It is done to identify abnormalities in the rate of protein synthesis and removal
What are the normal ranges for Serum Globulin
2.5g/dl – 3.5g/dl
What causes increase in serum Globulin
What causes decrease in serum Globulin
Assists in confirming myocardial or pulmonary infarction. It is also used in differential diagnosis of muscular dystrophy and pernicious anaemia.
HIGH LEVELS ASSOCIATED WITH:
Serum creatinine is a better indicator of overall renal function and progression to renal failure.
Serum creatinine levels are less affected than urea levels by age, dehydration, and catabolic states, e.g. fever, sepsis, and internal bleeding as compared to UREA
Creatinine levels are also less influenced by changes in diet such as low intake of protein (providing this is not prolonged).
Increasingly the measurement of serum creatinine is being used to investigate HIV associated renal disease and to monitor patients being treated
with nephrotoxic antiretroviral drugs, e.g. tenofovir.
What are normal Ranges?
Males: 60–130 mol/l 0.7 to 1.4 mg/100 ml
Females: 40–110 mol/l 0.4 to 1.2 mg/100 ml
Lower in children depending on
muscle mass.
What does results indicate?
Increase in serum creatinine levels is associated with diseases that cause renal failure:
Diseases that can cause renal failure with a reduced GFR include glomerulonephritis (inflammation of the kidney glomeruli), pyelonephritis (inflammation of the pelvis of the kidney), and renal tuberculosis.
Continue reading “SERUM CREATININE TEST”Is an indicator of renal function but is more affected by state of hydration and dietary intake. CREATININE is therefore more preferred.
What are normal ranges for UREA TEST?
Adults: 3.3–7.7 mmol/l OR 20–46 mg/100 ml
Infants: 1.3–5.8 mmol/l OR 8–35 mg/100 ml
Values are higher in the elderly and slightly lower in females.
What causes rise in serum Urea levels?
Renal causes of increase are same as those of CREATININE
Non-renal causes: Slight increases in urea (not more than three times the upper limit of the reference range) may occur when there is:
– Dehydration
– Diuretic therapy
– Gastrointestinal blood loss
– Any condition associated with increased protein breakdown such as pneumonia, malaria, meningitis, typhoid, major trauma, and surgical operations.
What causes low serum levels?
Low urea levels may be found in:
– Pregnancy
– Malnutrition and AIDS
– Severe liver disease
– Water overload
Measurement of serum or plasma amylase activity is usually requested to assist in the differentiation of acute pancreatitis from other acute abdominal disorders. It is an early indicator of acute pancreatitis.
What are the Normal ranges for Serum amylase test?
70-340 U/l
What causes high levels of serum amylase?
Acute pancreatitis
Very high concentrations of serum or plasma amylase (over 1850 U/l) are virtually diagnostic of acute pancreatitis or acute episodes of chronic relapsing
pancreatitis. Read more.
Other conditions giving raised amylase values
Serum or plasma amylase levels of approximately 740–1500 U/l may be due to:
– Renal failure
– Salivary gland obstruction or inflammation such as
with mumps
– Diabetic ketoacidosis
– Opiate drugs and some antiretroviral drugs
– Alcoholism
– Hypothermia
– Ectopic pregnancy
– Almost any acute abdominal emergency, and also cholecystitis, perforated peptic ulcer, or peritonitis.
Falsely raised amylase level
Falsely elevated amylase levels may result if the serum is markedly turbid or the sample has been contaminated with amylase during analysis.
Also referred to as to Glutamate Pyruvate Transaminase (GPT)
Measurement of ALT activity is mainly performed to investigate liver disease. Increasingly ALT is being measured to monitor patients receiving antiretroviral drugs associated with hepatotoxicity such
as nevirapine (NVP) and stavudine (d47).
While both ALT and AST are raised with hepatocellular injury, ALT is more specific for detecting liver cell damage.
What are the Normal ranges for Serum ALT ?
5–35 IU/l
Causes of high levels of serum ALT
Liver disease
The most important cause of raised ALT activity is hepatocellular injury. With acute hepatocellular injury, AST levels are usually higher than ALT levels. As damage continues, ALT activity becomes higher. In viral hepatitis, both enzymes are usually raised before the patient becomes jaundiced.
In Liver cirrhosis:
ALT levels fall below AST levels. Both ALT and AST are raised in hepatitis caused by hepatotoxic antiretroviral drugs.
Obstructive liver disease is usually accompanied by only small or moderate ALT and AST rises especially in the early stages. With complete obstruction, enzyme levels fall.
