Changes in serum total protein values occurring in clinical samples during shipment.

Total protein and protein electrophoresis determinations were performed on paired serum samples before and after shipment of the samples via parcel post. After shipment, one serum from each pair of samples was analyzed at the same laboratory that had performed the initial analysis; the other sample from the pair was analyzed after its receipt by a referral laboratory. The results indicate that, due to some factor or a combination of factors occurring during shipment, statistically significant apparent increases were observed in 86 per cent of the total protein values and in 66 per cent of the albumin values. Experimentally, both mechanical agitation and bacterial contamination are capable of causing slight elevations similar in pattern to those observed in the shipped samples. The significance of these findings relative to clinical interpretation and to analytical quality control programs is discussed.