Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schöffl, C; Haas, A; Herrmann, M; Aberer, W.
The crux of C1-INH testing in everyday lab work.
J Immunol Methods. 2021; 497:113109
Doi: 10.1016/j.jim.2021.113109
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Schöffl Clemens
- Co-Autor*innen der Med Uni Graz
- Aberer Werner
- Herrmann Markus
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- Abstract:
- BACKGROUND: The determination of functional C1-INH is complex and depends on methodology, sample transport, and storage conditions. In clinical practice, we encounter individuals with pathological values which then cannot be proved true, and HAE patients in whom the values were wrongly found to be normal under non-optimum conditions. We aimed to test realistic real-life sample processing conditions for accurate C1-INH determination. METHODS: We conducted two national inter-laboratory comparisons with optimal sample preparation but different dispatch conditions. We also investigated variations of temperature and time, and their influence on C1-INH. RESULTS: C1-INH levels showed a significantly wider dispersion under suboptimal transport conditions than under optimal conditions (p < 0.00001). Two putatively healthy patient samples turned out to be pathological. Contrary to our expectations, we found no significant trend in a specific direction when the variables of temperature, time and sample material were combined and varied under realistic conditions. However, the range of variation in [%] functionality was markedly greater in supposedly healthy volunteers. Thus, under experimental conditions we obtained false pathological results that were not far from reality. CONCLUSION: C1- INH determination is crucial for the diagnosis of HAE. Time, temperature, and sample handling have a significant impact on this laboratory value, sometimes leading to incorrect values, inaccurate diagnoses, and inappropriate therapies. This underlines the importance of proper handling of samples. If a patient has ambiguous C1-INH values despite optimized conditions, thus hindering a conclusive diagnosis of HAE, we recommend genetic testing.
- Find related publications in this database (using NLM MeSH Indexing)
- Angioedemas, Hereditary - blood, diagnosis, immunology
- Biomarkers - blood
- Case-Control Studies - administration & dosage
- Centrifugation - administration & dosage
- Complement C1 Inhibitor Protein - analysis
- Humans - administration & dosage
- Immunologic Techniques - administration & dosage
- Laboratory Proficiency Testing - administration & dosage
- Observer Variation - administration & dosage
- Predictive Value of Tests - administration & dosage
- Reproducibility of Results - administration & dosage
- Specimen Handling - administration & dosage
- Temperature - administration & dosage
- Time Factors - administration & dosage
- Find related publications in this database (Keywords)
- Complement
- Hereditary angioedema
- C1-inhibitor
- Diagnosis
- Laboratory testing