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Endocrinology
Leucocytosis-induced artefactual hypoglycaemia in the setting of chronic neutrophilic leukaemia
  1. Katherine Drummond1,
  2. Nisha Gupta2,
  3. Elizabeth Mac Namara3 and
  4. Stavroula Christopoulos4
  1. 1 Department of Medicine, McGill University, Montreal, Québec, Canada
  2. 2 Division of Endocrinology and Metabolism, McGill University, Montreal, Québec, Canada
  3. 3 Department of Medical Biochemistry, Jewish General Hospital, Montreal, Québec, Canada
  4. 4 Division of Endocrinology and Metabolism, Jewish General Hospital, Montreal, Québec, Canada
  1. Correspondence to Dr Katherine Drummond; katherine.drummond{at}mail.mcgill.ca

Abstract

A man in his late 70s with newly diagnosed chronic neutrophilic leukaemia with marked leucocytosis was found to have recurrent low plasma glucose levels on routine bloodwork. Nevertheless, he did not exhibit any signs or symptoms of hypoglycaemia, and capillary blood glucose measurements taken at the same time were within normal limits. Time-dependent plasma glucose concentration decline with delayed processing confirmed the suspected diagnosis of artefactual hypoglycaemia secondary to hyperleucocytosis. This phenomenon is caused by excessive in vitro glycolysis, which can be mitigated by rapid sample processing or the use of tubes containing glycolysis inhibitors. This case report adds to the existing body of evidence on artefactual hypoglycaemia with the aim of raising awareness of this entity among healthcare professionals. In asymptomatic individuals with low glucose measurements, the possibility of spurious results should be considered prior to initiating further diagnostic work-up.

  • Hypoglycemia
  • Leucocytosis
  • Endocrinology
  • Malignant and Benign haematology

https://doi.org/10.1136/bcr-2024-264459

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    Footnotes

    • Contributors KD: experiment execution, manuscript preparation and guarantor. NG: initial patient evaluation and manuscript preparation. EMN: scientific advisor, experimental design and data analysis. SC: manuscript revision and senior author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.