There was a histology stain that used salivary amylase in the prep [I
think it was as a negative control for the glycogen stain].
The saliva on one occasion was provided by a female MLSO who had just
come back from lunch with her boyfriend and the microscopy gave the
surprising result that the liver biopsy specimen included motile
sperm...
TIM
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Prof. Tim Reynolds,
Queen's Hospital,
Belvedere Rd,
Burton-on-Trent,
Staffordshire,
DE13 0RB
work tel: 01283 511511 ext. 4035
work fax: 01283 593064
work email: [log in to unmask]
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-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of ablumsohn
Sent: 30 July 2007 08:59
To: [log in to unmask]
Subject: Re: Help - false positive pregnancy tests
Semen has a lot of hCG and other like substances.
Suppose this might show up in some assays. There
are at least two case reports of a false positive
pregnancy tests (in cloudy urine) from distant
past. Look for sperm in your precipitate.
I was also the proud first author of the
following:
Just the sort of the important stuff that has been
entirely lost from the system as a result of the
destruction of our research by people who have no
idea what laboratories do.
Blumsohn,A., Price,A., Morris,B.W.,
Griffiths,H., Ramsay,C.F., Gray,T.A.G. (1991). The
effect of semen contamination on the concentration
of low molecular weight proteins in male urine.
Annals of Clinical Biochemistry 28: 187-188.
Aubrey
AK> A few months ago we had a similar strange
AK> false positive: a woman in her
AK> thirties presenting to A/E with abdo pain
AK> tested positive with a pregnancy
AK> dipstick. She denied there was any chance she
AK> could be pregnant. The sample
AK> was sent to the lab for confirmation. The
AK> sample still tested positive with
AK> a urine dipstick (Guest Medical).
AK> Fortunately a blood sample was also sent
AK> and was negative. The urine sample was very
AK> cloudy and when spun the urine
AK> tested negative by dipstick. A sample was
AK> also sent to the Microbiology
AK> lab, where it was reported to have high white
AK> and red blood cell count, but
AK> did not grow any organisms.
AK> We have tried to investigate the incident and
AK> it is likely that there is
AK> some relation between high white cell count
AK> and false positive pregnancy
AK> dipstick tests, (at least that's what we
AK> think but we still haven't got to
AK> the bottom of it).
AK> Any chance that this particular patient had a UTI or cloudy urine or
AK> contained precipitates?
AK> Several similar situations have arisen since
AK> this time, more recently a 15
AK> year old tested positive but was subsequently
AK> shown to be negative, causing
AK> a lot of distress to the patient and family
AK> In addition, a recent NEQAS external Quality
AK> assessment sample (December)
AK> indicated that some pregnancy strips in use may show an increased
AK> sensitivity compared to the recommended manufacturers "cut-off
AK> "level i.e a QC specimen with base level of 15 u/l tested positive
AK> with most commercially available kits though the
AK> cut-offs were reported as 25 u/l
AK> Angela
AK> Angela Kremmyda
AK> Trainee Clinical Biochemist
AK> Dept of Clinical Biochemistry
AK> Arrowe Park Hospital
AK> Upton, Wirral
AK> CH49 5PE
AK> 0151-678 5111 ext. 2830
AK>
AK> Fiona Bethell
AK> <[log in to unmask]
AK> To: [log in to unmask]
AK> OM>
AK> cc:
AK> Sent by: Clinical
AK> Subject: Help - false positive pregnancy tests
AK> biochemistry discussion
AK> list
AK> <ACB-CLIN-CHEM-GEN@JISC
AK> MAIL.AC.UK>
AK>
AK>
AK> 24/07/2007 13:49
AK> Please respond to Fiona
AK> Bethell
AK>
AK>
AK> 48 year old lady is brought to A/E Sunday
AK> afternoon after being found
AK> collapsed, pale, nausea, abdo pain.
AK> Assessment shows Hb of 5g/dL and urine preg
AK> test positive (Clinitek Status)
AK> but patient with GCS 14/15 says definitely
AK> not pregnant. Not catheterised
AK> at time of sample collection ( and have my doubts about lidocaine
AK> interference anyway). Urine not kept. Drug history nil of note but
AK> possessions in bag list co-codamol/paracetamol/zomig/brufen.
AK> Given blood/FFP/plts and whisked off to
AK> theatre but not before to serum
AK> bhCGs (Roche E170) are done and give 1 and 6
AK> U/L. ??reliability if v low
AK> Hb.
AK> Intraoperative notes say no obvious cause for bleed (no AAA/ectopic
AK> rupture)
AK> and given 15 units of blood during op.
AK> Another urine arrives and is
AK> positive using Quidel QuikVue one step test
AK> so put it through E170 and get
AK> 21.5 U/L.
AK> 06:30 bloods this morning - bhCG (E170) =2
AK> but ?reliability after massive
AK> transfusion.
AK> What's next?
AK> Fiona
AK> Fiona Ivison
AK> Dept Clinical Biochemistry
AK> Royal Liverpool University Hospital
AK> _________________________________________________________________
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AK> community working in clinical biochemistry. Please note, archived
AK> messages are public and can be viewed via the internet. Views
AK> expressed are those of the individual and they are responsible for
AK> all message content. ACB Web Site
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Regards
Aubrey Blumsohn
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