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歷 年 稿 件 內 容
 
*類別： A組-鏡檢、血液、血庫
* 姓名： 杜琦超
投稿種類： 壁報
*中文投稿標題： 運用LIS資料庫整合分析報告提升檢驗品質-冷凝集素造成Hb與Hct比例不符之案例分享
*中文作者姓名列： 杜琦超1*、吳孟庭1、徐志豪1、王志勇1、王愛1、李培寧1、藍健元1
*中文服務單位： 衛生福利部基隆醫院 醫事檢驗科1
*英文投稿標題： Improving Laboratory Quality by Consolidating Analysis Results into LIS Database A case report of cold agglutinin induce to a mismatch between hematocrit and hemoglobin values
*英文作者姓名列： Tu Chi-Chao1*; Wu Meng-Ting 1; Hsu Chih-Hao1 ; Wang Jyn-Yeong 1; Wang Ai 1; Lee Pei-Ning1; Lan Chien-Yuan 1
*英文服務單位： Department of Medical Laboratory1, Keelung Hospital Ministry of Health and Welfare, R.O.C, Taiwan
* 投稿摘要： Purpose:At room temperature RBCs would agglutinate invitro with high titer cold agglutinin. Ht would be falsely low and not in concordance with Hb. The clinics would misjudge anemia by single Ht. In addition to considering factors from diseases, a MT should incorporate more factors to judge abnormal results, rule out as many as possible factors. Material:A 59 yo woman underwent long-term dialysis treatment, on 2015-9-9 came ER for acute respiratory infection, with Hb 11, 32.7%. 9-22 she came for routine dialysis with Ht 28.7%. The Ht continued to decrease, and dropped to 23% on Oct-8. Method:We inspected the blood, sedimentation. It looked like containing sands, suspensions were dispersed after shaking which tallied with cold agglutination. We suspected Ht was effected by interferences. Under microscope RBCs agglutinated, cold agglutination test 1:128(1+). Using pre-treat including plasma replacement and water bath to bring the sample to 37℃ for 30 min, we checked RBC morphology to make sure no more agglutination, then examined CBC immediately on the sample from bath. Result:On 10-8 before pre-treat Hb 12.4, Ht 23%, MCHC 53.9. After pre-treat Ht raised to 37.6% and Hb remained 12.8. Ht falsely low by cold agglutination was confirmed. Conclusion:Clinics followed the practices from Ministry of Health and Welfare, and Taiwan Society of Nephrology, the dialysis order set for lab contained only Ht for CBC, could lead a misjudgment on anemia. After discussion, the order set included Ht and Hb. All data from analyzers was collected eg MCHC, to reinforce data verification in LIS.
*關鍵字1 ： Cold agglutinin
*關鍵字2 ： Falsely low
*關鍵字3 ： Plasma replacement
*關鍵字4 ： High MCHC
*關鍵字5 ： RBC morphology
* 服務機關：
* 第一作者： 杜琦超
* 身分字號： *****51821
其他投稿作者： 吳孟庭
身分字號： *****16987
其他投稿作者： 徐志豪
身分字號： *****60227
其他投稿作者： 王志勇
身分字號： *****09775
其他投稿作者： 王愛
身分字號： *****35825
其他投稿作者： 李培寧
身分字號： *****80326
其他投稿作者： 藍健元
身分字號： *****27655
其他投稿作者：
身分字號：  
上傳稿件檔：
審查委員意見： Being an indicator of cold hemagglutinin as MCHC, it is no need to discuss.
審查委員意見： 不OK
主任委員意見：
 
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