Interference in specialized coagulation assays affecting the protein C pathway: Effects of marked haemolysis, hyperbilirubinaemia and lipaemia on chromogenic and clotting tests on two coagulation platforms.
APC resistance
HIL
coagulation
protein C
protein S
Journal
International journal of laboratory hematology
ISSN: 1751-553X
Titre abrégé: Int J Lab Hematol
Pays: England
ID NLM: 101300213
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
19
11
2018
revised:
08
02
2019
accepted:
11
02
2019
pubmed:
13
3
2019
medline:
13
11
2019
entrez:
13
3
2019
Statut:
ppublish
Résumé
Haemolysis, lipaemia and hyperbilirubinaemia represent important challenges in the coagulation laboratory. Test results are influenced not only by the degree of the interfering substance but also by the detection system. We investigated the interference of free haemoglobin, triglycerides and bilirubin on a "modified activated protein C (APC) resistance test," protein C activity and protein S (antigen and activity) with two coagulation analysers, the STA-R Evolution and the ACL TOP. Haemolysis interfered with all assays on the STA-R Evolution resulting in higher levels of protein C activity and lower levels of protein S and a decreased APC ratio compared with baseline levels. On the ACL TOP, haemolysis only diminished protein S antigen levels and the APC ratio. Lipaemia increased protein C activity and protein S activity levels on the STA-R Evolution, whereas APC-R decreased on the ACL TOP and protein S antigen could not be measured in any lipaemic samples. Hyperbilirubinaemia caused an increase in protein C activity and in protein S antigen and a decrease in APC-R on the STA-R Evolution, whereas a decline of protein C activity, of protein S antigen and of the APC-R could be observed in icteric samples on the ACL TOP. Our data show that the degree of interference associated with haemolysis, lipaemia and hyperbilirubinaemia is different in several assays. Some assay limitations were not reproduced, and limitations stated in kit inserts cannot be assumed to apply to all analysers.
Sections du résumé
BACKGROUND
BACKGROUND
Haemolysis, lipaemia and hyperbilirubinaemia represent important challenges in the coagulation laboratory. Test results are influenced not only by the degree of the interfering substance but also by the detection system.
METHODS
METHODS
We investigated the interference of free haemoglobin, triglycerides and bilirubin on a "modified activated protein C (APC) resistance test," protein C activity and protein S (antigen and activity) with two coagulation analysers, the STA-R Evolution and the ACL TOP.
RESULTS
RESULTS
Haemolysis interfered with all assays on the STA-R Evolution resulting in higher levels of protein C activity and lower levels of protein S and a decreased APC ratio compared with baseline levels. On the ACL TOP, haemolysis only diminished protein S antigen levels and the APC ratio. Lipaemia increased protein C activity and protein S activity levels on the STA-R Evolution, whereas APC-R decreased on the ACL TOP and protein S antigen could not be measured in any lipaemic samples. Hyperbilirubinaemia caused an increase in protein C activity and in protein S antigen and a decrease in APC-R on the STA-R Evolution, whereas a decline of protein C activity, of protein S antigen and of the APC-R could be observed in icteric samples on the ACL TOP.
CONCLUSIONS
CONCLUSIONS
Our data show that the degree of interference associated with haemolysis, lipaemia and hyperbilirubinaemia is different in several assays. Some assay limitations were not reproduced, and limitations stated in kit inserts cannot be assumed to apply to all analysers.
Substances chimiques
Hemoglobins
0
Protein C
0
Protein S
0
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
404-411Informations de copyright
© 2019 John Wiley & Sons Ltd.