Spurious hypertriglyceridaemia in unconscious patient

Authors

  • Biswajit Saha Department of Biochemistry, Durgapur Steel Plant Hospital, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174186

Keywords:

False, Glycerol, Hypertriglyceridaemia, Plasma, Spurious, Serum

Abstract

Background: Routine biochemical investigation of one patient admitted with a diagnosis of CVA as mentioned in the requisition revealed high hypertriglyceridaemia in a non-lipemic serum for the first time. Later, after scrutiny of the case sheet in the ward, it was found that apart from other management, blood was drawn about 90 minutes after administration of 4th dose of oral glycerol through nasogastric tube and sent to the laboratory. This was suspected to be the probable cause. In order to find out the degree of interference in blood sample, a small amount of glycerol was brought from the ward to experiment.

Methods: Glycerol was initially diluted to 1 in 100 in distilled water and then artificially mixed in various dilutions with pooled serum from indoor patients and pooled heparinized plasma from outdoor patients. These samples were subjected to triglycerides estimation while routine analyses were going on.

Results: A concentration of about 13,50,500 mg/dl falsely measured triglycerides was found in glycerol solution. This needed a dilution of 1 in 1500 for distilled water, serum and plasma which had 0, 190 and 113 mg/dl triglycerides respectively to bring the level to near the highest range of linearity. The recovery of added glycerol in distilled water was almost 100% but there was some positive bias more with plasma than serum.

Conclusions: The spurious hypertriglyceridaemia in serum resulted from positive interference due to temporary high glycerolaemia by the commonly employed GPO-PAP method for its measurement and would cause the same depending on glycerol level.

 

Author Biography

Biswajit Saha, Department of Biochemistry, Durgapur Steel Plant Hospital, West Bengal, India

Joint Director (Medical & Health Services) & Head, Deptt of Biochemistry, Durgapur Steel Plant Hospital

References

Kalita J, Ranjan P, Mishra UK. Current status of osmotherapy in intracerebral haemorrhage. Neurol India. 2003;51(1):104-9.

Jha SK. Cerebral edema and its management. MJAFI. 2003;59(4):326-31.

Sommer S, Nau R, Wieland E, Prange HW. Pharmacokinetics of glycerol administered orally in healthy volunteers. Arzneimittelforschung. 1993;43(7):744-7.

Takagi H, Tsuyusaki H, Endo M, Kitahara T. Pharmacokinetics of serum glycerol and changes of ICP: Comparison of gastric and duodenal administration. Acta Neurochir. 1998;71:34-6.

Charoenhirunyingyos W, Vannasaeng S. Psudohypertriglyceridaemia from oral glycerine. J Med Assoc Thai. 2010;93(7):870-2.

Wahlefeld AW. Triglycerides. Determination after enyzmatic hydrolysis. In: Bergmeyer HU Ed Methods of Enzymatic Analysis, 2nd English ed. New York, NY: Academic Press; 1974:1831-1835.

Reilly R, Jackson E. Regulation of renal function and vascular volume. In: Brunton LL, Chabner BA, Knollmann BC eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th Ed, New York, NY: McGraw- Hill; 2011:671-719.

Fabiani Romero F, Bermudez de la Vega JA, Gonzalezz Martin C, Getil Gonzalez J, Oribe A, Cruz C. Hyperglycerolaemia, a psudo-hypertriglyceridaemia: a case report. An Pediatr (Barc). 2009;71(1):68-71.

Arrobas-Veililia T, Mondejar-Garcia R, Gomez-Gerique JA, Canizares Diaz I, Cruz Mengibar MC, Prive de Diego, et al. Peudo- hypertriglyceridaemia or hyperglycerolaemia? Clin Investig Arterioscler. 2013;25(3):123-6.

Nauck M, Winkler K, Siekmeier R, Marangos N, Richter B, Marz W, et al. Pseudo-psedohypertriglyceridaemia: a case of increased free glycerol without evidence for glycerol kinase deficiency. Clin Chem. 1995;41(4):619-20.

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Published

2017-09-28

How to Cite

Saha, B. (2017). Spurious hypertriglyceridaemia in unconscious patient. International Journal of Research in Medical Sciences, 5(10), 4610–4613. https://doi.org/10.18203/2320-6012.ijrms20174186

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Section

Short Communication