Variability of Biological Parameters in Blood Samples Between Two Consecutive Schedules of Hemodialysis

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Aurelian Udristioiu1Radu G. Iliescu2, Manole Cojoraru³ 1Emergency County Hospital Târgu Jiu,, Clinical Laboratory, Department of Hematology, Romania, aurelianu2007@yahoo.com 2Polytechnic Institute of New York University, Department of Researches Variability of Bilirubin Values in Serum Samples with High Triglycerides; Interference Brooklyn, New York, radugiliescu@yahoo.com ³Titu Maiorescu University, Medicine Faculty, Physiology, Bucharest, E-mail: mancojocaru@yahoo.com ABSTRACT The aim of this work was to identify and to interpret the variability of bilirubin values in serum samples together with high values of Triglycerides and variable values of Cholesterol, for to exclude a congenital liver syndrome because of interference in serum, to patients which were presented in a private laboratory for the para-clinical controls. Method In our prospective study, in time of 30 days, we have analyzed 160 patients which performed 10 major tests; 5 substrates/chemistries: cholesterol, total bilirubin, conjugated bilirubin, un-conjugated bilirubin, triglycerides, 5 enzymatic tests, AST, ALT, ALP, LDH, GGT, measured on automatic analyzer Hitachi 912 and hepatic viral markers (Ag HBS, Anti HCV) performed on Elisa Analyzer. The additional samples, hemograms with differential count and reticulocytes, were accomplished on Coulter Analyzer with 22 hematological parameters. From the total patients 70 were females (20-30 years, mean age= 26, SD=2.6) and 90 males (25-36 year, mean age 30, SD=2.8). Results: Laboratory studies revealed the following: -to patients from cohort study, the healthy young patients with all normal analysis, were registered in 90 % percent (n=.144). -were registered in 6.8% of cases an increased of total bilirubin (average = 1.4-7.7 mg/dl, mean value =1.99 mg/dl, interval of reference = 0.2-1.0; CV= 0.13 p = 0.02 ) and an increase of un-conjugated bilirubin (average = 1-4.9 mg/dl, mean value =1.45 mg/dl, interval of reference = 0.3-0..7 mg/dl; CV=0.18, p=0.01), results correlated with normal liver enzymes, but with high triglycerides in values of past 243 mg/dl, in samples without macroscopic aspect of turbidity. After performing un-conjugated bilirubin tests, from samples with high triglycerides, in dilution 1/5, only 2.8% of tests were with normal values of un-conjugated bilirubin, (negative predictive value=66%) and 4% of tests have had the same high results of un-conjugated bilirubin, resulting a congenital liver syndrome, (positive predictive value=72%). Conclusions: Elevated values of triglycerides, correlated with increased levels of total bilirubin in these cases, can present a differential diagnosis with liver congenital syndromes with isolated high indirect bilirubin values (Gilbert's Syndrome or Crigler Najar Syndrome). Keywords: Crigler Najar Syndrome, GGT-Gama-glutamyltransferase, GS-Gilbert's Syndrome.

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