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Elevated serum levels of bromine do not always indicate pseudohyperchloremia
Takayasu Ito1, Eiji Ishikawa, Yoshikazu Matsuda
1Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edo-bashi, Tsu, Mie, 514-8507, Japan. takayasu@clin.medic.mie-u.ac.jp
Clinical and Experimental Nephrology
|August 13, 2010
Summary
Bromine (Br(-)) can interfere with chloride (Cl(-)) assays on ion electrode machines, leading to pseudohyperchloremia and potentially revealing bromism. Assay interference varies significantly between machine types.
Area of Science:
- Clinical Chemistry
- Analytical Chemistry
- Nephrology
Background:
- Bromism can be masked or revealed by pseudohyperchloremia.
- The interference of bromide (Br(-)) in chloride (Cl(-)) assays using ion electrode machines is not widely recognized.
Observation:
- Chloride concentrations in samples increased when bromide was added, indicating interference.
- The degree of interference varied significantly across four different ion electrode machines.
- The increase in measured chloride was not consistently proportional to the amount of bromide added.
Findings:
- Ion electrode machines exhibit variable susceptibility to bromide interference in chloride assays.
- One machine showed a substantial increase in measured chloride (from 94.9 to 139.6 mEq/L) with 10 mEq/L bromide addition.
- Another machine demonstrated less interference, with chloride increasing from 95.0 to 103.0 mEq/L under the same conditions.
Implications:
- Clinical nephrologists must be aware of potential bromide interference in chloride measurements.
- Understanding the specific characteristics of laboratory equipment is crucial for accurate diagnosis.
- This highlights the need for careful interpretation of electrolyte results in patients with suspected bromide exposure.
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