Evidence map›Paper›PMID 41659293›Full record

ArticleEJIFCC2026

Lipemia-Induced Hemoglobin Overestimation and Correction by Plasma Replacement in a Pediatric Acute Lymphoblastic Leukemia Patient.

Zeynep Şule Evren, Kamil Taha Uçar

Abstract readCase Reports
In one paragraph

Article in EJIFCC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Zeynep Şule EvrenDepartment of Biochemistry, Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye.
Kamil Taha UçarDepartment of Biochemistry, Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pre-analytical and analytical errors in laboratory testing can lead to clinical misinterpretation. This case highlights a falsely elevated hemoglobin level due to lipemia and the corrective laboratory intervention. Case: A 3-year-7-month-old girl with acute lymphoblastic leukemia underwent a follow-up complete blood count which reported a hemoglobin level of 16.9 g/dL. The hemoglobin result was inconsistent with previous clinical findings and hematocrit. A simultaneously drawn venous blood gas sample showed a hemoglobin value of 9.2 g/dL. The biochemistry sample showed visible lipemia, with a lipemia index of 3041. The same sample revealed a triglyceride level of 8042 mg/dL (1:50 dilution) and total cholesterol of 492.2 mg/dL. These findings indicated a falsely elevated hemoglobin due to lipemia. The patient was not on parenteral nutrition. Pediatric endocrinology consultation attributed lipemia to L-asparaginase and corticosteroids in the treatment regimen. To eliminate lipemic interference, the EDTA blood sample was centrifuged at 1000 x g for 10 minutes, and the lipemic plasma was replaced with an equal volume of 0.9% NaCl solution. The sample was gently mixed to restore whole blood integrity. After this plasma replacement procedure, hemoglobin was measured as 10.2 g/dL, consistent with the blood gas result and clinical picture. Conclusion: This case emphasizes the need to correlate laboratory results with clinical and biochemical data. In lipemic samples, plasma replacement may provide a practical correction method for falsely elevated hemoglobin values when resampling is not feasible. Recognition and prompt correction of lipemia-induced errors are crucial to avoid inappropriate clinical decisions.

Indexed as

acute lymphoblastic leukemia (ALL)analytical interferencehemoglobinlipemiaplasma replacement

Identifiers

PMID41659293
PMCPMC12882086

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