http://www.clinchem.org/cgi/content/full/55/11/1905
Commentaries
Glen L. Hortin, Neil S. Harris, and William E. Winter
Clin Chem 2009 55: 1908-1909
http://www.clinchem.org/cgi/content/full/55/11/1908
Robert Richardson
Clin Chem 2009 55: 1909
http://www.clinchem.org/cgi/content/full/55/11/1909
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete November 2009 issue at http://www.clinchem.org/content/vol55/issue11/
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October 2009
Unexpected Urine Drug Testing Results in a Hospice Patient on High Dose Morphine Therapy
Gary M Reisfield, Chris W Chronister, Bruce A Goldberger and Roger L Bertholf
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for October 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
Gary M. Reisfield, Chris W. Chronister, Bruce A. Goldberger, and Roger L. Bertholf
Unexpected Urine Drug Testing Results in a Hospice Patient on High-Dose Morphine Therapy
Clin Chem 2009 55: 1765-1768.
http://www.clinchem.org/cgi/content/full/55/10/1765
Commentaries
Larry A. Broussard
Clin Chem 2009 55: 1768.
http://www.clinchem.org/cgi/content/full/55/10/1768
Douglas Gourlay and Howard A. Heit
Clin Chem 2009 55: 1769
http://www.clinchem.org/cgi/content/full/55/10/1769
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete October 2009 issue at http://www.clinchem.org/content/vol55/issue10/
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September 2009
A Case of Renal Osteodystrophy with Unexpected Serum Intact Parathyroid Hormone Concentrations
Danni L Meany, Suzanne M Jan de Beur, Mary Jo Bill and Lori J Sokoll
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August 2009
Persistent Increase in Aspartate Aminotransferase in an Asymptomatic Patient
Smita Krishnamurthy, Kevin M. Korenblat, and Mitchell G. Scott
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for August 2009. This published version includes a discussion of the case, important points to remember, and comments from experts in the field.
Smita Krishnamurthy, Kevin M Korenblat, and Mitchell G Scott
Persistent Increase in Aspartate Aminotransferase in an Asymptomatic Patient
Clin Chem 2009 55: 1573-1575.
http://www.clinchem.org/cgi/content/full/55/8/1573
Commentaries
D. Robert Dufour
Clin Chem 2009 55: 1576.
http://www.clinchem.org/cgi/content/full/55/8/1576
Henry C. Bodenheimer
Clin Chem 2009 55: 1576-1577.
http://www.clinchem.org/cgi/content/full/55/8/1576-a
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete August 2009 issue at http://www.clinchem.org/content/vol55/issue8/
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July 2009
A Patient with a Leg Rash, Pedal Edema, Renal Failure and Thrombocytopenia
Kareena L Schnabl, Matt Sibbald, Wayne L Gold, Pak Cheung Chan and Khosrow Adeli
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for July 2009. This published version includes a discussion of the case, important points to remember, and comments from experts in the field.
Kareena L. Schnabl, Matt Sibbald, Wayne L. Gold, Pak Cheung Chan, and Khosrow Adeli
A Patient with a Leg Rash, Pedal Edema, Renal Failure, and Thrombocytopenia
Clin Chem 2009 55: 1419-1422.
http://www.clinchem.org/cgi/content/full/55/7/1419
Commentaries
Robert M.A. Richardson
Clin Chem 2009 55: 1423.
http://www.clinchem.org/cgi/content/full/55/7/1423-a
Charles E. Alpers
Clin Chem 2009 55: 1423-1424.
http://www.clinchem.org/cgi/content/full/55/7/1423
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete July 2009 issue at http://www.clinchem.org/content/vol55/issue7/
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June 2009
A Patient with a Previous Diagnosis of Hemoglobin S/C Disease with an Unusually Severe Disease Course
Elizabeth K O'Keefe, Melissa M Rhodes and Alison Woodworth
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for June 2009. This published version includes a discussion of the case, important points to remember, and comments from experts in the field.
