Pneumatic transport is critical for leukaemic patients with major leukocytosis: what precautions to measure lactate dehydrogenase, potassium and aspartate aminotransferase?
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.
Guiheneuf
Raphael
R
UF Analyses automatisées, Pôle de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, France.
Vuillaume
Isabelle
I
Mangalaboyi
Jacques
J
Launay
David
D
Berthon
Céline
C
Maury
J-Claude
JC
Maboudou
Patrice
P
Rousseaux
Jean
J
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*
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D011188:Potassium