脂血症诱导的血红蛋白过高估计和通过血替代在儿科急性淋巴细胞白血病患者的纠正
Zeynep Şule Evren1, Kamil Taha Uçar1
1Department of Biochemistry, Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye.
EJIFCC
|February 9, 2026
概括
实验室错误,如脂血症,可能导致血红蛋白虚假高. 血替代疗法在儿科患者中纠正了这种错误升高的血红蛋白,确保了准确的临床决定.
科学领域:
- 临床实验室科学 临床实验室科学
- 儿科血液学 儿科血液学
- 生物化学 生物化学
背景情况:
- 实验室测试中的预分析和分析错误可能导致对患者结果的误解.
- 脂血症是一种常见的干扰,可以显著影响实验室值,包括血红蛋白.
- 准确的实验室结果对于适当的临床决策至关重要.
研究的目的:
- 要突出一个儿童患者由于严重的脂血症导致血红蛋白水平错误升高的案例.
- 描述实验室干预以纠正血红蛋白测量中的脂质干扰.
- 强调实验室发现与临床数据的相关性的重要性.
主要方法:
- 在患有急性淋巴细胞白血病的儿科患者身上进行了全血细胞计 (CBC).
- 确定了严重的脂血症,导致血红蛋白结果不一致.
- 在重新测量血红蛋白之前,采用了血替代技术来减轻脂质干扰.
主要成果:
- 最初的血红蛋白测量被错误地提高到16.9 g/dL,这是由于脂血症 (三糖8042 mg/dL).
- 同时抽取的静脉血液气体样本显示血红蛋白为9.2g/dL.
- 在用0.9%NaCl替代血后,修正后的血红蛋白水平为10.2g/dL,与临床数据保持一致.
结论:
- 这一案例强调了与临床和生化参数相关联的实验室结果的必要性.
- 血替代是一种可行的方法,用于纠正因脂血症引起的错误升高的血红蛋白,当重新采样是不可能的.
- 迅速识别和纠正脂血症引起的实验室错误对于防止临床误诊和不适当的治疗至关重要.
相关概念视频
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
274
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
274
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
326
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
326
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
242
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
242
01:24Hemoglobin
8.6K
Hemoglobin is a globular protein made up of four subunits. Two of these subunits are alpha chains, and the other two are beta chains. Each subunit contains a molecule of heme, which has an iron atom and can bind to oxygen. When an oxygen molecule binds to one heme group, it changes the shape of hemoglobin, making it easier for the other heme groups to bind oxygen as well.
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
8.6K
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
305
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
305
01:15Distance Corrections
299
To achieve precise distance measurements, especially in surveying and construction, certain corrections must be applied to account for potential sources of error like the standardization errors, temperature variations, and slope adjustments.Standardization error emerges when measurement equipment undergoes changes, such as wear, repairs, or weather impacts. To address this, surveyors compare the equipment’s readings to a standard. This process identifies any deviation that might lead to...
299