title: Pneumatic transport is critical for leukaemic patients with major leukocytosis: what precautions to measure lactate dehydrogenase, potassium and aspartate aminotransferase?
abstract: False elevations of plasma lactate dehydrogenase (LDH), potassium and aspartate aminotransferase (AST) have been described, in relation to haemolysis, occurring most often by mechanical release during phlebotomy or specimen processing. We present the cases of two leukaemic patients with severe hyperleukocytosis for whom LDH, potassium and AST were dramatically but falsely elevated. This false elevation was not caused by haemolysis but could be related to white cells lysis during transport through a pneumatic transportation system, enhanced by a specific fragility of leukaemic cells. Interestingly, this interference almost completely disappeared when serum rather than plasma was used, or when leukocytosis came back to normal. This work is meant to alert clinicians to the risks of errors in LDH, potassium and AST in leukaemic patients and suggest what precautions to take.
authors: UF Analyses automatisées, Pôle de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, France.
authors: Raphael
authors: R
authors: Guiheneuf
authors: Isabelle
authors: I
authors: Vuillaume
authors: Jacques
authors: J
authors: Mangalaboyi
authors: David
authors: D
authors: Launay
authors: Céline
authors: C
authors: Berthon
authors: J-Claude
authors: JC
authors: Maury
authors: Patrice
authors: P
authors: Maboudou
authors: Jean
authors: J
authors: Rousseaux
mesh_terms: D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000032:analysis / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods* / Q000592:standards; D001800:Blood Specimen Collection / Q000379:methods*; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis / Q000097:blood; D007938:Leukemia / Q000097:blood* / Q000150:complications; D007964:Leukocytosis / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011188:Potassium / Q000032:analysis / Q000097:blood; D014186:Transportation / Q000379:methods*
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D011188:Potassium