Clinical Chemistry
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Clinical Chemistry 53: 359-361, 2007; 10.1373/clinchem.2006.083154
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(Clinical Chemistry. 2007;53:359-361.)
© 2007 American Association for Clinical Chemistry, Inc.

Letters to the Editor

Indican Interference in Bilirubin Assays: A Classical Solution Still Applies

Lorin M. Henricha, David E. Bruns, Doris M. Haverstick, Victoria G. Reynolds and James C. Boyd

Department of Pathology, University of Virginia, Health System, Charlottesville, VA

aAddress correspondence to this author at: Department of Pathology, P.O. Box 800214, University of Virginia Health System, Charlottesville, VA 22908. Fax 434-924-2151; e-mail lmh5p@virginia.edu.

The first 20% of the full text of this article appears below.


To the Editor:

Abbott Laboratories recently supplied a new reagent for total bilirubin (catalog no. 6L45-20) for use with the Architect cSystems analyzer. The reagent uses 2,4-dichlorophenyl diazonium (2,4-DCPD) and is described as minimizing interference from hemoglobin, although interference from indican was reported to be higher than with the previous reagent (1). Our initial comparison of the new and previous reagents yielded a regression equation with a slope of 1.05 (Fig. 1 , upper panel, {blacksquare}) and similar imprecision (not shown) for the 2 reagents. After introduction of the new reagent into routine use, however, bilirubin results in renal dialysis patients were noted to be higher than with the previous reagent. Among ~512 predialysis samples received during a 3-day period from patients on renal dialysis, 43% had bilirubin values above the upper limit of the reference interval (3–13 mg/L). For most of these patients, bilirubin concentrations reported within the previous 1–2 months had been within the reference interval.


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  		Figure 1. Effect of indican interference on a new bilirubin reagent formulation.

Upper panel, comparison of results of previous and new . . . [Full Text of this Article]






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