A 35-year-old female patient presented with scleral icterus for more than 12 years and intermittent pruritus

and was finally diagnosed with primary biliary cholangitis (PBC). During diagnosis and treatment

the patient showed significantly elevated and fluctuating levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C)

accompanied by markedly increased liver function indexes such as bilirubin and transaminase. The laboratory department verified the instrument operation status

internal quality control

reagent validity period

and repeated detection with alternative equipment

and no abnormalities were found in the detection system. Literature analysis confirmed that lipoprotein X (LpX)

an abnormal lipoprotein specifically present in the plasma of patients with cholestasis

could seriously interfere with the routine blood lipid detection system and cause pseudo-elevation of LDL-C and TC results

thereby misleading clinicians in the evaluation of cardiovascular risk and formulation of diagnosis and treatment plans. After clarifying the etiology

the patient was prioritized for primary disease treatment of PBC without blind lipid-lowering intervention. Finally

the patient's condition improved

blood lipid indexes returned to normal

and the clinical outcome was favorable. This case suggests that when reviewing abnormal blood lipid test results

laboratory staff should fully combine the patient's underlying medical history

avoid methodological interference

actively identify pseudo-abnormal results and communicate with clinicians in a timely manner

so as to give full play to the auxiliary diagnostic value of laboratory clinical thinking.