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Multiple Choice

A patient sample results are as follows: LDH 700 U/L, AST 100 U/L, K+ 8.2, iCAL 1.60, Fe 40, ALT 66, T4 5pmol/L. What do you report?

Hemolysis in a blood sample causes intracellular components to spill into the plasma, which can spuriously raise several analytes. In this case, the markedly high potassium along with elevated LDH and AST strongly points to red cell rupture rather than true patient physiology. Because these values are susceptible to artifactual interference, you need a recollection to obtain accurate measurements. Rejecting and recollecting, while noting that hemolysis was present, is the safest course. Accepting the results as reported risks acting on misleading data; simply noting possible hemolysis doesn’t resolve the unreliability of the full panel; repeating only ALT doesn’t fix the other affected parameters.

Hemolysis in a blood sample causes intracellular components to spill into the plasma, which can spuriously raise several analytes. In this case, the markedly high potassium along with elevated LDH and AST strongly points to red cell rupture rather than true patient physiology. Because these values are susceptible to artifactual interference, you need a recollection to obtain accurate measurements. Rejecting and recollecting, while noting that hemolysis was present, is the safest course. Accepting the results as reported risks acting on misleading data; simply noting possible hemolysis doesn’t resolve the unreliability of the full panel; repeating only ALT doesn’t fix the other affected parameters.