Hello.
Other conditions to consider as possible causes of high viscosity:
- Elevated hyaluronic acid (can be assessed addition of hyaluronidase to reduce viscosity).
- We recently investigated a patient that was cryoglobulin positive, but the cryoglobulin rapidly formed transparent gel ( a non-traditional cryoprecipitate). Collection of routine serum for testing total protein and electrophoresis were repetitive negative for a monoclonal band (because the transparent gel was removed with room temperature separation of serum from red cells), and only electrophoresis testing of the serum prepared on a continuously warm sample (treated with dithiothreitol to improve solubility during electrophoresis) was able to confirm the detection of a monoclonal band of about 25 g/L.
regards, Andrew
Dr. A. Lyon, Clinical Biochemist
Royal University Hospital,
Saskatoon, SK, Canada
----- Original Message -----
From: "EDWARDS, Rebecca (THE ROYAL MARSDEN NHS FOUNDATION TRUST)" <[log in to unmask]>
To: "ACB-CLIN-CHEM-GEN" <[log in to unmask]>
Sent: Wednesday, November 29, 2023 5:44:10 AM
Subject: Highly viscous sample
Dear Colleagues,
We have been having significant difficulties in generating results on a patient because serum and plasma are both highly viscous, however unusually this is not associated with a raised total protein or paraprotein. Our colleagues in haematology have also had difficulty in measuring total WBC, which we believe is also because of the viscosity of whole blood samples. The viscosity improves to some extent on warming, however cryoglobulin testing has been negative (sample was delivered to the lab promptly in a thermos with thermal beads and temperature checked).
Has anyone come across a similar scenario and if so were you able to establish a cause?
Best wishes,
Rebecca
Rebecca Edwards
Principal Clinical Biochemist, Blood Sciences
The Royal Marsden NHS Foundation Trust
Sutton
07825 102880
www.royalmarsden.nhs.uk<http://www.royalmarsden.nhs.uk/>
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