ARTIFACTUAL HYPOGLYCEMIA ASSOCIATED WITH HEMATOPOIETIC CYTOKINES

We observed apparent hypoglycemia in seven patients manifesting granul ocytosis associated with hematopoietic cytokine treatment or with a le ukemoid reaction. All seven patients had confounding preanalytic condi tions of specimen transport delay and lack of antiglycolytic agents. C ytokine-stimulated leukocytes may cause artifactual hypoglycemia by co nsuming glucose in vitro, possibly leading to unnecessary diagnostic e valuation. The glucose depletion was faster in blood drawn from patien ts receiving granulocyte colony-stimulating factor (0.29 mmol/L/h) tha n in blood from a control group (0.17 mmol/L/h) or from a group with l eukemia (0.23 mmol/L/h). Stabilization with sodium fluoride (60 mmol/L ) slowed the glucose depletion in both the cytokine group (0.13 mmol/L /h) and the leukemic group (0.09 mmol/L/h), which were then statistica lly indistinguishable from the control rate (0.10 mmol/L/h). In blood obtained from patients being treated with hematopoietic cytokines or w ho have leukemoid reactions, an antiglycolytic agent should be used wh enever separation of plasma might be delayed more than 1 hour.