Our daughter, Rachel, has Epilepsy. For proper seizure control, her medications need to be at the proper levels. This can pose significant challenges, especially if other system-taxing, chemotherapeutic agents are added into the mix for other medical conditions that arise.

Recently, she was on another medication, Accutane, for a dermatology condition.  When she was tested for the Accutane levels an increase in her liver numbers was detected, which was a cause for concern and led to backing off the additional therapy.

At around the same time, she had her scheduled test to check the levels of her anti-epileptic/anti-convulsant medications, Topamax and Keppra, which have successfully controlled her Epilepsy since 2012.   They both came back as “0,” despite the fact that she regularly took these medications.  (The normal readings when taking these drugs as prescribed should be in the range of 2.0 – 25.0 ug/ml and 5.0 to 63.0 ug/ml, respectively.)  Obviously, the first thought was that her test results were in error, with these results being an anomaly.   Indeed, later tests showed this to be the case.

However, what if her liver numbers as a result of taking the additional medication had been more pronounced? What if she had needed to back off Keppra and Topomax for a time, in order to allow her liver to recover? It would have been best to actually have confidence in the numbers reported to be able to make the most educated decision.

If it was a problem of the samples being switched, was there someone else out there who was given the results of our daughter’s blood sample?  The ramifications are obvious, including delays in or incorrect treatment.   The results could be disastrous.   It makes you realize the importance of quality laboratory testing, and that regulations governing the practice of laboratory medicine are there for a reason.

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