Increased levels of bilirubin, hemoglobin, and lipids interfere in assays through their spectrophotometric, fluorimetric, or chemiluminescence properties, or through side reactions. Protein interference can occur in both hypo- or hyper-proteinemia because of alteration in matrix composition. Such interference occurs mostly in immunoassays. In addition to watching for interference from these four sources, one must consider the potential of sample or reagent carryover in probes and cuvettes in the auto-analyzers. Assay developers undertake steps such as sample blanking to minimize such interferences. Auto-analyzers may include measurements of icterus, hemolysis, and turbidity to flag results that may be affected by such interferents. Sample blanking and robust assay design can be used to minimize these interferences, including matrix effect arising from protein and other non-specific constituent in the specimen. When suspected, the interferents may be removed from the specimen by specific agents, ultrafiltration, or centrifugation, before reanalysis. Alternatively, the specimen may be analyzed by a different method that is known to be free from such interference.

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