Guillaume Grzych1, Estelle Roland2, David Beauvais3, Patrice Maboudou2, Giuseppe Lippi4. 1. University of Lille, CHU Lille, Department of Biochemistry and Molecular Biology, Laboratory of Endocrinology, Metabolism-Nutrition, Oncology, Biology Pathology Center, Lille, France + University of Lille, INSERM, UMR-1011-European Genomic Institute for Diabetes, Pasteur Institute, Lille, France. 2. University of Lille, CHU Lille, Biochemistry Emergency Department, Biology and Pathology Center, Lille, France. 3. University of Lille, CHU Lille, Huriez Hospital, Hematology Department, Lille, France. 4. University of Verona, Section of Clinical Biochemistry, Verona, Italy.
Abstract
BACKGROUND: Extreme leukocytosis is known to induce remarkable variations of some clinical chemistry tests, thus leading to possible clinical misinterpretation. This study aimed to define whether also moderate leukocytosis may influence the stability of glucose and blood gases. METHODS: Blood samples are sent to the local laboratory through a pneumatic tube system. Clinical chemistry testing is routinely performed using Lithium-heparin tubes (for glucose) and heparin blood gases syringes (for blood gas analysis). Stability of glucose (in uncentrifuged blood tubes) and blood gases (in syringes) was hence evaluated in samples maintained at room temperature. Results were also analyzed in 2 subgroups of samples with different leukocyte counts, i.e., those with leukocytes <15 × 109/L and those with leukocytes >15 × 109/L. RESULTS: An accelerated decrease of pH was observed in blood gases syringes with leukocytosis (i.e., >15 × 109/L), while no difference was noted for other blood gases parameters (PCO2, PO2). Spurious and time-dependent hypoglycemia was noted in uncentrifuged blood tubes of patients with leukocytosis. CONCLUSIONS: The results of our study suggest that even modest leukocytosis (i.e., around 15 × 109/L), which is frequently encountered in clinical and laboratory practice, may be associated with significant variations of both glucose and pH. This would lead us to conclude that results of these parameters shall be accompanied by those of hematologic testing to prevent clinical misinterpretation, namely with leukocyte counts. 2020 Guillaume Grzych, Estelle Roland, David Beauvais, Patrice Maboudou, Giuseppe Lippi, published by CEON/CEES.
BACKGROUND: Extreme leukocytosis is known to induce remarkable variations of some clinical chemistry tests, thus leading to possible clinical misinterpretation. This study aimed to define whether also moderate leukocytosis may influence the stability of glucose and blood gases. METHODS: Blood samples are sent to the local laboratory through a pneumatic tube system. Clinical chemistry testing is routinely performed using Lithium-heparin tubes (for glucose) and heparin blood gases syringes (for blood gas analysis). Stability of glucose (in uncentrifuged blood tubes) and blood gases (in syringes) was hence evaluated in samples maintained at room temperature. Results were also analyzed in 2 subgroups of samples with different leukocyte counts, i.e., those with leukocytes <15 × 109/L and those with leukocytes >15 × 109/L. RESULTS: An accelerated decrease of pH was observed in blood gases syringes with leukocytosis (i.e., >15 × 109/L), while no difference was noted for other blood gases parameters (PCO2, PO2). Spurious and time-dependent hypoglycemia was noted in uncentrifuged blood tubes of patients with leukocytosis. CONCLUSIONS: The results of our study suggest that even modest leukocytosis (i.e., around 15 × 109/L), which is frequently encountered in clinical and laboratory practice, may be associated with significant variations of both glucose and pH. This would lead us to conclude that results of these parameters shall be accompanied by those of hematologic testing to prevent clinical misinterpretation, namely with leukocyte counts. 2020 Guillaume Grzych, Estelle Roland, David Beauvais, Patrice Maboudou, Giuseppe Lippi, published by CEON/CEES.
Authors: Philip E Cryer; Lloyd Axelrod; Ashley B Grossman; Simon R Heller; Victor M Montori; Elizabeth R Seaquist; F John Service Journal: J Clin Endocrinol Metab Date: 2008-12-16 Impact factor: 5.958
Authors: Gianni Turcato; Gianfranco Cervellin; Antonio Bonora; Danieli Prati; Elisabetta Zorzi; Giorgio Ricci; Gian Luca Salvagno; Antonio Maccagnani; Giuseppe Lippi Journal: J Med Biochem Date: 2018-07-01 Impact factor: 3.402