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Haemolysis as an interference factor in clinical chemistry
Journal of Clinical Chemistry and Clinical Biochemistry. Zeitschrift Fur Klinische Chemie Und Klinische Biochemie
|February 1, 1986
Summary
Hemolysis significantly interferes with specific clinical chemistry tests. High hemoglobin levels cause falsely elevated or decreased results for enzymes like lactate dehydrogenase and aspartate aminotransferase, and analytes such as potassium and bilirubin.
Area of Science:
- Clinical Chemistry
- Biochemistry
- Laboratory Medicine
Background:
- Hemolysis, the rupture of red blood cells, is a common pre-analytical issue in clinical laboratories.
- Interference from hemolysis can lead to inaccurate patient test results, impacting clinical decisions.
- Understanding the extent of interference for various analytes is crucial for reliable diagnostic testing.
Purpose of the Study:
- To quantitatively assess the interference of hemolysis on 26 common clinical chemical parameters.
- To establish hemoglobin concentration thresholds that cause significant interference for each parameter.
- To provide guidance on the reliability of laboratory results in the presence of hemolysis.
Main Methods:
- Serum samples were spiked with varying concentrations of hemolysate to simulate different levels of hemolysis.
- Twenty-six clinical chemical parameters were analyzed using fully mechanized analytical equipment.
- Interference was quantified by comparing results from hemolyzed samples to non-hemolyzed controls.
Main Results:
- No significant interference was observed for albumin (immuno-nephelometric), calcium, glucose, and electrolytes up to 6.6 g/l hemoglobin.
- Erroneously high results were noted for lactate dehydrogenase (>0.2 g/l Hb), potassium (>1.5 g/l Hb), and creatine kinase (>2.5 g/l Hb).
- Erroneously low results were observed for bilirubin (>0.8 g/l Hb), alkaline phosphatase (>1.5 g/l Hb), and gamma-glutamyltransferase (>3.0 g/l Hb).
Conclusions:
- Hemolysis interferes with the accurate determination of several key clinical chemistry analytes.
- Specific hemoglobin concentration thresholds are identified for significant interference, varying by analyte.
- Awareness of these interferences is essential for accurate interpretation of clinical laboratory data.