Pathology and Laboratory Medicine

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Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis

Received: 04 November 2018    Accepted: 26 November 2018    Published: 21 December 2018
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Abstract

The aims of this study were to determine the frequency, and evaluate the effects of haemolysis, icterus and lipaemia in samples for lipid lipoprotein tests in an academic medical hospital patient population. This was a retrospective study on data from the central Chemical pathology laboratory at the largest academic hospital in Africa. Serum indices (haemolysis, icterus and lipaemia) were available for all the lipid and lipoprotein chemistry specimens analysed over a 4 year (2007 – 2010) period (n=10, 5555). In the study the effects of haemolysis, lipaemia and icterus on the lipid profiles was determined. From a very large sample pool submitted to Chemical pathology laboratory for lipid and lipoprotein tests, serum indices for lipaemia, hemolysis and icterus were analysed. One thousand six hundred and eighteen (15.33%) were identified as having some form of interferent. Results were as follows: lipaemia, 13.92%; hemolysis, 1.17%; and icterus, 0.25%. There were significant differences between the clear and icteric samples in all the measured lipids and lipoproteins except HDL. Icteric samples had lower HDL levels than the clear samples. However, the frequency of icterus and haemolysis serum indices found in this study is lower than reports from other studies. The frequency of lipaemia found in this study constitutes the highest serum index at the hospital. The study concluded that lipaemia, hemolysis, and icterus occur frequently in blood specimens analysed in the laboratory. Therefore, serum indices are important interfering factors, which require an objective assessment.

DOI 10.11648/j.plm.20180202.13
Published in Pathology and Laboratory Medicine (Volume 2, Issue 2, December 2018)
Page(s) 41-46
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Haemolysis, Icterus, Lipaemia, Lipid and Lipoproteins and Serum Indices

