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Interference of hydroxyphenylpyruvic acid, hydroxyphenyllactic acid and tyrosine on routine serum and urine clinical chemistry assays; implications for biochemical monitoring of patients with alkaptonuria treated with nitisinone.
Clin Biochem 2019; 71:24-30CB

Abstract

OBJECTIVES

We have assessed the effect of elevated concentrations of hydroxyphenylpyruvic acid (HPPA), hydroxyphenyllactic acid (HPLA) and tyrosine, on a range of chemistry tests in serum and urine to explore the potential for chemical interference on routine laboratory analyses in patients with alkaptonuria (AKU) treated with nitisinone and similarly implications for patients with hereditary tyrosinemia type 1 (HT-1).

MATERIALS AND METHODS

HPPA, HPLA and tyrosine were added separately to pooled serum from subjects without AKU in a range of assays with Roche Modular chemistries. Effects on urine were assessed by changes in urine strip chemistries after mixing a positive control urine with various amounts of the test compounds and reading on a Siemens urine strip meter.

RESULTS

No significant effect (p > 0.1) was observed up to 225 μmol/L of HPPA and HPLA, and up to 5000 μmol/L tyrosine, on any of the serum-based assays including those with peroxidase-coupled reaction systems of enzymatic creatinine, urate, total cholesterol, HDL cholesterol and triglyceride. Both the monohydroxy HPPA, and the dihydroxy homogentisic acid (HGA), at increased urine concentrations typical of nitisinone-treated AKU and non-treated AKU respectively, did however show marked negative interference in strip assays for glucose and leucocytes; i.e. those with peroxide-linked endpoints. The effect of increased HPLA was less marked.

CONCLUSIONS

In patients with AKU or on nitisinone treatment and HT-1 patients on nitisinone, urine strip chemistry testing should be used sparingly, if at all, to avoid false negative reporting. It is recommended that urine assays should be organised with a suitable specialist laboratory.

Authors+Show Affiliations

Department of Clinical Biochemistry, Royal Liverpool and Broadgreen University Hospitals, Prescot Street, Liverpool L7 8XP, UK.Institute of Ageing & Chronic Disease, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX, UK.Department of Clinical Biochemistry, Royal Liverpool and Broadgreen University Hospitals, Prescot Street, Liverpool L7 8XP, UK.Institute of Ageing & Chronic Disease, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX, UK.Sobi, SE-112 76 Stockholm, Sweden.Department of Clinical Biochemistry, Royal Liverpool and Broadgreen University Hospitals, Prescot Street, Liverpool L7 8XP, UK.Department of Clinical Biochemistry, Royal Liverpool and Broadgreen University Hospitals, Prescot Street, Liverpool L7 8XP, UK. Electronic address: n.b.roberts@liverpool.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31228435

Citation

Curtis, S L., et al. "Interference of Hydroxyphenylpyruvic Acid, Hydroxyphenyllactic Acid and Tyrosine On Routine Serum and Urine Clinical Chemistry Assays; Implications for Biochemical Monitoring of Patients With Alkaptonuria Treated With Nitisinone." Clinical Biochemistry, vol. 71, 2019, pp. 24-30.
Curtis SL, Norman BP, Milan AM, et al. Interference of hydroxyphenylpyruvic acid, hydroxyphenyllactic acid and tyrosine on routine serum and urine clinical chemistry assays; implications for biochemical monitoring of patients with alkaptonuria treated with nitisinone. Clin Biochem. 2019;71:24-30.
Curtis, S. L., Norman, B. P., Milan, A. M., Gallagher, J. A., Olsson, B., Ranganath, L. R., & Roberts, N. B. (2019). Interference of hydroxyphenylpyruvic acid, hydroxyphenyllactic acid and tyrosine on routine serum and urine clinical chemistry assays; implications for biochemical monitoring of patients with alkaptonuria treated with nitisinone. Clinical Biochemistry, 71, pp. 24-30. doi:10.1016/j.clinbiochem.2019.06.010.
Curtis SL, et al. Interference of Hydroxyphenylpyruvic Acid, Hydroxyphenyllactic Acid and Tyrosine On Routine Serum and Urine Clinical Chemistry Assays; Implications for Biochemical Monitoring of Patients With Alkaptonuria Treated With Nitisinone. Clin Biochem. 2019;71:24-30. PubMed PMID: 31228435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interference of hydroxyphenylpyruvic acid, hydroxyphenyllactic acid and tyrosine on routine serum and urine clinical chemistry assays; implications for biochemical monitoring of patients with alkaptonuria treated with nitisinone. AU - Curtis,S L, AU - Norman,B P, AU - Milan,A M, AU - Gallagher,J A, AU - Olsson,B, AU - Ranganath,L R, AU - Roberts,N B, Y1 - 2019/06/20/ PY - 2019/03/08/received PY - 2019/06/11/revised PY - 2019/06/18/accepted PY - 2019/6/23/pubmed PY - 2019/6/23/medline PY - 2019/6/23/entrez KW - Alkaptonuria KW - Creatinine KW - Hydroxyphenyllactic acid KW - Hydroxyphenylpyruvic acid KW - Interference KW - Nitisinone KW - Peroxide KW - Routine clinical analysis KW - Tyrosine KW - Urate SP - 24 EP - 30 JF - Clinical biochemistry JO - Clin. Biochem. VL - 71 N2 - OBJECTIVES: We have assessed the effect of elevated concentrations of hydroxyphenylpyruvic acid (HPPA), hydroxyphenyllactic acid (HPLA) and tyrosine, on a range of chemistry tests in serum and urine to explore the potential for chemical interference on routine laboratory analyses in patients with alkaptonuria (AKU) treated with nitisinone and similarly implications for patients with hereditary tyrosinemia type 1 (HT-1). MATERIALS AND METHODS: HPPA, HPLA and tyrosine were added separately to pooled serum from subjects without AKU in a range of assays with Roche Modular chemistries. Effects on urine were assessed by changes in urine strip chemistries after mixing a positive control urine with various amounts of the test compounds and reading on a Siemens urine strip meter. RESULTS: No significant effect (p > 0.1) was observed up to 225 μmol/L of HPPA and HPLA, and up to 5000 μmol/L tyrosine, on any of the serum-based assays including those with peroxidase-coupled reaction systems of enzymatic creatinine, urate, total cholesterol, HDL cholesterol and triglyceride. Both the monohydroxy HPPA, and the dihydroxy homogentisic acid (HGA), at increased urine concentrations typical of nitisinone-treated AKU and non-treated AKU respectively, did however show marked negative interference in strip assays for glucose and leucocytes; i.e. those with peroxide-linked endpoints. The effect of increased HPLA was less marked. CONCLUSIONS: In patients with AKU or on nitisinone treatment and HT-1 patients on nitisinone, urine strip chemistry testing should be used sparingly, if at all, to avoid false negative reporting. It is recommended that urine assays should be organised with a suitable specialist laboratory. SN - 1873-2933 UR - https://www.unboundmedicine.com/medline/citation/31228435/Interference_of_hydroxyphenylpyruvic_acid,_hydroxyphenyllactic_acid_and_tyrosine_on_routine_serum_and_urine_clinical_chemistry_assays L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-9120(19)30231-0 DB - PRIME DP - Unbound Medicine ER -