Cornes Michael
Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom.
Biochem Med (Zagreb). 2017 Jun 15;27(2):426-429. doi: 10.11613/BM.2017.046.
The case presented highlights a common pre-analytical problem identified in the laboratory that was initially missed. It concerns a young, generally healthy adult patient with no significant medical history and no significant family history. They presented with common flu like symptoms to their primary care clinician who considered this was most likely a viral problem that would pass with time. The clinician, however, did some routine bloods to reassure the patient despite a lack of clinical indication. When the sample was analysed the sample was haemolysed with strikingly low calcium. This led to the patient being called into hospital for urgent repeat investigations, all of which turned out to be within normal ranges. On further investigation the original sample was found to be contaminated. This result would normally have been flagged but was missed due to the complication of haemolysis.
所呈现的病例凸显了实验室中一个常见的分析前问题,该问题最初被遗漏了。病例涉及一名年轻的、总体健康的成年患者,无重大病史且无重大家族病史。他们因出现常见的流感样症状就诊于初级保健医生,医生认为这很可能是一个会随时间自愈的病毒问题。然而,尽管缺乏临床指征,医生还是做了一些常规血液检查以安抚患者。当对样本进行分析时,样本出现溶血且钙含量极低。这导致患者被紧急召回医院进行重复检查,结果所有检查结果均在正常范围内。进一步调查发现原始样本被污染了。这个结果通常会被标记出来,但由于溶血的并发症而被遗漏了。