أخي هناك التي يكون الارتفاع فيها بسيط مثل Phosphate, Total Protein, Albumin, Magnesium, Calcium,
Alkaline Phosphatase ALP وهناك التي يكون الانخفاض بسيط مثل
Haptoglobin, Bilirubin
وهناك التي يكون الارتفاع فيها الرتفاع ملاحظ مثل
ALT, CK, Iron, Coagulation tests
وهناك التي يكون الانخفاظ فيها ملاحظ مثل
Thyroxine T4
وهناك التي يكون فيها ارتفاع واضح جدا مثل
Potassium (K+), Lactate Dehydrogenase (LD), AST
استاذي الفاضل هناك بعض الاجهزة الحديثة التي يكون فيها معامل تصحيح لهذه العوامل المؤثرة و هناك بعض الاجهزة لاتتاثر بهذه العوامل لان نفس المحلول المستعمل في الجهاز له القدرة على تلافي مثل هذه العوامل .. ودمت بخير
ffects of Hemolysis on Clinical Specimens
Hemolysis due to the breakdown of red blood cells is important to the laboratory because it can have an effect on laboratory results. The effects can be the result of products liberated from the red cells themselves, or due to interferences with laboratory analyzers. This may vary from one test to another depending on the formulation of the reagent.
Hemolysis can occur in vivo (in the patient), due to a variety of medical conditions, including antigen-antibody reactions, hemolytic anemias, toxins and poisons, mechanical RBC rupture due to artificial heart valves, as well as treatments such as hemodialysis and the use of the heart-lung bypass machine. Hemolysis can occur during suboptimal blood collection, or in vitro (e.g. in the collection tube) due to improper storage.
Hemolysis is graded as slight, moderate or gross.
Slight hemolysis has little effect on most test values.
Gross hemolysis causes a slight dilutional effect on analytes present at a lower concentration in the red cells compared to plasma. However, a marked elevation may be observed for analytes present at a higher concentration in red cells than in plasma.
Test results on specimens with slight hemolysis are usually processed.
Comments are attached indicating the degree of hemolysis.
Some tests are affected more than others. Notable example of tests affected by hemolysis are found in the table below.
Effect of Hemolysis on some Clinical Biochemistry and Hematology Test Results
Degree of change in analyte Test result increased by hemolysis
Test result decreased by hemolysis Test result increased or decreased by hemolysis
Slight change Phosphate, Total Protein, Albumin, Magnesium, Calcium, Alkaline Phosphatase (ALP) Haptoglobin, Bilirubin
Noticeable change ALT, CK, Iron, Coagulation tests Thyroxine (T4)
Significant change Potassium (K+), Lactate Dehydrogenase (LD), AST Troponin T HGB, RBC, MCHC, Platelet Count
Note: If the specimen is grossly hemolyzed, a recollected specimen will be requested. If the recollected specimen is also grossly hemolyzed, it will be processed and a comment added.
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