Pneumatic transport is critical for leukaemic patients with major leukocytosis: what precautions to measure lactate dehydrogenase, potassium and aspartate aminotransferase?

Annals of Clinical Biochemistry
Raphael GuiheneufJean Rousseaux

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.

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Citations

Jun 1, 2013·North American Journal of Medical Sciences·Jaya R AsirvathamLoring Bjornson
May 24, 2011·International Journal of Nephrology·Stephen I Rifkin
Oct 17, 2014·Critical Reviews in Clinical Laboratory Sciences·Qing H Meng, Elizabeth A Wagar
Oct 16, 2016·Scandinavian Journal of Clinical and Laboratory Investigation·Árpád LábadiGábor L Kovács
Oct 29, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Sara PasqualettiMauro Panteghini
Apr 21, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Mustafa KorogluSeyit Ali Kayis
May 29, 2019·Diabetes Technology & Therapeutics·Guillaume GrzychPatrice Maboudou
Jan 26, 2021·The Journal of Pediatrics·Zelda GhersinPhoebe Yager
Dec 29, 2018·Clinical Biochemistry·Guillaume GrzychThierry Brousseau
Sep 21, 2013·Annals of Clinical Biochemistry·Milan Dastych, Zdenka Cermáková

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