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Severe Underestimation of Serum Na following IVIG Treatment.

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Citation: Laboratory Medicine. 49(4):372-376, 2018 Oct 11.PMID: 29897485Institution: MedStar Washington Hospital CenterDepartment: PathologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Immunoglobulins, Intravenous/tu [Therapeutic Use] | *Purpura, Thrombocytopenic, Idiopathic/bl [Blood] | *Purpura, Thrombocytopenic, Idiopathic/dt [Drug Therapy] | *Sodium/bl [Blood] | Adolescent | Diagnostic Errors | Female | Humans | Purpura, Thrombocytopenic, Idiopathic/di [Diagnosis] | Purpura, Thrombocytopenic, Idiopathic/pp [Physiopathology] | Reproducibility of ResultsYear: 2018 ISSN:

0007-5027

Name of journal: Laboratory medicineAbstract: Current chemistry analyzers measure ion concentration using ion- selective electrodes; however, may differ in the specific technology at the bedside versus the central laboratory. Instruments utilized for point-of-care testing (POCT) at the bedside use direct ion-selective electrodes, whereas central-laboratory analyzers use indirect ion-selective electrodes. Under most circumstances, these instruments will deliver the same result; however, various substances can cause interferences in one or the other. An 18-year-old Hispanic woman with a history of immune thrombocytopenic purpura (ITP) presented at Children's National Medical Center (CNMC) with a severe headache and required intravenous immunoglobulin (IVIG) therapy. Because a discrepancy developed between her point-of-care and central-laboratory sodium values, another instrument was used to retest the central-laboratory plasma specimens. The results were more in agreement with those from the point-of-care instrument and revealed a unique interference in sodium measurement related to IVIG use.All authors: Dean NP, Virk MS, Wong ECCFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier:

https://dx.doi.org/10.1093/labmed/lmy025

Date added to catalog: 2018-07-06

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Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	29897485	Available		29897485

Current chemistry analyzers measure ion concentration using ion- selective electrodes; however, may differ in the specific technology at the bedside versus the central laboratory. Instruments utilized for point-of-care testing (POCT) at the bedside use direct ion-selective electrodes, whereas central-laboratory analyzers use indirect ion-selective electrodes. Under most circumstances, these instruments will deliver the same result; however, various substances can cause interferences in one or the other. An 18-year-old Hispanic woman with a history of immune thrombocytopenic purpura (ITP) presented at Children's National Medical Center (CNMC) with a severe headache and required intravenous immunoglobulin (IVIG) therapy. Because a discrepancy developed between her point-of-care and central-laboratory sodium values, another instrument was used to retest the central-laboratory plasma specimens. The results were more in agreement with those from the point-of-care instrument and revealed a unique interference in sodium measurement related to IVIG use.

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