CLINICAL HEMATOLOGY Hematological samples are anticoagulated ones. So, the following precautions must be followed:
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Test Name |
Sample |
Test Interference |
Remarks |
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Citrated blood |
Increases by anabolics Decreases by Heparin |
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Increases by Aspirin,Penicillin G,non steroidal anti-inflammatory drugs |
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Citrated blood |
Gram negative septicaemia |
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Contact Lab |
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Contact Lab |
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EDTA-anticoagulated sample Send to the lab within 2 hours
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Follow up of anemia by Hb and reticulocyte count after one week from start of supportive therapy Bi or pancytopneia recommend BM examination. |
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EDTA anticoagulated blood |
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Serum sample (clotted blood) |
Previous blood transfusion must be excluded |
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Heparinized BM sample |
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Contact the Lab |
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Order a special Lab-supplied tube |
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Citrated sample in the ratio 1:4 (blood should reach the mark on the tube) |
Increases by oral contraceptives, vitamin A , phenytoin. Decrease by corticisteroids, salicylate, quinidine, streptomycin, tetracyclins, sulfonamides. |
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Citrated sample (1:9) (blood sample should reach the mark on the tube) |
Drugs interacting with anticoagulant therapy as some antibiotics |
Prenanlytic precautions must be followed: Ratio of blood to the anticoagulant Timing of the sample related to therapy Immediate assay |
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Morning serum, to exclude diurnal variation |
Iron therapy and recent transfusion must be excluded |
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Order a special Lab-supplied tube |
High titre of Rheumatoid factor |
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Order a special Lab-supplied tube |
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EDTA blood sample
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Recent blood transfusion must be excluded Recent hemolytic crises |
Done 3rd week after hemolytic attack |
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EDTA blood sample |
Same as above |
Same as above |
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Test Name |
Sample |
Test Interference |
Remarks |
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EDTA blood sample |
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Patients' CBC, blood incices should be supplied , good family history. Recent blood transfusion should be excluded (at least 2 weeks) |
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Contact the Lab
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Contact the Lab |
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Serum , morning sample in a plastic tube |
Increases by iron therapy, recent blood transfusion, aspirin, corticosteroids, chloramphenicol. Decease by stress and sleep deprivation |
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EDTA BM sample |
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Citrated blood Lab supplied tube |
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EDTA anticoagulated blood taken during the attack of fever Fresh direct blood film (EDTA blood) |
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In between attacks examine for the presence of antibodies in serum |
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Fresh direct blood film |
Decreases by EDTA |
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Fresh heparinized blood (within 2 hrs) |
Malaria infection |
Assay done within 6 hours |
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Citrated blood+ EDTA blood |
Lipemia,aspirin,diuretics,indo-methacin, nitrofurantoin,penicillin, antidepressants, anesthetics |
Aspirin or antiplatelet drugs should be discontinued 15 days before the test |
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Fresh EDTA sample
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Epinephrine, analgesics, aspirin, salicylate, codeine, sulfonamides, penicillin, diuretics, insulin, hypoglycemics |
Manual platelet count is requested only in cases of suspected platelet function abnormality or high PDW as in Bernard Soulier disease. |
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Citrated sample (1:9) (blood sample should reach the mark on the tube) Immediate assay |
Anabolic steroids, antibiotics, , quinines,cyclophosphamide, laxatives, halothane, heparin, methotrexate, niacin, pyrazinamide, thiazides. Chloralhydrate, chloramphenicol,glucagons enhance the effect of oral anticoagulant. Barbiturates, carbamazepine, phenytoin suppress the effect of oral anticoagulant. |
Prolonged storage at 4◦C, poor venipuncture, hemolyzed samples may shorten PT. Prenanlytic precautions must be followed: Ratio of blood to the anticoagulant Timing of the sample related to therapy. Used for follow up of oral anticoagulants |
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Citrated sample (1:9) (blood sample should reach the mark on the tube) Immediate assay |
Traumatic venipuncture shorten shorten PTT
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Following a recent thrombotic event the PTT is often below normal, and responds slowly to anti vit K drugs |
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Citrated blood |
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Citrated blood |
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Fresh EDTA sample Immediate assay
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Decrease by high glucose level |
Reticulocyte index, corrected reticulocyte count must be requested in anemic patients |
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EDTA blood sample |
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EDTA blood sample |
Indicated during suspected crisis |
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Citrated blood sample Lab supplied tube Immediate assay |
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Serum sample |
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Morning serum, to exclude diurnal variation |
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Iron therapy and recent transfusion must be excluded |
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- Ratio of blood to the anticoagulant - Timing of the sample related to therapy - Immediate assay - Other interfering drugs interacting with anticoagulant therapy as some antibiotics. |
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EDTA blood |
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