References
[1] Ryder, K. W., Glick, M. R. and Glick, S. J. 1991. Incidence and Amount of Turbidity, Hemolysis, and Icterus in Serum from Outpatients. Laboratory Medicine, 22 (6): p 415–418.
[2] Akbas, N., Eppert, B., Miller, J., Schulten, C., Wallace, C. and Turner, T. 2018. Effect of Hemolysis, Icterus and Lipemia on Chemistry Tests and Association between the Amount of Interfering Substances and LIH Indices. https://www.medpace.com/wp-content/uploads/2018/08/Effect-of-Hemolysis-Icterus-and-Lipemia-on-Chemistry-Tests-and-Association-between-the-Amount-of-Interfering-Substances-and-LIH-Indices-2.pdf [Accessed 22nd November 2018].
[3] Glick, M. R., Ryder, K. W., Glick, S. J. and Woods, J. R. 1989. Unreliable visual estimation of the incidence and amount of turbidity, hemolysis, and icterus in serum from hospitalized patients. Clinical Chemistry, 35 (5): p837-9.
[4] Farrell C-J. L. and Carter, A. C. 2016. Serum indices: managing assay interference. Annals of Clinical Biochemistry, 53 (5): p527-538.
[5] Grafmeyer, D. , Bondon, M. , Manchon, M. and Levillairi, P. 1995. The Influence of Bilirubin, Haemolysis and Turbidity on 20 Analytical Tests Performed on Automatic Analysers. European journal of clinical chemistry and clinical biochemistry, 33: p31-52.
[6] Kroll, M, McCudden, C. 2013. Endogenous interferences in clinical laboratory tests, 1st ed. Berlin: Walter de Gruyter.
[7] Spain, M. and Wu, A.1986. Bilirubin interference with determination of uric acid, cholesterol, and triglycerides in commercial peroxidase-coupled assays, and the effect of ferricyanide. Clinical Chemistry, 32: p518-521.
[8] Kroll, M. H. and Elin, R, J. 1994. Interferences with clinical laboratory analyses. Clinical Chemistry, 40: p1996-2005.
[9] Jay, D. W. and Provasek, D. 1993. Characterization and mathematical correction of hemolysis interference in selected Hitachi 717 assays. Clinical Chemistry, 39: p1804–10.
[10] Vermeer, H. J., Thomassen, E. and de Jonge, N. 2005. Automated Processing of Serum Indices Used for Interference Detection by the Laboratory Information System. Clinical Chemistry, 51 (1): p276-277.
[11] Darby, D, and Broomhead, C. 2008. Interference with serum indices measurement, but not chemical analysis, on the Roche Modular by Patent Blue V. Annals of Clinical Biochemistry, 45: p289–292.
[12] Drum, W., Grimm, G. and Laggner, A. N. 1991. Hyperlipidemia in acute haemolysis. Wiener klinische Wochenschrift, 69: p426.
[13] Gofman, J. W., Delalla, O., Glazier, F., Freeman, N. K., Lindgren, F. T., Nichols, A. V., Strisower, B. and Tamplin, A. R. 1954. The serum lipoprotein transport system in health, metabolic disorders, atherosclerosis and coronary heart disease. Plasma, 2: p413-484.
[14] Epstein, E. M. and Greenspan, E. B. 1936. Clinical significance of the cholesterol partition of the blood plasma in hepatic and biliary disease. Archives of Internal Medicine 58 (5): p860-890.
[15] Whipple, G. H. and King, J. H. 1911. The pathogenesis of icterus. The Journal of Experimental Medicine, 13(1): p115–135.
[16] Friedewald, W. T. , Levy, R. I. and Fredrickson, D. S. 1972. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical chemistry, 18(6): p499-502.
[17] Carraro, P. , Servidio, G. and Plebani, M. 2000. Haemolysed Specimens: A Reason for Rejection or a Clinical Challenge? Clinical Chemistry, 46, 2: p306.
[18] Zorca, S., Freeman, L., Hildesheim, M., Allen, D., Remaley, A. T., Taylor, J. G. and Kato, G. J. 2010. Lipid Levels in Sickle-Cell Disease Associated with Haemolytic Severity, Vascular Dysfunction and Pulmonary Hypertension. British Journal of Haematology, 149 3: p436–445.
[19] Mainali, S., Davis, S. R. and Krasowski, M. D. 2017. Frequency and causes of lipaemia interference of clinical chemistry laboratory tests. Practical Laboratory Medicine, 8: p1-9.
[20] Kackov, S., Simundic. A. M. and Gatti-Drnic, A. 2013. Are patients well informed about the fasting requirements for laboratory blood testing? Biochemical Medicine, 23: p326-31.
[21] Dufour, D. R., Lott, J. A. and Nolte, F. S. 2000. Diagnosis and monitoring of hepatic injury. Recommendations for use of laboratory tests in screening, diagnosis, and monitoring. Clinical Chemistry, 46: p2050-68..
[22] Rao, N., Jain, A., Goyale, A. , Persaud, J. W., Al-Musalhi, K. and Nair, D. R. 2017. Lipoprotein X in autoimmune liver disease causing interference in routine and specialist biochemical investigations, Clinical Lipidology, 12: 1, 8-13.
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Author Information
  • School of Pathology, University of the Witwatersrand and NHLS, Johannesburg, South Africa

  • National Health Laboratories, Johannesburg, South Africa

  • School of Pathology, University of the Witwatersrand and NHLS, Johannesburg, South Africa

  • School of Pathology, University of the Witwatersrand and NHLS, Johannesburg, South Africa

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    Agnes Magwete, Florence Marule, Taryn Pillay, Donald M. Tanyanyiwa. (2018). Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis. Pathology and Laboratory Medicine, 2(2), 41-46. https://doi.org/10.11648/j.plm.20180202.13

