Dear Reza,
We have recently changed to the Roche Modular Serum Folate assay and took this as
an opportunity to review our haemolysis protocol, especially as the use of the
linked chemistry and immunoassay system allows us to measure the amount of
haemolysis (as free oxyhaemoglobin using the Roche H indices) on each request.
The goal has been to release as many useful results as possible and not release
results which may compromise clinical decision making. We are most concerned about
results near the decision point which may indicate folate deficiency. As
haemolysis gives false increases in serum folate we are concerned about makign a
low serum folate falsely look normal.
Thus results which are clearly well above our lower limit of normal, even given
the widest possible range of red cell folate we to release.
The algorithm is as follows: H (in mg/dL) < 25 release all results H> 150
(withhold all results as seek recollection, after checking to see if we have a
seonc tube which is not haemolysed) H between 25 and 150, and the serum folate is
sufficiently high that even a very high red cell folate cannot have made a low
result normal, the result is released.
I am sure there wioo be interesting alternate views on this topic.
Regards,
Graham
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Ph: (02) 8382-9160
Fax: (02) 8382-2489
>>> Reza Morovat <[log in to unmask]> 26/09/2010 10:55 pm >>>
Dear Colleagues,
I am interested to learn what other labs do when dealing with serum folate
measurements on haemolysed specimens. Do you check for haemolysis (and if
so, how?), do you add a comment, do you report the result?
Thanks,
Reza
Reza Morovat
Clinical Biochemist
Oxford Radcliffe Hospitals
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