Plasma osmolality was normal on the original sample
which meant that the plasma sodium value was
overestimated by the Olympus indirect ISE for one
reason or another (wrong result). The plasma sodium
should have never been released and a repeat sample
should have been requested. Another way to check for
true hypernatramia apart from checking osmolality is
to check chloride. For a serum sodium of 170 mmol/L
you would expect the chloride to be 120-130 mmol/L. In
cases of sample contamination with sodium citrate or
sodium salt of antibiotics, the high sodium is
associated with normal chloride result.
regards
Mohammad
--- "Hogan, Tim" <[log in to unmask]>
wrote: > We recently received a blood sample taken
from a six
> year old boy who
> attended our phlebotomy Dept. His clinical details
> were recurrent cough and
> abdominal pains with possible weight loss, he was
> not on a drip.
> The sample was taken into a disposable 5ml syringe
> and then transferred to a
> small plastic Lithium heparin tube for Chemistry and
> an EDTA for
> Haematology.
> The patients results which were very abnormal are
> listed below. The results
> were phoned to the GP and the patient was admitted
> to the paediatric ward a
> few hours later and another blood sample taken. The
> results for which were
> normal. This same situation occurred about a month
> ago but on an adult
> patient who was on plasma expanders and the samples
> taken into 7ml Beckton
> Dickenson SST tubes.
>
> The original sample appears diluted but with a high
> Sodium which is not
> detected (or not so detected) by Direct ISE. The
> high Sodium is repeatable
> on two different Olympus AU600 (indirect ISE)
> analysers. The Haematology
> sample also showed similar dilution effect. Has
> anyone any ideas what could
> be causing this effect?
> Original Original Direct ISE
> Repeat
> Analyser A Analyser B
> sample
> Na 173 171 148 140
> K 3.2 3.2 2.7 3.7
> Urea 3.6 6.1
> Glucose 2.9 4.8
> Creat 46 62
> Calcium 1.34 2.5
> Albumin 31 46
> TP 51 70
> ALT 12 12
> ALP 128 187
> Bilirubin 4 3
> Osmolality 275 289
> Hb 8.3 11
> WCC 7.2 13.1
> platelets 411 570
> HCT 25% 32%
> RBC 3.1 4.1
> MCV 80 78
>
>
> Tim Hogan
> Basildon
>
>
>
>
**********************************************************************
> This email and any files transmitted with it are
> confidential and
> intended solely for the use of the individual or
> entity to whom they
> are addressed. If you have received this email in
> error please notify
> the system manager at
> mailto:[log in to unmask]
>
> This footnote also confirms that this email message
> has been swept by
> MIMEsweeper for the presence of computer viruses.
>
> www.mimesweeper.com
>
**********************************************************************
>
=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
__________________________________________________
Do You Yahoo!?
Everything you'll ever need on one web page
from News and Sport to Email and Music Charts
http://uk.my.yahoo.com
|