Publication:
Hyperleukocytosis: A Unique Cause of an Unidentifiable Hemoglobin A1c Peak

Simple item page
dc.contributor.authorAriff Aizzat Abdul Razak
dc.contributor.authorTuan Salwani Tuan Ismail
dc.contributor.authorRazan Hayati Zulkeflee
dc.contributor.authorSiti NadirahAb Rahim
dc.contributor.authorHani Ajrina Zulkeflee
dc.contributor.authorWan Nor Fazila Hafizan Wan Nik
dc.date.accessioned2024-06-16T06:28:32Z
dc.date.available2024-06-16T06:28:32Z
dc.date.issued2024
dc.date.submitted2024-6-11
dc.descriptionBiomedical Research and Therapy Volume: 11 Issue:1 (page: 6146-6150)
dc.description.abstractBackground: Glycosylated hemoglobin (HbA1c) serves as a crucial biomarker for the diagnosis and monitoring of diabetes. It can be measured via different methods. Interference during analysis can potentially arise from various factors, including rare occurrences such as hyperleukocytosis. Case presentation: Here, we present the case of a 54-year-old male patient with a 20-year history of type 2 diabetes mellitus who complained of prolonged lethargy, epigastric discomfort, and constitutional symptoms of malignancy. Further investigation revealed a diagnosis of T-cell prolymphocytic leukemia accompanied by hyperleukocytosis, indicated by a white cell count of 574.60 x 109/L with predominant lymphocytes. Chemotherapy and tumor lysis syndrome prophylaxis were initiated. During diabetic monitoring, analysis of HbA1c using capillary electrophoresis revealed an absent HbA1c peak; this has not previously been observed. To address this finding, the sample underwent repeated saline washing and centrifugation. Subsequent analysis demonstrated an improvement, with a well-fractionated HbA1c peak present at 8.7% (71 mmol/mol). Various factors can interfere with HbA1c analysis. Drug and hemoglobin variant interference was ruled out following the recovery of the peak post saline washing. The accelerated migration speed of the sample caused by interfering substances in the plasma was postulated to result in a profile shift, leading to the non-recognition of HbA1c fractions. Conclusion: By implementing the important step of washing out interfering molecules, the shift was eliminated, allowing for a true HbA1c level measurement. The appearance of an HbA1c peak post saline wash suggests the presence of endogenous substances that interfere with the assay's analytical method.
dc.identifier.citationAriff Aizzat Abdul Razak, Tuan Salwani Tuan Ismail, Razan Hayati Zulkeflee, Siti Nadirah Ab Rahim, Hani AjrinaZulkeflee, & Wan Nor Fazila Hafizan Wan Nik. (2024). Hyperleukocytosis: a unique cause of an unidentifiable hemoglobin A1c peak. Biomedical Research and Therapy, 11(1), 6146–6150. https://doi.org/10.15419/bmrat.v11i1.858
dc.identifier.doi10.15419/bmrat.v11i1.858
dc.identifier.epage6150
dc.identifier.issn2198-4093
dc.identifier.issue1
dc.identifier.spage6146
dc.identifier.urihttp://bmrat.org/index.php/BMRAT/article/view/858
dc.identifier.urihttps://oarep.usim.edu.my/handle/123456789/19425
dc.identifier.urihttps://www.scopus.com/record/display.uri?eid=2-s2.0-85192652178&origin=resultslist&sort=plf-f&src=s&sid=10f085899bde0c2620a889488e8a218f&sot=b&sdt=b&s=TITLE-ABS-KEY%28Hyperleukocytosis+A+Unique+Cause+of+an+Unidentifiable+Hemoglobin+A1c+Peak%29&sl=88&sessionSearchId=10f085899bde0c2620a889488e8a218f&relpos=0
dc.identifier.volume11
dc.language.isoen_US
dc.publisherBioMedPress (BMP)
dc.relation.ispartofBiomedical Research and Therapy
dc.relation.journalBiomedical Research and Therapy
dc.subjectHbA1c
dc.subjecthyperleukocytosis
dc.subjectT-PLL
dc.subjectassay interference
dc.titleHyperleukocytosis: A Unique Cause of an Unidentifiable Hemoglobin A1c Peak
dc.typetext::journal::journal article::research article
dspace.entity.typePublication
oaire.citation.endPage6150
oaire.citation.issue1
oaire.citation.startPage6146
oaire.citation.volume11
oairecerif.author.affiliation#PLACEHOLDER_PARENT_METADATA_VALUE#
oairecerif.author.affiliation#PLACEHOLDER_PARENT_METADATA_VALUE#
oairecerif.author.affiliation#PLACEHOLDER_PARENT_METADATA_VALUE#
oairecerif.author.affiliation#PLACEHOLDER_PARENT_METADATA_VALUE#
oairecerif.author.affiliationUniversiti Sains Islam Malaysia
oairecerif.author.affiliation#PLACEHOLDER_PARENT_METADATA_VALUE#

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Hyperleukocytosis A Unique Cause Of An Unidentifiable Hemoglobin A1c Peak.pdf
Size:
12.58 MB
Format:
Adobe Portable Document Format
Download

Collections

Scopus