Grainne
Wonder if biliverdin may be playing a role. Not 100% sure on how sample
indices are measured with the Roche systems. Generally with sample
indice detection systems, elevated biliverdin does cross interfere with
lipemia/turbidity index resulting in a false increase in the turbidity
level.
May want to check with Roche on this possibility
Remember with neonates have a some what higher red cell volume as
compared to adults, as red cells break down they release heme, hem
breaks down to biliverdin, , Biliverdin in the presence of biliveridn
reductase will lead to bilirubin
Best regards
Joe I
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Connolly, Grainne
Sent: Friday, July 15, 2011 12:47 PM
To: [log in to unmask]
Subject:
Hi all,
We would be grateful for any thoughts on the following case. There is a
baby in our neonatal ICU with multiple medical problems who has a high
bilirubin. On our Roche method we have been unable to report a direct
bilirubin due to a high lipaemic index (index 130). However on
inspection of the sample it is not lipaemic and triglycerides are 0.79.
We have centrifuged the sample, there is no lipid and the results
(including the indices) are unchanged. The baby also has had no lipid
for the last 3 days and the lipaemic index has held at this level.
Has anyone any suggestions as to what may be interfering or causing the
lipaemic index?
Many thanks,
Grainne
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