What factors cause a factitiously elevated hemoglobin?
Measuring hemoglobin values:
- Automated cell counter from a tube of well-mixed EDTA-anticoagulated blood filled to a predetermined level.
- RBCs are lysed, all forms of hemoglobins are converted to the colored protein cyanomethemoglobin and measured by a colorimeter.
- An inadequate sample, whether due to insufficient volume or inadequate anticoagulation, may give false readings.
- Hemoglobin is quantified based on its absorption characteristics. Conditions such as hyperlipidemias, hyperbilirubinemia, a very high white blood cell count, and high serum protein can interfere with this measurement and result in falsely elevated hemoglobin values.