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    ACS Style

    Agnes Magwete; Florence Marule; Taryn Pillay; Donald M. Tanyanyiwa. Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis. Pathol. Lab. Med. 2018, 2(2), 41-46. doi: 10.11648/j.plm.20180202.13

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    AMA Style

    Agnes Magwete, Florence Marule, Taryn Pillay, Donald M. Tanyanyiwa. Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis. Pathol Lab Med. 2018;2(2):41-46. doi: 10.11648/j.plm.20180202.13

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  • @article{10.11648/j.plm.20180202.13,
      author = {Agnes Magwete and Florence Marule and Taryn Pillay and Donald M. Tanyanyiwa},
      title = {Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis},
      journal = {Pathology and Laboratory Medicine},
      volume = {2},
      number = {2},
      pages = {41-46},
      doi = {10.11648/j.plm.20180202.13},
      url = {https://doi.org/10.11648/j.plm.20180202.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.plm.20180202.13},
      abstract = {The aims of this study were to determine the frequency, and evaluate the effects of haemolysis, icterus and lipaemia in samples for lipid lipoprotein tests in an academic medical hospital patient population. This was a retrospective study on data from the central Chemical pathology laboratory at the largest academic hospital in Africa. Serum indices (haemolysis, icterus and lipaemia) were available for all the lipid and lipoprotein chemistry specimens analysed over a 4 year (2007 – 2010) period (n=10, 5555). In the study the effects of haemolysis, lipaemia and icterus on the lipid profiles was determined. From a very large sample pool submitted to Chemical pathology laboratory for lipid and lipoprotein tests, serum indices for lipaemia, hemolysis and icterus were analysed. One thousand six hundred and eighteen (15.33%) were identified as having some form of interferent. Results were as follows: lipaemia, 13.92%; hemolysis, 1.17%; and icterus, 0.25%. There were significant differences between the clear and icteric samples in all the measured lipids and lipoproteins except HDL. Icteric samples had lower HDL levels than the clear samples. However, the frequency of icterus and haemolysis serum indices found in this study is lower than reports from other studies. The frequency of lipaemia found in this study constitutes the highest serum index at the hospital. The study concluded that lipaemia, hemolysis, and icterus occur frequently in blood specimens analysed in the laboratory. Therefore, serum indices are important interfering factors, which require an objective assessment.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Assessing the Incidence and Effect of Haemolysis, Lipaemia, and Icterus in Samples for Lipid and Lipoprotein Analysis
    AU  - Agnes Magwete
    AU  - Florence Marule
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    AU  - Donald M. Tanyanyiwa
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.plm.20180202.13
    AB  - The aims of this study were to determine the frequency, and evaluate the effects of haemolysis, icterus and lipaemia in samples for lipid lipoprotein tests in an academic medical hospital patient population. This was a retrospective study on data from the central Chemical pathology laboratory at the largest academic hospital in Africa. Serum indices (haemolysis, icterus and lipaemia) were available for all the lipid and lipoprotein chemistry specimens analysed over a 4 year (2007 – 2010) period (n=10, 5555). In the study the effects of haemolysis, lipaemia and icterus on the lipid profiles was determined. From a very large sample pool submitted to Chemical pathology laboratory for lipid and lipoprotein tests, serum indices for lipaemia, hemolysis and icterus were analysed. One thousand six hundred and eighteen (15.33%) were identified as having some form of interferent. Results were as follows: lipaemia, 13.92%; hemolysis, 1.17%; and icterus, 0.25%. There were significant differences between the clear and icteric samples in all the measured lipids and lipoproteins except HDL. Icteric samples had lower HDL levels than the clear samples. However, the frequency of icterus and haemolysis serum indices found in this study is lower than reports from other studies. The frequency of lipaemia found in this study constitutes the highest serum index at the hospital. The study concluded that lipaemia, hemolysis, and icterus occur frequently in blood specimens analysed in the laboratory. Therefore, serum indices are important interfering factors, which require an objective assessment.
    VL  - 2
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