Dear Colleagues
Recently we received a specimen requesting serum iron in a baby who had
ingested (up to) 15 of mum's FeSO4 tablets. For various reasons, we asked a
nearby adult lab to do the analysis for us on their Ortho Vitros analyser
and they returned a result of <1 micromol/l. From the combination of this
result, abdominal x-ray that failed to show any tablets in baby's GI tract
and favourable clinical observations, clinicians were satisfied that baby
had not ingested an iron overdose. Thus, they witheld desferrioxamine Rx,
monitored baby (who remained well) and discharged him 24 hours later.
Interestingly, they did not query iron-deficiency anaemia.
The next day, we ran the sample through our iron assay (ILAB 600,
Ferrozine), for completeness. The result was around 75 micromol/l, and in
reasonable aggreement neat and on a 1 in 3 dilution. Because of the
discrepant results, we asked a third lab to run the sample through their
assay (Roche Integra, Ferrozine), and they returned a result of 84
micromol/l.
Examination of the reaction curves on the ILAB 600 indicates a positive
interferent. Best estimate of 'true' iron was 15-20 micromol/L.
On direct questioning, the Registrar reiterated that baby did not receive
desferrioxamine Rx.
We'd appreciate any observations to help us get to the bottom of this
problem.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|