Background: Routine screening for hereditary disorders in newborns includes screening for treatable metabolic and endocrine disorders, such as biotidinase deficiency, galactosemia, maple syrup urine disease, hypothyroidism, and cystic fibrosis. Incorrect test results may be encountered due to the use of vitamin K1. To investigate the interference effect of vitamin K1 on neonatal screening tests and to raise awareness of erroneous measurements.
Methods: Heel blood samples were taken from 25 newborns born in a neonatal intensive care unit. Dry blood C0, C2, C3, C4, C4DC, C5:1, C5OH, C5DC, C6, C6DC, C8, C8:1, C8DC, C10, C10:1, C10DC, C12, C14, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2, C18:OH, methylglutaryl, valine, leucine/isoleucine, methionine, phenylalanine, argininosuccinic acid, aspartate, alanine, arginine, citrulline, glycine, ornithine, and glutamate tests were studied using the tandem mass spectrometry (MS) method. The results of the heel blood samples obtained before and after the application of vitamin K1 (Phyto menadione) were compared.
Results: In two studies conducted with in vitro and in vivo tests, C0, C2, C3, C4, C4DC, C5, C5OH, C6, C8, C10, C10:1, C14, C16, C16:1, C18, C18:1, methylglutaryl, phenylalanine, argininosuccinic acid, tyrosine, aspartate, arginine, citrulline, glycine, and glutamine were all significantly elevated (p < 0.05).
Conclusions: Heel blood samples may yield false results due to vitamin K1 administration. In the case of doubtful results, a new sample should be taken and the measurement should be repeated.
Uvod: Rutinski skrining za nasledne poremećaje kod novorođenčadi uključuje skrining metaboličkih i endokrinih poremećaja koji se mogu lečiti, kao što su nedostatak biotidinaze, galaktozemija, bolest urina od javorovog sirupa, hipotiroidizam i cistična fibroza. Mogu se naći i netačni rezultati zbog upotrebe vitamina K1. Cilj je bio da se istraži efekat interferencije vitamina K1 na neonatalne skrining testove i da se podigne svest o pogrešnim merenjima.
Metode: Uzorci krvi iz pete uzeti su od 25 novorođenčadi rođenih u neonatalnoj jedinici intenzivne nege. Suva krv C0, C2, C3, C4, C4DC, C5:1, C5OH, C5DC, C6, C6DC, C8, C8:1, C8DC, C10, C10:1, C10DC, C12, C14, C14:1, C14: 2, C16, C16:1, C18, C18:1, C18:2, C18:OH, metilglutaril, valin, leucin/izoleucin, metionin, fenilalanin, ar ginin osukcinska kiselina, aspartat, alanin, arginin, citrulin, glicin, ornitin i glutamat testovi su proučavani metodom tandem masene spektrometrije (MS). Upoređeni su rezultati uzoraka krvi pete pre i posle primene vitamina K1 (Phito menadion).
Rezultati: U dve studije sprovedene sa in vitro i in vivo testovima, C0, C2, C3, C4, C4DC, C5, C5OH, C6, C8, C10, C10:1, C14, C16, C16:1, C18, C18: 1, metilglutaril, fenilalanin, argininosukcinska kiselina, tirozin, aspartat, arginin, citrulin, glicin i glutamin koji su svi značajno bili povišeni (p < 0,05).
Zaključak: Uzorci krvi pete mogu dati lažne rezultate zbog davanja vitamina K1. U slučaju sumnjivih rezultata, treba uzeti novi uzorak i ponoviti merenje.
Keywords: Vitamin K1; heel blood; hereditary disorders; interference; newborn; tandem MS.
2023 Murat Caglayan, Ataman Gonel, Cuneyt Tayman, Ufuk Cakir, Ismail Koyuncu, Ebru Temiz, Yasemin Sert, published by CEON/CEES.