Leukocytosis and artifactual hypoglycemia

Area of Science:

• Clinical Biochemistry
• Hematology

Background:

• Accurate blood glucose measurement is crucial for diagnosing and managing metabolic disorders, including diabetes mellitus.
• Artifacts in laboratory assays can lead to misinterpretation of patient results, necessitating careful pre-analytical sample handling.

Observation:

• Two patients presented with asymptomatic hypoglycemia.
• Excessive in vitro glucose consumption by leukocytes was noted prior to serum separation for analysis.

Findings:

• Leukocyte-mediated glucose consumption can lead to artifactual hypoglycemia.
• This phenomenon is not necessarily linked to leukemia or high white blood cell counts.
• The same artifactual process can mask hyperglycemia, leading to factitious euglycemia.

Implications:

• Clinicians should be aware of leukocyte glucose consumption as a potential cause of erroneous blood glucose readings.
• Proper sample handling protocols are essential to prevent artifactual hypoglycemia and ensure accurate glucose assays.
• This artifact can complicate the diagnostic evaluation of suspected diabetes mellitus.