Shweta Agarwal1, German Vargas1, Cristina Nordstrom1, Estella Tam1, Gregory J Buffone1, Sridevi Devaraj2. 1. Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA. 2. Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA. Electronic address: sxdevara@texaschildrens.org.
Abstract
BACKGROUND: Clinical laboratory assays can be affected by interferents like hemoglobin (Hb), lipids and bilirubin. We evaluated the effect of these interferences on pediatric samples for different chemistry assays. Further we established cut-off indices above which these interferences confound sample results. METHODS: Three separate serum pools were spiked with increasing concentrations of hemolysate or intralipid or bilirubin and different analytes were analyzed. The Hemolysis-(H), Lipemia-(T) and Icterus-(I) indices were measured on Vitros 5600. Analytes affected by lipemia were treated with LipoClear ® and re-analyzed. All the measured analytes were compromised by gross hemolysis (H-Index >1000). RESULTS: Except lipase and magnesium (Mg(++)), all other analytes were affected by moderate (H-Index >250) and significant hemolysis (H-Index >500). Low estradiol levels showed a significant effect at severe icterus (I-Index >20.0). C3, C4, Ceruloplasmin, Haptoglobin, Immunoglobulins (Ig) and Vitamin D were significantly affected by moderate (T-Index >100) and severe (T-Index >500) lipemia. LipoClear ® treatment significantly attenuated the lipemic interference on the above analytes except for C3, C4, and IgG. CONCLUSIONS: Accurate reporting of pediatric samples for the analytes affected by common interferences will lead to better clinical interpretation.
BACKGROUND: Clinical laboratory assays can be affected by interferents like hemoglobin (Hb), lipids and bilirubin. We evaluated the effect of these interferences on pediatric samples for different chemistry assays. Further we established cut-off indices above which these interferences confound sample results. METHODS: Three separate serum pools were spiked with increasing concentrations of hemolysate or intralipid or bilirubin and different analytes were analyzed. The Hemolysis-(H), Lipemia-(T) and Icterus-(I) indices were measured on Vitros 5600. Analytes affected by lipemia were treated with LipoClear ® and re-analyzed. All the measured analytes were compromised by gross hemolysis (H-Index >1000). RESULTS: Except lipase and magnesium (Mg(++)), all other analytes were affected by moderate (H-Index >250) and significant hemolysis (H-Index >500). Low estradiol levels showed a significant effect at severe icterus (I-Index >20.0). C3, C4, Ceruloplasmin, Haptoglobin, Immunoglobulins (Ig) and Vitamin D were significantly affected by moderate (T-Index >100) and severe (T-Index >500) lipemia. LipoClear ® treatment significantly attenuated the lipemic interference on the above analytes except for C3, C4, and IgG. CONCLUSIONS: Accurate reporting of pediatric samples for the analytes affected by common interferences will lead to better clinical interpretation.
Authors: Johannes Wolf; Norman Haendel; Johannes Remmler; Carl Elias Kutzner; Thorsten Kaiser; Thomas Mothes Journal: J Clin Lab Anal Date: 2017-11-23 Impact factor: 2.352