21/07/2026
Hemolysis, icterus, and lipemia (HIL) are the three major pre-analytical interferences that can compromise the accuracy of laboratory test results, causing falsely increased or decreased analyte values and potentially affecting clinical decision-making.
1. ๐๐ฒ๐บ๐ผ๐น๐๐๐ถ๐
Rupture of red blood cells, releasing hemoglobin and intracellular contents into plasma or serum, giving the sample a pink to cherry-red appearance.
๐๐ผ๐บ๐บ๐ผ๐ป ๐ฐ๐ฎ๐๐๐ฒ๐:
โ Improper blood collection, handling, transport, or storage (most common)
โ Less commonly, in vivo hemolysis (e.g., hemolytic anemia, transfusion reactions)
๐ ๐ฒ๐ฐ๐ต๐ฎ๐ป๐ถ๐๐บ ๐ผ๐ณ ๐ถ๐ป๐๐ฒ๐ฟ๐ณ๐ฒ๐ฟ๐ฒ๐ป๐ฐ๐ฒ:
โ Release of intracellular analytes into serum/plasma
โ Spectrophotometric interference by free hemoglobin
โ Hemoglobin-mediated chemical interference
โ Dilution of plasma/serum components
๐ฃ๐ฎ๐ฟ๐ฎ๐บ๐ฒ๐๐ฒ๐ฟ๐ ๐ฎ๐น๐๐ฒ๐ฟ๐ฒ๐ฑ:
โ Increased (โ): K+, LDH, SGOT/AST, SGPT/ALT, CK, Iron , Phosphate, Total Protein, Albumin, Mg++, Ca++, ALP
โ Decreased (โ): Troponin T, Bilirubin, Haptoglobin, Amylase, HCO3-
2. ๐๐ถ๐ฝ๐ฒ๐บ๐ถ๐ฎ
Excess triglyceride-rich lipoproteins (especially chylomicrons) causing a cloudy or milky appearance of serum or plasma.
๐๐ผ๐บ๐บ๐ผ๐ป ๐ฐ๐ฎ๐๐๐ฒ๐:
โ Hypertriglyceridemia
โ Postprandial (non-fasting) samples
๐ ๐ฒ๐ฐ๐ต๐ฎ๐ป๐ถ๐๐บ ๐ผ๐ณ ๐ถ๐ป๐๐ฒ๐ฟ๐ณ๐ฒ๐ฟ๐ฒ๐ป๐ฐ๐ฒ:
โ Light scattering affecting photometric assays
โ Volume displacement, particularly causing falsely low electrolyte results
โ Sample non-homogeneity
โ Physical and chemical assay interference
๐ฃ๐ฎ๐ฟ๐ฎ๐บ๐ฒ๐๐ฒ๐ฟ๐ ๐ฎ๐น๐๐ฒ๐ฟ๐ฒ๐ฑ:
โ Increased (โ): Bile acids, Direct bilirubin, TIBC, Mg++
โ Decreased (โ): Na+, K+, Cl-, HCO3-, LDH
3. ๐๐ฐ๐๐ฒ๐ฟic
Elevated bilirubin levels producing dark to bright yellow serum or plasma.
๐๐ผ๐บ๐บ๐ผ๐ป ๐ฐ๐ฎ๐๐๐ฒ๐:
โ Hemolytic disorders
โ Liver disease
โ Biliary obstruction
๐ ๐ฒ๐ฐ๐ต๐ฎ๐ป๐ถ๐๐บ ๐ผ๐ณ ๐ถ๐ป๐๐ฒ๐ฟ๐ณ๐ฒ๐ฟ๐ฒ๐ป๐ฐ๐ฒ:
โ Bilirubin reacts with assay reagents, altering analyte measurements
โ Spectral (colorimetric) interference during photometric analysis
๐ฃ๐ฎ๐ฟ๐ฎ๐บ๐ฒ๐๐ฒ๐ฟ๐ ๐ฎ๐น๐๐ฒ๐ฟ๐ฒ๐ฑ:
โ Increased (โ): Mg+
โ Decreased (โ): Cholesterol, Triglycerides, Creatinine, Bile acids, Lipase, Total protein, Uric acid, GGT