Les interférences analytiques en biochimie clinique : l’impact de l’hémolyse, ictère et la lipémie sur les résultats

Abstract

Analytical interferences of endogenous origin—particularly hemolysis, icterus, and lipemia (HIL)—represent a major source of disruption in clinical biochemistry, especially during the pre-analytical phase of the testing process. These phenomena can significantly alter the apparent concentration of numerous blood analytes, thus compromising the reliability of results provided to clinicians. To assess the actual extent of this impact, a descriptive study was conducted at the central laboratory of Mostaganem University Hospital (CHU), analyzing a total of 58 biological samples divided into three groups based on the type of interference: 24 hemolyzed, 17 icteric, and 17 lipemic samples. The analysis revealed substantial variations depending on the nature of the interference. Hemolysis led to a marked overestimation of creatinine (+37.9%), and an underestimation of albumin (-12.5%). Transaminases AST and ALT were also artificially elevated due to intracellular enzyme release. In icteric samples, AST showed a significant increase of +45.4%, and total cholesterol rose by +26.8%, attributable to the spectral interference caused by bilirubin. Lipemic samples exhibited an overestimation of total cholesterol by +33.3%, along with an apparent decrease in glucose of -9.4%, due to serum turbidity. Although sometimes subtle, these variations may have major clinical consequences, leading to misdiagnosis or inappropriate therapeutic decisions. This study emphasizes the importance of incorporating robust detection and management strategies for HIL indices in routine practice. The implementation of standardized methods, combined with critical result interpretation, is essential to ensure the validity of biochemical analyses, enhance patient safety, and support medical decisions based on reliable data.