Elizabeth K. O'Keeffe, Melissa M. Rhodes, and Alison Woodworth
A Patient with a Previous Diagnosis of Hemoglobin S/C Disease with an Unusually Severe Disease Course
Clin Chem 2009 55: 1228-1231
http://www.clinchem.org/cgi/content/full/55/6/1228
Commentaries
Carlo Brugnara
Clin Chem 2009 55: 1231-1232.
http://www.clinchem.org/cgi/content/full/55/6/1231
James Hoyer
Clin Chem 2009 55: 1232-1233.
http://www.clinchem.org/cgi/content/full/55/6/1232
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete June 2009 issue at http://www.clinchem.org/content/vol55/issue6/
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May 2009
Chronic Diarrhea in 5 Year-Old Girl: Pitfall in Routine Laboratory Testing with Potentially Severe Consequences
Jürgen J Wenzel, Heidi Rossmann, Ulrike Kullmer, Bettina Oberman, Eugen Mengel, Karl J Lackner and Johannes Lotz
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April 2009
Genetic Testing for Developmental Delay: Keep Searching for an Answer
David T Miller, Yiping Shen, David J Harris, Bai-Lin Wu and Magdi M Sobeih
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for April 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
David T. Miller, Yiping Shen, David J. Harris, Bai-Lin Wu, and Magdi M. Sobeih
Genetic Testing for Developmental Delay: Keep Searching for an Answer
Clin Chem 2009 55: 827-830.
http://www.clinchem.org/cgi/content/full/55/4/827
Commentaries
Sau Wai Cheung
Clin Chem 2009 55: 830-831.
http://www.clinchem.org/cgi/content/full/55/4/830
Nelson L.S. Tang
Clin Chem 2009 55: 831-832.
http://www.clinchem.org/cgi/content/full/55/4/831
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete April 2009 issue at http://www.clinchem.org/content/vol55/issue4/
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March 2009
Two Cases with Unusual Vancomycin Measurements
Stacey A Simons, Alejandro R Molinelli, Kimia Sobhani, Petrie M Rainey & Andrew N Hoofnagle
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for March 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
Stacey A. Simons, Alejandro R. Molinelli, Kimia Sobhani, Petrie M. Rainey, and Andrew N. Hoofnagle
Two Cases with Unusual Vancomycin Measurements
Clin Chem 2009 55: 578-580.
http://www.clinchem.org/cgi/content/full/55/3/578
Commentaries
David F. Keren
Clin Chem 2009 55: 580-581.
http://www.clinchem.org/cgi/content/full/55/3/580
Amitava Dasgupta
Clin Chem 2009 55: 581-582.
http://www.clinchem.org/cgi/content/full/55/3/581
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete March 2009 issue at http://www.clinchem.org/content/vol55/issue3/
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February 2009
Myocardial Infarction in a 72 year old Woman with Low LDL-C and Increased hsCRP: Implications for Statin Therapy
Paul M Ridker
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for February 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
Paul M Ridker
Myocardial Infarction in a 72-Year-Old Woman with Low LDL-C and Increased hsCRP: Implications for Statin Therapy
Clin Chem 2009 55: 369-374.
http://www.clinchem.org/cgi/content/full/55/2/369
Commentaries
Ernst J. Schaefer
Clin Chem 2009 55: 374-375.
http://www.clinchem.org/cgi/content/full/55/2/374
Eric Yang and Christie M. Ballantyne
Clin Chem 2009 55: 375.
http://www.clinchem.org/cgi/content/full/55/2/375
We hope you find this feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete February 2009 issue at http://www.clinchem.org/content/vol55/issue2/
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January 2009
A Patient with Primary Biliary Cirrhosis and Elevated LDL Cholesterol
Kevin F Foley, Marina G Silveira, Jean M Hornseth, Keith D Lindor & Joseph P McConnell
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for January 2009. This published version includes a discussion of the case, important points to remember, and comments from an expert in the field.
Kevin F. Foley, Marina G. Silveira, Jean M. Hornseth, Keith D. Lindor, and Joseph P. McConnell
A Patient with Primary Biliary Cirrhosis and Elevated LDL Cholesterol
Clin Chem 2009 55: 187-192.
http://www.clinchem.org/cgi/content/full/55/1/187
Commentary
James Otvos
http://www.clinchem.org/cgi/content/full/55/1/191
We hope you find this new feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete January 2009 issue at http://www.clinchem.org/content/vol55/issue1/
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December 2008
Hemolytic Anemia Following Attempted Suicide
Nichole L Korpi-Steiner, Jonathan B Hoyne, James D Hoyer & Amy K Saenger
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Studies for December 2008. This published version includes a discussion of the case, important points to remember, and comments from 2 experts in the field.