ALT and AST enzymes are artefactually increased when haemolysis is present or if the blood has been stored without separation of the serum or
plasma.
What causes increase in Serum ALT?
It also referred to as Glutamate Oxaloacetate Transaminase (GOT)
Myocardial infarction
An important cause of elevated AST activity is myocardial infarction, i.e. destruction of an area of heart muscle because its blood supply has been cut off due to a blood clot in a coronary artery. The enzyme level rises soon after the coronary vessel becomes blocked, reaches its highest value 24–48 hours after the infarct and returns to normal usually within 3–5 days. In general, the more extensive the infarct, the higher the AST peak level.
Other causes of raised AST levels
Because AST is widely distributed in body tissues, many other diseases involving cellular injury may be accompanied by increases in AST levels:
– Severe bacterial infections, – -Malaria,pneumonia
– Infectious mononucleosis, Pulmonary infarcts, and tumours.
AST activity is also increased in some muscle disorders and following surgery, injury or blood transfusion.
ALT and AST enzymes are artefactually increased when haemolysis is present or if the blood
has been stored without separation of the serum or
plasma.
Serum albumin is mainly measured to investigate liver diseases, protein energy malnutrition, disorders of water balance, nephrotic syndrome, and protein-losing gastrointestinal diseases.
What are the Normal ranges for Serum albumin Test?
30 – 40g/dl
What does test result mean?
Increases Serum albumin levels are rarely raised except in
diarrhoea or prolonged vomiting and artefactually by prolonged venous stasis.
Decreases
Hypoalbuminaemia occurs whenever there is increased plasma volume (e.g. in pregnancy).
Pathological causes include:
– Low protein intake as in protein energy malnutrition.
– Malabsorption as in chronic pancreatitis, coeliac disease, and sprue.
See also:
The measurement of serum or plasma bilirubin is usually performed to investigate the causes of liver disease and jaundice, and to monitor a patient’s progress, e.g. an infant with serious neonatal jaundice (high levels of unconjugated bilirubin).
Bilirubin is a product of erythrocytes breakdown and exists as conjugated or non- conjugated. These two combined gives the Total Bilirubin.
What are normal ranges for Total bilirubin?
Adults: 3–21 mol/l 0.2–1.3 mg/100 ml
Newborns: 8–67 mol/l 0.5–4.0 mg/100 ml
What does high serum Bilirubin indicate?
RISE in the level of bilirubin in the blood is called hyperbilirubinaemia. The main causes are as follows:
● Overproduction of bilirubin caused by an excessive breakdown of red cells (haemolytic jaundice). The bilirubin is of the unconjugated type.
In tropical countries haemolysis is due mainly to:
– Severe falciparum malaria.
– Sickle cell disease haemolytic crisis.
– Haemolysis associated with glucose-6-
phosphate dehydrogenase deficiency and
hereditary spherocytosis.
– Antigen antibody reactions as in haemolytic disease of the newborn, autoimmune haemolytic anaemias, or following an incompatible blood transfusion.
– Toxins from bacteria, snake venoms, drugs or herbs.
● Liver cell damage in which there is usually an increase in both conjugated and unconjugated bilirubin (hepatocellular jaundice). The commonest causes are:
– Hepatitis caused by hepatitis viruses and other viruses
– Leptospirosis
– Relapsing fever
– Brucellosis
– Typhoid
– Chemicals, plant toxins and drugs
● Metabolic disturbances in the liver involving defective conjugation, transport and, or, excretion
of bilirubin. Examples include:
– type of neonatal jaundice, often referred to as ‘ physiological jaundice’
– Rare inherited disorders of conjugation such as Gilbert’s and Crigler-Najjar syndromes.
● Partial or complete stoppage of the flow of bile through bile channels with a build up of conjugated bilirubin in the blood (obstructive
jaundice). Cholestasis can be due to:
– Obstruction of the extra-hepatic biliary ducts by gallstones, tumours (especially hepatomas and carcinoma of the pancreas), cholangitis
(inflammation of the biliary ducts), or by
helminths such as Opisthorchis and Fasciola species. Occasionally heavy Ascaris infections, especially in children, may result in blockage of the common bile duct.
– Pressure on the small bile ducts as may occur in hepatitis or as a side effect of drugs.
NB: Mild to moderate hyperbilirubinaemia may also be found in association with any serious condition such as a terminal illness, or following major trauma, surgery, or blood transfusion
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