A falsely low lactate: discrepancies in lactate measurement between blood gas and core laboratory instruments due to β-hydroxybutyrate interference-a case report.

Abstract

Introduction: Laboratory tests play a crucial role in diagnosing and managing illness. Accurate interpretation, which includes evaluating false-negative and false-positive results, is essential for guiding appropriate clinical interventions and ensuring patient safety.

Methods: We present a case involving clinically significant discrepancies in lactate measurements in a patient with acute myeloid leukemia and diabetic ketoacidosis.

Results: These discrepancies were caused by interference from elevated levels of ketone bodies-specifically, β-hydroxybutyrate-which may have delayed recognition of the severity of the patient's condition.

Discussion: Dilution and spike experiments suggested potential interferences in core laboratory instruments using the Trinder reaction, leading to inaccurate lactate readings.