Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
Departments of Pathology and Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
Clin Chim Acta. 2022 Jun 1;531:91-93. doi: 10.1016/j.cca.2022.03.012. Epub 2022 Mar 26.
Glycated hemoglobin (HbA1c) assays are currently utilized to monitor patients with diabetes mellitus type 2 (T2DM). These assays employ various methods, some of which are more prone to interference than others. Commonly recognized causes of interference include hemoglobin variants and conditions that result in reduced red blood cell survival such as hemolytic anemia and certain medications. Enzymatic assays represent one of the predominant methods for HbA1c testing for practical reasons. Herein, we describe a potentially novel interference in an enzymatic HbA1c assay by neoplastic lymphocytes in a patient with chronic lymphocytic leukemia. We hypothesize that the marked number of neoplastic lymphocytes are interfering in the enzymatic steps inherent to this assay, resulting in a discordantly low HbA1c result. Awareness of this possibility and further investigation into the precise mechanism by which this interference is occurring are warranted.
糖化血红蛋白（HbA1c）检测目前用于监测 2 型糖尿病（T2DM）患者。这些检测方法采用了不同的方法，其中一些比其他方法更容易受到干扰。常见的干扰原因包括血红蛋白变体和导致红细胞存活减少的情况，如溶血性贫血和某些药物。由于实际原因，酶法检测是 HbA1c 检测的主要方法之一。在此，我们描述了一例慢性淋巴细胞白血病患者中肿瘤淋巴细胞对酶法 HbA1c 检测的一种潜在新型干扰。我们假设大量的肿瘤淋巴细胞干扰了该检测中固有的酶学步骤，导致 HbA1c 检测结果显著偏低。需要注意这种可能性，并进一步研究这种干扰发生的确切机制。
