Pneumatic transport is critical for leukaemic patients with major leukocytosis: what precautions to measure lactate dehydrogenase, potassium and aspartate aminotransferase?

This version was published on 1 January 2010

Ann Clin Biochem 2010;47:94-96
© 2010 Association for Clinical Biochemistry


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Case Reports

Raphael Guiheneuf1,
Isabelle Vuillaume1,
Jacques Mangalaboyi2,
David Launay3,
Céline Berthon4,
J-Claude Maury1,
Patrice Maboudou1 and
Jean Rousseaux1

1 UF Analyses automatisées, Pôle de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie;
2 Service de Réanimation Polyvalente, Hôpital Roger Salengro;
3 Service de Médecine Interne, Hôpital Huriez;
4 Service des Maladies de Sang, secteur stérile, Hôpital Huriez, CHRU de Lille, 59037 Lille Cedex, France

Corresponding author: Isabelle Vuillaume. Email: i-vuillaume{at}

False elevations of plasma lactate dehydrogenase (LDH), potassiumand aspartate aminotransferase (AST) have been described, inrelation to haemolysis, occurring most often by mechanical releaseduring phlebotomy or specimen processing. We present the casesof two leukaemic patients with severe hyperleukocytosis forwhom LDH, potassium and AST were dramatically but falsely elevated.This false elevation was not caused by haemolysis but couldbe related to white cells lysis during transport through a pneumatictransportation system, enhanced by a specific fragility of leukaemiccells. Interestingly, this interference almost completely disappearedwhen serum rather than plasma was used, or when leukocytosiscame back to normal. This work is meant to alert cliniciansto the risks of errors in LDH, potassium and AST in leukaemicpatients and suggest what precautions to take.

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