Hi everyone, I’m hoping medical laboratory professionals can help me understand a sample-quality question about my five-year-old son’s bloodwork.
He had an MRI under sedation, and afterward blood was collected through the IV catheter in his arm, which had also been used for contrast and IV fluids. His tests included CBC, CMP, ANA by IFA, complements (C3, C4, CH50), and immunoglobulins (IgG, IgE, IgA, IgM).
All the results have come back, but the CMP included a comment that slight hemolysis was present and could affect certain results. The comment was under phosphatase and AST only.
These were follow-up tests after six months. His previous ANA by multiplex was positive, with a low anti-RNP result of 1.2. His rheumatologist thought this was likely a false positive, and his immunologist ordered ANA by IFA for the repeat testing. This time, the ANA by IFA was negative, which was reassuring.
However, several results, including complements, seem to be toward the lower end of their reference ranges or lower than before. Now I’m wondering whether the sample collection or hemolysis could have influenced them.
My questions are:
Could mild hemolysis affect ANA by IFA, particularly by causing a false negative?
Could it affect C3, C4, or CH50, and could it make them appear lower?
Could it affect the CBC, especially WBC or lymphocyte counts?
Is hemolysis different from contamination or dilution from IV fluids, and how does the lab assess these possibilities?
Is sample quality checked separately for these tests, or could a hemolysis comment on the CMP also matter for the other results?
I’m looking to understand the reliability of the samples and testing, rather than asking for a diagnosis. Thank you for any insight.

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