Nichole L. Korpi-Steiner, Jonathan B. Hoyne, James D. Hoyer, and Amy K. Saenger
Hemolytic Anemia Following Attempted Suicide
Clin Chem 2008 54: 2071-2074.
http://www.clinchem.org/cgi/content/full/54/12/2071
Commentaries
Ernest Beutler
Clin Chem 2008 54: 2074-2075
http://www.clinchem.org/cgi/content/full/54/12/2074
Ian D. Watson
Clin Chem 2008 54: 2075.
http://www.clinchem.org/cgi/content/full/54/12/2075
We hope you find this new feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete December 2008 issue at http://www.clinchem.org/content/vol54/issue12/
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November 2008
Elevated C3-Carnitine in a Healthy Premature Infant
Kimberly A Chapman, Michael J Bennett & Neil Sondheimer
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Studies for November 2008. This published version includes a discussion of the case, important points to remember, and comments from 2 experts in the field.
Kimberly A Chapman, Michael J. Bennett, and Neal Sondheimer
Increased C3-Carnitine in a Healthy Premature Infant
Clin Chem 2008 54: 1914-1917.
http://www.clinchem.org/cgi/content/full/54/11/1914
Commentaries
Charles P. Venditti
Clin Chem 2008 54: 1917-1918.
http://www.clinchem.org/cgi/content/full/54/11/1917
Dietrich Matern
Clin Chem 2008 54: 1918.
http://www.clinchem.org/cgi/content/full/54/11/1918
We hope you find this new feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments online with the complete November 2008 issue at http://www.clinchem.org/content/vol54/issue11/
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October 2008
A Girl with Severe Hand Swelling and Abdominal Cramps
Arturo Borzutzky, Lynda C Schneider and Raif S Geha
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Studies for October 2008. This published version includes a discussion of the case, important points to remember, and comments from 2 experts in the field.
Arturo Borzutzky, Lynda C. Schneider, and Raif S. Geha
A Girl with Severe Hand Swelling and Abdominal Cramps
Clin Chem 2008 54: 1733-1736.
http://www.clinchem.org/cgi/content/full/54/10/1733
Commentaries
Michael M. Frank
Clin Chem 2008 54: 1736.
http://www.clinchem.org/cgi/content/full/54/10/1736
Bruce L. Zuraw
Clin Chem 2008 54: 1737.
http://www.clinchem.org/cgi/content/full/54/10/1737
We hope you find this new feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments now online with the complete October 2008 issue at http://www.clinchem.org/content/vol54/issue10/
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September 2008
Unusual Serum Electrophoresis Pattern in a Woman with Pancreatic Carcinoma
Joris R Delanghe, Marc L De Buyzere, Veerle Casneuf and Marc Peeters
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August 2008
Marion L. Snyder and Corinne R. Fantz
Cirrhosis Originally Diagnosed as Nonalcoholic Steatohepatitis
Clin Chem 2008 54: 1395-1398
http://www.clinchem.org/cgi/content/full/54/8/1395
Commentaries
Morten Dahl
Clin Chem 2008 54: 1398-1399
http://www.clinchem.org/cgi/content/full/54/8/1398
Melissa R. Snyder and W. Edward Highsmith, Jr
Clin Chem 2008 54: 1399
http://www.clinchem.org/cgi/content/full/54/8/1399
We hope you find this new feature in the Journal useful. If you have any problems with the links above, you can also find the cases and comments now online with the complete August 2008 issue at http://www.clinchem.org/content/vol54/issue8/
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July 2008
Euthyroid Patient with Elevated Serum Free Thyroxine
George van der Watt, David Haarburger & Peter Berman
A Girl with Goiter and Inappropriate Thyroid-Stimulating Hormone Secretion
Mark D. Kellogg, Terence C. Law, Stephen Huang, and Nader Rifai
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Studies for July 2008. This published version includes a discussion of the case, important points to remember, and comments from two experts in the field.
