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Fernández Prendes C, Castro Castro MJ, Sánchez Navarro L, Rapún Mas L, Morales Indiano C, Arrobas Velilla T. Handling of lipemic samples in the clinical laboratory. ADVANCES IN LABORATORY MEDICINE 2023; 4:5-27. [PMID: 37359904 PMCID: PMC10197190 DOI: 10.1515/almed-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/11/2022] [Indexed: 06/28/2023]
Abstract
Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in a sample caused by the accumulation of lipoproteins, mainly very-low density lipoproteins (VLDL) and chylomicrons. Several methods are available for the detection of lipemic samples, including the lipemic index, or triglyceride quantification in serum or plasma samples, or mean corpuscular hemoglobin (MCHC) concentration in blood samples. According to the European Directive 98/79/CE, it is the responsibility of clinical laboratories to monitor the presence of interfering substances that may affect the measurement of an analyte. There is an urgent need to standardize interference studies and the way interferences are reported by manufacturers. Several methods are currently available to remove interference from lipemia and enable accurate measurement of biological quantities. The clinical laboratory should establish a protocol for the handling of lipemic samples according to the biological quantity to be tested.
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Affiliation(s)
- Carla Fernández Prendes
- Laboratory Medicine Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
| | - María José Castro Castro
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
- Biochemistry Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Lourdes Sánchez Navarro
- Haematological Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Loreto Rapún Mas
- Haematological Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Cristian Morales Indiano
- Laboratory Medicine Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
| | - Teresa Arrobas Velilla
- Laboratory of Nutrition and Cardiovascular Risk, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
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Yue J, Lian X, Yue P, Xiang D, Wang C. Impact on major CBC parameters caused by different types of lipids in patient plasma. Int J Lab Hematol 2017; 40:e1-e3. [PMID: 29058373 DOI: 10.1111/ijlh.12706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J Yue
- Department of Clinical Laboratory, General Hospital of PLA, Beijing, China
| | - X Lian
- Department of Clinical Laboratory, General Hospital of PLA, Beijing, China
| | - P Yue
- Department of Clinical Laboratory, General Hospital of PLA, Beijing, China
| | - D Xiang
- Department of Clinical Laboratory, General Hospital of PLA, Beijing, China
| | - C Wang
- Department of Clinical Laboratory, General Hospital of PLA, Beijing, China
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Grunbaum AM, Gilfix BM, Hoffman RS, Lavergne V, Morris M, Miller-Nesbitt A, Gosselin S. Review of the effect of intravenous lipid emulsion on laboratory analyses. Clin Toxicol (Phila) 2015; 54:92-102. [DOI: 10.3109/15563650.2015.1115515] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ami M. Grunbaum
- Division of Medical Biochemistry, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Brian M. Gilfix
- Division of Medical Biochemistry, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Robert S. Hoffman
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, USA
| | - Valéry Lavergne
- Department of Medical Biology, Sacré-Coeur Hospital, University of Montréal, Montréal, Québec, Canada
| | - Martin Morris
- Schulich Library of Science and Engineering, McGill University, Montréal, Québec, Canada
| | - Andrea Miller-Nesbitt
- Schulich Library of Science and Engineering, McGill University, Montréal, Québec, Canada
| | - Sophie Gosselin
- Department of Emergency Medicine, McGill University Health Centre & Department of Medicine, McGill University, Montreal, Québec, Canada
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