Journal of Diagnostics Concepts & Practice >
Analysis of interference factors in measurement of serum uric acid by uricase-peroxidase coupled reaction
Received date: 2019-01-01
Online published: 2022-07-15
Objective To explore the possible interference factors in the measurement of serum uric acid (UA)by uricase-peroxidase coupled reaction and the methods to eliminate these interference factors. Methods: Two cases with pseudo-hypouricemia detected by uricase-peroxidase coupled reaction were analyzed. Causes for interference on measurement were analyzed via alarm message and reaction curve displayed on the instrument. Different approaches were adopted to eliminate the interference on measurement of serum UA. Results: The initial measurement value of serum UA for case 1 was 18.2 μmol/L. According to the reaction curve, it was speculated that the low UA value might be caused by the admi-nistration of Rasburicase. Thereafter, the blood sample withdrawn from case 1 was recollected into pre-cooled heparin tube, and the corrected value was 102.0 μmol/L. The initial measurement value of serum UA of case 2 was a negative value, the reaction curve and appearance of protein precipitation in in-vitro test indicated that the internal M protein was suspected to lead to the false decrease of serum UA value. The UA value of case 2 was normalized to 158.5 μmol/L via the PEG6000 protein precipitation method. Conclusions: Measurement of serum UA by uricase-peroxidase coupled reaction may be affected by various exogenous and endogenous factors. When the UA value comes to be abnormal, comprehensive analysis of reaction curve is needed to confirm the interference factor, which helps to achieve more accurate test results in clinical setting.
Key words: Uric acid; Rasburicase; M Protein; Interference
ZHOU Xiaona, FANG Honggang, CAO Yanfei, LI Xinna, ZHANG Lina, LU Yide . Analysis of interference factors in measurement of serum uric acid by uricase-peroxidase coupled reaction[J]. Journal of Diagnostics Concepts & Practice, 2020 , 19(04) : 426 -429 . DOI: 10.16150/j.1671-2870.2020.04.019
[1] | Dos Santos M, Veronese FV, Moresco RN. Uric acid and kidney damage in systemic lupus erythematosus[J]. Clin Chim Acta, 2020, 508:197-205. |
[2] | Li M, Ye ZC, Li CM, et al. Low serum uric acid levels increase the risk of all-cause death and cardiovascular death in hemodialysis patients[J]. Ren Fail, 2020, 42(1):315-322. |
[3] | Braga TT, Foresto-Neto O, Camara NOS. The role of uric acid in inflammasome-mediated kidney injury[J]. Curr Opin Nephrol Hypertens, 2020, 29(4):423-431. |
[4] | Davidson DF, Scott JG. Detection of creatine kinase macroenzymes[J]. Ann Clin Biochem, 2012, 49(Pt 5):482-485. |
[5] | 中华医学会风湿病学分会. 原发性痛风诊断和治疗指南[J]. 中华风湿病学杂志, 2011, 15(6):410-413. |
[6] | 程湧江, 李丽, 卢卫国, 等. 酚磺乙胺对部分生化检验项目干扰的相关研究[J]. 国际检验医学杂志, 2011, 32(11):1244-1245. |
[7] | 国秀芝, 张江涛, 侯立安, 等. 羟苯磺酸钙对尿酸酶-过氧化物酶偶联法尿酸检测的干扰研究[J]. 中华检验医学杂志, 2015, 38(9):600-604. |
[8] | Clinic and Laboratory Standards Institute. Interference testing in clinical chemistry; Approved Guideline-Second Edition (EP07)[S]. Wayne,PA:CLSI, 2018. |
[9] | Berth M, Delanghe J. Protein precipitation as a possible important pitfall in the clinical chemistry analysis of blood samples containing monoclonal immunoglobulins: 2 case reports and a review of the literature[J]. Acta Clin Belg, 2004, 59(5):263-273. |
[10] | 沈敏娜, 吴炯, 郭玮, 等. M蛋白干扰对血清样本常规生化检测项目的影响[J]. 检验医学, 2011, 26(11):730-735. |
[11] | Aiyer R, Kazory A. Spurious hyperphosphatemia: a case for caution[J]. Am J Kidney Dis, 2012, 60(6):1050-1051. |
[12] | King RI, Florkowski CM. How paraproteins can affect laboratory assays: Spurious results and biological effects[J]. Pathology, 2010, 42(5):397-401. |
[13] | Yang Y, Howanitz PJ, Howanitz JH, et al. Paraproteins are a common cause of interferences with automated chemistry methods[J]. Arch Pathol Lab Med, 2008, 132(2):217-223. |
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