Department of Forensic Pathology, School of Forensic Medicine, China Medical University, No. 77, Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, People's Republic of China.
The Second Division of Clinical Medicine, China Medical University, Shenyang, 110122, People's Republic of China.
Int J Legal Med. 2021 Jul;135(4):1661-1668. doi: 10.1007/s00414-021-02578-z. Epub 2021 Mar 30.
Forensic diagnosis of anaphylactic shock is a challenging task in forensic practice due to the lack of characteristic morphological changes. Postmortem analysis of serum IgE can provide helpful information for determining anaphylaxis. However, postmortem serum always suffers from hemolysis. To investigate the interference of hemolysis on postmortem analysis of total IgE by electrochemiluminescent immunoassay (ECLIA) and verify the suitability of the commercially available ECLIA kit for postmortem hemolyzed blood with the dilution-correction method, different levels of hemolyzed serum were prepared to evaluate the interference of hemolysis. A linear regression analysis was then performed on the concentration of total IgE in the completely hemolyzed blood and the corresponding serum. Our results indicated that hemolysis negatively interfered with the total IgE analysis by ECLIA and the interference (|Bias%|) increased with increasing levels of hemolysis. After controlling for |Bias%| by dilution, the test concentration of total IgE in the completely hemolyzed blood was still significantly lower than that in the serum (P < 0.05) and resulted in eight false-negative cases. A strong correlation was observed between the test concentration of total IgE in the completely hemolyzed blood and that in the serum (r = 0.983). After correction by the regression formula, the corrected concentration revealed no significant differences and exhibited the same diagnostic ability, compared with the serum total IgE concentration. These results indicate that the completely hemolyzed blood is not recommended for postmortem analysis of total IgE directly. The dilution-correction method might have potential utility in forensic practice for evaluating serum total IgE concentrations.
法医鉴定中，因缺乏特征性的形态学改变，过敏性休克的鉴定极具挑战性。血清 IgE 的死后分析可为确定过敏反应提供有价值的信息。然而，死后血清常常受到溶血的影响。为了研究溶血对电化学发光免疫分析（ECLIA）死后总 IgE 分析的干扰，并通过稀释校正法验证市售 ECLIA 试剂盒在死后溶血血液中的适用性，我们制备了不同程度溶血的血清来评估溶血的干扰。然后对完全溶血血中总 IgE 浓度与相应血清进行线性回归分析。结果表明，溶血对 ECLIA 检测总 IgE 具有负性干扰，且干扰程度（|Bias%|）随溶血程度的增加而增加。通过稀释校正控制 |Bias%|后，完全溶血血中总 IgE 的检测浓度仍显著低于血清中的浓度（P < 0.05），导致 8 例假阴性结果。完全溶血血中总 IgE 的检测浓度与血清中浓度之间存在很强的相关性（r = 0.983）。用回归公式校正后，校正浓度与血清总 IgE 浓度无显著差异，且具有相同的诊断能力。这些结果表明，完全溶血血不建议直接用于死后总 IgE 的分析。稀释校正法可能在评估血清总 IgE 浓度方面具有潜在的法医应用价值。
