Dry ice exposure of plasma samples influences pH and lupus anticoagulant analysis
-
Ingrid Hov Odsæter
,
Ingrid Alsos Lian
Abstract
Background: Tests for lupus anticoagulant (LA), including silica clotting time (SCT) and diluted Russel’s viper venom time (dRVVT) are used to diagnose antiphospholipid syndrome. Due to sample instability, it is recommended that samples are frozen if analysis is postponed >4 h. Shipping on dry ice is common practice to keep samples frozen during transport. Recent data suggest that exposure to dry ice may affect sample pH and results in subsequent analyses. We aimed to determine the effect of dry ice on pH and LA analysis.
Methods: Citrated plasma from eight healthy volunteers was allocated to three preanalytical regimes: 1) storage at –20 °C; 2) dry ice exposure followed by storage at –20 °C; or 3) dry ice exposure followed by storage at –80 °C.
Results: Samples stored at –20 °C after dry ice exposure had significantly lower median pH (1.2 units, p=0.01) and prolonged clotting time ratios (up to 55% for dRVVT tests, p<0.02) in LA analysis, compared to samples not exposed to dry ice. This resulted in poor test specificity (25%). Similar changes were not observed in samples placed at –80 °C after dry ice exposure.
Conclusions: Dry ice may affect sample pH and increase the fraction of false positive LA results. This preanalytical factor should be taken into account by laboratories receiving frozen samples for these tests.
Acknowledgments
The authors wish to thank Wenche Knutsen for her technical assistance in this work, and volunteers for contributing with their time and blood samples.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Financial support: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
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©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Editorial
- High-sensitivity assays for cardiac troponins
- Reviews
- High sensitivity cardiac troponin assays in the clinical laboratories
- Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm
- Cardiac troponin assays: a review of quantitative point-of-care devices and their efficacy in the diagnosis of myocardial infarction
- Cardiovascular Diseases
- Evaluation of standardization capability of current cardiac troponin I assays by a correlation study: results of an IFCC pilot project
- Estimation of age- and comorbidities-adjusted percentiles of high-sensitivity cardiac troponin T levels in the elderly
- High-sensitivity cardiac troponin I in the general population – defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study
- Kinetics of high-sensitivity cardiac troponin T or troponin I compared to creatine kinase in patients with revascularized acute myocardial infarction
- Biological variation of high sensitivity cardiac troponin-T in stable dialysis patients: implications for clinical practice
- Diagnosis of acute myocardial infarction in patients with renal insufficiency using high-sensitivity troponin T
- General Clinical Chemistry and Laboratory Medicine
- Active intervention in hospital test request panels pays
- An approach to establish the uncertainty budget of catalytic activity concentration measurements in a reference laboratory
- Uric acid: a potential biomarker of multiple sclerosis and of its disability
- Experience with the first fully automated chemiluminescence immunoassay for the quantification of 1α, 25-dihydroxy-vitamin D
- I-FABP and L-FABP are early markers for abdominal injury with limited prognostic value for secondary organ failures in the post-traumatic course
- Quantification of piperacillin, tazobactam, cefepime, meropenem, ciprofloxacin and linezolid in serum using an isotope dilution UHPLC-MS/MS method with semi-automated sample preparation
- Plasma visfatin/nicotinamide phosphoribosyltransferase (visfatin/NAMPT) concentration is not related to kidney function in elderly subjects
- Diagnostic performance study of an antigen microarray for the detection of antiphospholipid antibodies in human serum
- Dry ice exposure of plasma samples influences pH and lupus anticoagulant analysis
- Reference Values and Biological Variations
- A new robust statistical model for interpretation of differences in serial test results from an individual
- Cancer Diagnostics
- The value of red blood cell distribution width in endometrial cancer
- Letters to the Editors
- Serum high-sensitivity troponin concentrations in a multi-ethnic Asian population of stable chronic kidney disease patients
- Comparison between BNP values measured in capillary blood samples with a POCT method and those measured in plasma venous samples with an automated platform
- Reply to the article entitled “Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D” by Farrell et al., Clin Chem Lab Med 2014;52:1579–87
- Reply. Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D. Authors’ response to the Letter to the Editor by Donnelly et al.
- Therapeutic drug monitoring of voriconazole: validation of a novel ARK™ immunoassay and comparison with ultra-high performance liquid chromatography
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Articles in the same Issue
- Frontmatter
- Editorial
- High-sensitivity assays for cardiac troponins
- Reviews
- High sensitivity cardiac troponin assays in the clinical laboratories
- Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm
- Cardiac troponin assays: a review of quantitative point-of-care devices and their efficacy in the diagnosis of myocardial infarction
- Cardiovascular Diseases
- Evaluation of standardization capability of current cardiac troponin I assays by a correlation study: results of an IFCC pilot project
- Estimation of age- and comorbidities-adjusted percentiles of high-sensitivity cardiac troponin T levels in the elderly
- High-sensitivity cardiac troponin I in the general population – defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study
- Kinetics of high-sensitivity cardiac troponin T or troponin I compared to creatine kinase in patients with revascularized acute myocardial infarction
- Biological variation of high sensitivity cardiac troponin-T in stable dialysis patients: implications for clinical practice
- Diagnosis of acute myocardial infarction in patients with renal insufficiency using high-sensitivity troponin T
- General Clinical Chemistry and Laboratory Medicine
- Active intervention in hospital test request panels pays
- An approach to establish the uncertainty budget of catalytic activity concentration measurements in a reference laboratory
- Uric acid: a potential biomarker of multiple sclerosis and of its disability
- Experience with the first fully automated chemiluminescence immunoassay for the quantification of 1α, 25-dihydroxy-vitamin D
- I-FABP and L-FABP are early markers for abdominal injury with limited prognostic value for secondary organ failures in the post-traumatic course
- Quantification of piperacillin, tazobactam, cefepime, meropenem, ciprofloxacin and linezolid in serum using an isotope dilution UHPLC-MS/MS method with semi-automated sample preparation
- Plasma visfatin/nicotinamide phosphoribosyltransferase (visfatin/NAMPT) concentration is not related to kidney function in elderly subjects
- Diagnostic performance study of an antigen microarray for the detection of antiphospholipid antibodies in human serum
- Dry ice exposure of plasma samples influences pH and lupus anticoagulant analysis
- Reference Values and Biological Variations
- A new robust statistical model for interpretation of differences in serial test results from an individual
- Cancer Diagnostics
- The value of red blood cell distribution width in endometrial cancer
- Letters to the Editors
- Serum high-sensitivity troponin concentrations in a multi-ethnic Asian population of stable chronic kidney disease patients
- Comparison between BNP values measured in capillary blood samples with a POCT method and those measured in plasma venous samples with an automated platform
- Reply to the article entitled “Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D” by Farrell et al., Clin Chem Lab Med 2014;52:1579–87
- Reply. Impact of assay design on test performance: lessons learned from 25-hydroxyvitamin D. Authors’ response to the Letter to the Editor by Donnelly et al.
- Therapeutic drug monitoring of voriconazole: validation of a novel ARK™ immunoassay and comparison with ultra-high performance liquid chromatography
- Interference of C-reactive protein with clotting times
