Three cases of false decrease interference of etamsylate on biochemical laboratory tests and correction methods

Etamsylate, a commonly used clinical hemostatic agent, may cause false decreases in biochemical test results through inhibition of enzymatic activity or interference with chromogenic reactions. However, insufficient research on its interference mechanisms and correction methods increases the risk of clinical misjudgment.

Serum samples were collected from three patients treated with etamsylate and analyzed using the Roche Cobas 8000 c701 automated biochemical analyzer. Samples were tested at undiluted (0-fold), 3-fold, 5-fold, and 10-fold dilution gradients to evaluate drug interference characteristics and the efficacy of dilution-based correction.

Among the 46 routine biochemical assays evaluated, etamsylate exhibited significant negative interference on 12 parameters, including creatinine (CREA), albumin (ALB), and cholyglycine (CG). The interference diminished linearly with increasing dilution factors, demonstrating a dose-dependent recovery trend. CG demonstrated the most pronounced changes. No significant interference was observed for 12 other tests, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Following dilution, six parameters, including apolipoprotein A1 (APOA1), apolipoprotein A2 (APOA2), and apolipoprotein B (APOB), exhibited a paradoxical decrease in assay results, suggesting the presence of distinct interference mechanisms.

The dilution method can effectively correct the false decrease interference of etamsylate on biochemical detection. However, it is necessary to optimize the dilution factors to avoid loss of sensitivity. It is recommended that laboratories establish a drug interference database, standardize the gradient dilution process, and promote multi-disciplinary collaboration to optimize the detection system.