Premium
Artifactually Increased Serum Bicarbonate Values in Two Horses and a Calf with Severe Rhabdomyolysis
Author(s) -
Collins Nathaniel D.,
LeRoy Bruce E.,
Vap Linda
Publication year - 1998
Publication title -
veterinary clinical pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.537
H-Index - 51
eISSN - 1939-165X
pISSN - 0275-6382
DOI - 10.1111/j.1939-165x.1998.tb01025.x
Subject(s) - lactate dehydrogenase , bicarbonate , anion gap , creatine kinase , chemistry , medicine , endocrinology , rhabdomyolysis , pyruvic acid , enzyme , biochemistry , biology , metabolic acidosis
— Extremely high bicarbonate (HCO 3 ‐ ) and anion gap values were measured in two horses and a calf using the Hitachi 911 automated serum biochemistry analyzer. All three animals had severe muscle disease as evidenced by markedly increased aspartate aminotransferase and creatine kinase activities. Laboratory error was suspected as the source of the increased HCO 3 ‐ because values calculated from blood gas analysis were normal. It was hypothesized that increased serum lactate dehydrogenase (LDH) activity and pyruvate concentration overwhelmed the oxamate LDH inhibitor in the enzymatic HCO 3 ‐ assay, resulting in consumption of NADH and a falsely elevated spectrophotometric reading. Serum LDH activity was markedly increased in all three patients. In an attempt to reproduce this interference in vitro, LDH and pyruvate were added to normal bovine serum. Bicarbonate concentration was artifactually increased in a linear, dose‐response relationship proportional to the amount of LDH activity in the sample; addition of pyruvate augmented this increase. It was concluded that increased serum LDH activity and pyruvate concentration secondary to severe muscle disease can result in artifactual increases in serum HCO 3 ‐ values obtained by routine enzymatic assay. (Vet Clin Pathol 27:85–90, 1998)