A severely lipemic specimen has sodium 121 mmol/L by an indirect ion-selective electrode, sodium 138 mmol/L by…

Question

A severely lipemic specimen has sodium 121 mmol/L by an indirect ion-selective electrode, sodium 138 mmol/L by a direct ion-selective electrode, and a measured serum osmolality within the reference interval. What best explains the discrepancy?

Accepted Answer

보기 4: Pseudohyponatremia caused by the electrolyte exclusion effect in the diluted indirect method

Indirect ISE methods dilute the specimen and assume a normal plasma water fraction. Markedly increased lipids reduce that fraction and can produce an artifactually low sodium result, while direct ISE avoids the dilution-related electrolyte exclusion effect.

Answer

보기 1: True hypotonic hyponatremia

Answer

보기 2: Sodium contamination of the direct electrode

Answer

보기 3: Water loss during specimen transport

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A severely lipemic specimen has sodium 121 mmol/L by an indirect ion-selective electrode, sodium 138 mmol/L by a direct ion-selective electrode, and a measured serum osmolality within the reference interval. What best explains the discrepancy?

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