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January 6, 1984

Propranolol and Spurious Hyperbilirubinemia

Author Affiliations

Oregon Health Sciences University School of Medicine University Hospital Portland

JAMA. 1984;251(1):38. doi:10.1001/jama.1984.03340250022009

To the Editor.—  Report of a Case.— Spurious hyperbilirubinemia was found in a 21-year-old man undergoing hemodialysis for chronic renal failure (CRF). Laboratory results were unremarkable except for an elevated bilirubin level on the third day of hospitalization before scheduled renal transplantation (Table). We suspected spurious hyperbilirubinemia because the bilirubin results were normal on the two previous days and the patient's clinical condition was unchanged. Analysis of the patient's serum with two different instruments produced discrepant results (Table). Elevated results were found for both total and direct bilirubin with the DuPont ACA, while the results from a Technicon SMAC were within the normal range. After renal transplant, the results from both analyzers were in agreement and were within the normal range (Table).Comment.—Spurious hyperbilirubinemia has previously been reported in patients with CRF being treated with propranolol hydrochloride when the tests were processed with a different analyzer.1,2 Since