小儿维生素 D：假性维生素过多症。
Pediatric vitamin D: Pseudo-hypervitaminosis.
机构信息
Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA.
Section of Clinical Chemistry, Division of Laboratory Medicine, Department of Pathology, Texas Children's Hospital, Houston, Texas, USA.
出版信息
J Clin Lab Anal. 2023 Jul;37(13-14):e24950. doi: 10.1002/jcla.24950. Epub 2023 Aug 1.
BACKGROUND
Vitamin D toxicity is rare in pediatric population. Falsely elevated levels of 25-hydroxyvitamin D have been reported as a major challenge with immunoassay methods for quantifying vitamin D metabolites.
CASE PRESENTATION AND METHOD
Here, we present two pediatric cases of falsely elevated 25-hydroxyvitamin D that resulted in unnecessary further testing. We also report significant same-day variation in the measurement of 25-hydroxyvitamin D using the Abbott i2000SR immunoassay. Samples were spun twice and their values were confirmed with the gold standard liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for confirmation.
CONCLUSION
The addition of a centrifugation step prior to sample testing resolved the variation observed in the measurement of 25-hydroxyvitamin D levels. The patient samples were confirmed with instruments from a different vendor and LC-MS/MS. Re-centrifugation of samples resolved the variation in the 25-hydroxyvitamin D values.
背景
维生素 D 中毒在儿科人群中较为罕见。已有报道称，免疫测定方法在定量检测维生素 D 代谢物时，会出现 25-羟维生素 D 水平假性升高，这是一个主要挑战。
病例介绍和方法
在此，我们介绍了两例儿科患者的 25-羟维生素 D 水平假性升高的情况，这导致了不必要的进一步检测。我们还报告了使用 Abbott i2000SR 免疫分析法测量 25-羟维生素 D 时，同一天的显著变化。我们对样本进行了两次离心，并使用液相色谱-串联质谱（LC-MS/MS）法这一金标准方法对其值进行了确认。
结论
在进行样本检测前增加离心步骤，可以解决 25-羟维生素 D 水平测量中观察到的变化。使用不同供应商的仪器和 LC-MS/MS 对患者样本进行了确认。重新离心样本解决了 25-羟维生素 D 值的变化问题。
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