Euthyroid Patient with Elevated Serum Free Thyroxine
George van der Watt, David Haarburger and Peter Berman
Clin Chem 2008 54: 1239-1241.
http://www.clinchem.org/cgi/content/full/54/7/1239
A Girl with Goiter and Inappropriate Thyroid-Stimulating Hormone Secretion
Mark D. Kellogg, Terence C. Law, Stephen Huang and Nader Rifai
Clin Chem 2008 54: 1241-1244.
http://www.clinchem.org/cgi/content/full/54/7/1241
Commentaries
Larry J. Kricka
Clin Chem 2008 54: 1245.
http://www.clinchem.org/cgi/content/full/54/7/1245
Kenneth D. Burman
Clin Chem 2008 54: 1246.
http://www.clinchem.org/cgi/content/full/54/7/1246
If you have any problems with the links above, you can also find the cases and comments now online with the complete July 2008 issue at http://www.clinchem.org/content/vol54/issue7/
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April 2008
Evaluation of a Prolonged Prothrombin Time
Joshua L Hood & Charles S Eby
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http://www.clinchem.org/cgi/content/full/54/4/765
http://www.clinchem.org/cgi/content/full/54/4/768
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March 2008
An Unusual Case of Severe Hypertriglyceridemia and Splenomegaly
Amit R Rahalkar, Jian Wang, Sandra Sirrs et al.
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Below, please find the link to the final version of Clinical Chemistry's Clinical Case Study for March 2008. This published version includes a discussion of the case, important points to remember, and comments from 2 experts in the field.
An Unusual Case of Severe Hypertriglyceridemia and Splenomegaly
Amit R. Rahalkar, Jian Wang, Sandra Sirrs, James Dimmick, Daniel Holmes, Nadine Urquhart, Robert A. Hegele, and Andre Mattman Clin Chem 2008;54 606-610
http://www.clinchem.org/cgi/content/full/54/3/606
Commentaries
Alan T. Remaley
Clin Chem 2008;54 610-611
http://www.clinchem.org/cgi/content/full/54/3/610
Robert Shamburek
Clin Chem 2008;54 611
http://www.clinchem.org/cgi/content/full/54/3/611
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February 2008
Celiac Disease Refractory to a Gluten-free Diet?
Leann M Mikesh, Sheila E Crowe, Grant C Bullock, Nancy E Taylor and David E Bruns
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Below, please find the link to the final version of Clinical Chemistry’s Clinical Case Study for February 2008. This published version includes a discussion of the case, important points to remember, and comments from two experts in the field.
Celiac Disease Refractory to a Gluten-free Diet?
Leann M. Mikesh, Sheila E. Crowe, Grant C. Bullock, Nancy E. Taylor, and David E. Bruns
Clin Chem 2008;54 441-444
http://www.clinchem.org/cgi/content/full/54/2/441
Commentaries
Robin G. Lorenz
Clin Chem 2008;54 444-445
http://www.clinchem.org/cgi/content/full/54/2/444
Susan H. Barton and Joseph A. Murray
Clin Chem 2008;54 445
http://www.clinchem.org/cgi/content/full/54/2/445
If you have any problems with the links above, you can also find the case and comments now online with the complete February 2008 issue at http://www.clinchem.org/content/vol54/issue2/
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January 2008
Persistent Low Concentration of Human Chorionic Gonadotrphin in a Non-Pregnant Female
Christopher R McCudden, Monte S Willis & David G Grenache
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Below, please find the link to the final version of Clinical Chemistry’s Clinical Case Study for January 2008. This published version includes a discussion of the case, important points to remember, and comments from two experts in the field.
Persistent Low Concentration of Human Chorionic Gonadotropin in a Nonpregnant Woman
Christopher R. McCudden, Monte S. Willis and David G. Grenache
University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC
http://www.clinchem.org/cgi/content/full/54/1/209
Commentaries
Carolyn Y. Muller
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131
http://www.clinchem.org/cgi/content/full/54/1/213
Ulf-Håkan Stenman
Department of Clinical Chemistry, Helsinki University Central Hospital, Biomedicum, PB 700, FIN-00029, Helsinki, Finland
http://www.clinchem.org/cgi/content/full/54/1/213-a
If you have any problems with the links above, you can also find the case and comments now online with the complete January 2008 issue at http://www.clinchem.org/content/vol54/issue1
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