Influence of lipid and leukocytes on the haemoglobin determination by Coulter Counter S Plus III, Technicon H 6000, Technicon H 1, LK 540, Reflotron and Hemocap

Abstract

The influence of lipid and high concentrations of leukocytes on the haemoglobin determination by six different instruments was examined. The increase in the determination of haemoglobin concentration with elevated amounts of lipid in the samples was greatest with the Coulter Counter S plus III and the Technicon H 1 followed by the LK 540 and the Technicon H 6000. There was no effect of lipid on the haemoglobin determination using the Reflotron. High concentrations of leukocytes increased the haemoglobin determination most by Coulter Counter S plus III and Hemocap. There were no changes in the haemoglobin determinations by the LK 540 and the Technicon H 6000 when the samples contained increased amounts of leukocytes.

Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes

“…Lipemia may cause erroneous PLT (see part I) and WBC counts (see above), but may also induce interferences by turbidity (Creer & Ladenson, 1983; Sandberg, Sonstabo & Christensen, 1989). An abnormally high MCHC (>36 g/dl) corresponding to an erroneously high Hb has been reported for patients with severe constitutional or acquired hypertryglyceridemia (Gagne et al.…”

“…White blood cell may induce excessive turbidity and disturb Hb measurement if their number is sufficiently high. There is no clear‐cut threshold for WBC counts associated with spuriously elevated Hb, but one must be careful with all samples with WBC count over 50 or 100 × 10 9 /l (Cornbleet, 1983; Sandberg, Sonstabo & Christensen, 1989), although some HA define threshold at 250 × 10 9 /l or even seem to be fully insensitive to WBC count because of entire WBC lysis performed before Hb measurement (Sysmex). As for lipid disturbance, CHCM determined on some HA may help to find the true Hb value (McVeigh, Faim & van der Weyden, 1989).…”

“…Lipemia may cause erroneous PLT (see part I) and WBC counts (see above), but may also induce interferences by turbidity (Creer & Ladenson, 1983;Sandberg, Sonstabo & Christensen, 1989). An abnormally high MCHC (>36 g/dl) corresponding to an erroneously high Hb has been reported for patients with severe constitutional or acquired hypertryglyceridemia (Gagne et al, 1977;Mayan et al, 1996), and for patients receiving intravenous administration of fat emulsions (Nosanchuck, Roark & Wanser, 1974;Shah, Patel & Rao, 1975;Nicholls, 1975Nicholls, , 1977Creer & Ladenson, 1983;Artiss & Zak, 1987;Sandberg, Sonstabo & Christensen, 1989;Cantero, Conejo & Jimenez, 1996). After the study of various types of hyperlipoproteinemias, it was observed that erroneous Hb and MCHC >36 g/dl were observed in patients with at least 20 g/l of triglycerids, corresponding to type I and part of type V hyperlipoproteinemias (rich in chylomicrons) but not to type IV hyperlipoproteinemias (rich in very low density lipoproteins; Gagne et al, 1977).…”

“…, 1977; Mayan et al. , 1996), and for patients receiving intravenous administration of fat emulsions (Nosanchuck, Roark & Wanser, 1974; Shah, Patel & Rao, 1975; Nicholls, 1975, 1977; Creer & Ladenson, 1983; Artiss & Zak, 1987; Sandberg, Sonstabo & Christensen, 1989; Cantero, Conejo & Jimenez, 1996). After the study of various types of hyperlipoproteinemias, it was observed that erroneous Hb and MCHC >36 g/dl were observed in patients with at least 20 g/l of triglycerids, corresponding to type I and part of type V hyperlipoproteinemias (rich in chylomicrons) but not to type IV hyperlipoproteinemias (rich in very low density lipoproteins; Gagne et al.…”

Biochezmical Interfering Factors and Blood Cells Indices

“…Sadeghian et al showed hypertriglyceridemia can falsely increase MCHC but cannot alter MCV or MCH and hypercholesterolemia does not alter the red cell indices (9). Sandberg et al reported increased in hemoglobin concentration with elevated amounts of lipid in the samples in some cell counters (16).…”