Artifactual hypoglycemia associated with hematopoietic cytokines.
We observed apparent hypoglycemia in seven patients manifesting granulocytosis associated with hematopoietic cytokine treatment or with a leukemoid reaction. All seven patients had confounding preanalytic conditions of specimen transport delay and lack of antiglycolytic agents. Cytokine-stimulated leukocytes may cause artifactual hypoglycemia by consuming glucose in vitro, possibly leading to unnecessary diagnostic evaluation. The glucose depletion was faster in blood drawn from patients receiving granulocyte colony-stimulating factor (0.29 mmol/L/h) than in blood from a control group (0.17 mmol/L/h) or from a group with leukemia (0.23 mmol/L/h). Stabilization with sodium fluoride (60 mmol/L) slowed the glucose depletion in both the cytokine group (0.13 mmol/L/h) and the leukemic group (0.09 mmol/L/h), which were then statistically indistinguishable from the control rate (0.10 mmol/L/h). In blood obtained from patients being treated with hematopoietic cytokines or who have leukemoid reactions, an antiglycolytic agent should be used whenever separation of plasma might be delayed more than 1 hour.
Astles
J R
JR
Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
Petros
W P
WP
Peters
W P
WP
Sedor
F A
FA
D016477:Artifacts; D016207:Cytokines / Q000009:adverse effects* / Q000502:physiology*; D003625:Data Collection; D005459:Fluorides / Q000494:pharmacology; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use; D006410:Hematopoiesis; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015994:Incidence; D007938:Leukemia / Q000097:blood; D007964:Leukocytosis / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
D016207:Cytokines; D016179:Granulocyte Colony-Stimulating Factor; D005459:Fluorides