Author Archives: د.حسام أبو فرسخ

(P- Anti Neutrophils Cytoplasmic Ab (P-ANCA

Normal range: Negative

Comment:Autoimmune

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antibodies, useful diagnostic test in patients with Wegener’s granulomatosis, related vasculitides, and glomerular diseases. P-ANCA shows high (>80%) association with pauci – immune glomerulonephritis

Sample: serum

(P- Anti Neutrophils Cytoplasmic Ab (P-ANCA

Normal range: Negative

Comment: Polyarteritis nodosa, idiopathic cresentic glomerunephritis, SLE, Rheumatoid Arthritis, Ulcerative Colitis, Crohn’s Disease, Primary Scleroing Cholangitis, Autoimmune Hepatitis, Primary Biliary Cirrhosis

Sample: serum

(Oxalate (Quantitative

:Normal range

Adult Male: 7-44 Mg/24hr

Adult F      : 4-31 Mg/24hr

Child          : 13-38 Mg/24hr

Comment: Increased excretion maybe due to oxalate rich food and absorption of oxalate in a number of gastrointestinal disorders that cause severe fat malabsorption. Decreased levels are associated with hyperglycinuria. Caliculi may form if renal function is poor. In children primary hyperoxaluria is a rare inborn error

Sample: 24 hrs urine

Osteocalcin

Comment: A major bone protein derived from osteoblasts and excreted by the kidney. Serum levels reflect osteoblast activity and bone turnover. Increased in metabolic bone disease (including osteoporosis), bone metastases and renal failure. Low values in hypoparathyrodism, hypothyrodism, liver disease and low bone turnover osteoporosis

Sample: Heparin tube & under ice

Osmotic fragility

Normal range: Starts 0.48-ends 0.42 gm NaCl

Comment: Increased in almost all cases of hereditary spheroccytosis, acquired hemolytic diseases of the newborns. Resistance to osmotic lysis i.e low osmotic fragility characteristic of b-thalassemia. Also in iron deficiency, sickle cell anemia, sideroblastic anemia

Sample: Heparinized whole blood

Osmolality, urine

Normal range: 350-1300 mOsm/Kg

Comment: Urine osmolality is use to evaluate the concentrating ability of the kidneys (e.g., in acute and chronic renal failure), electrolyte and water balance, renal disease, syndrome of inappropriate ant diuretic hormone secretion (SIADH), diabetes, dehydration, and amyloidosis. It is sometimes used in addition to urine analysis when the patient has been administrated radiopaque substances or has glycosuria or proteinuria. Estimation of urinary ammonium concentration and detection of increased osmolarity due to unusual molecules are possible using the urine osmolal gap. Osmolality is desirable in examination of neonatal urine when protein or glucose is present

Sample: Urine

Osmolality, serum

:Normal range

Adults & Children: 275-295 mOsm/Kg

60yrs: 280-298 mOsm/Kg<

Comment: Serum osmolality is used to evaluate electrolyte and water balance, hyperosmolar status, hydration/ dehydration status, acid – base balance, seizures, antiduretic hormone function, liver disease, and hyperosmolar coma. Osmolality is proportional to the concentration of particles in solution

Sample: Serum

(Ovulation Test (LH

:Normal range

Male

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: 1.1-7.0 mIU/mL

Follicular : 1.5-8.0 mIU/mL

Luteal : 0.2-0.6 mIU/mL

mid cycle: 9.6-80 mIU/mL

Comment: Markedly raised values maybe found in primary found in primary gonadal failure. A useful test in evaluating infertility in men and women in conjunction with FSH estimation

Sample: Serum

OH Progesterone

:Normal range

:Cycling female*

    5-15days      : 0.3-1.5 ng/mL

    12-22days    : 1.3-3.9 ng/mL

    22-28days    : 0.4-4.6 ng/mL

Male            : 0.5-2.9 ng/mL*

Comment: Investigation of congenital adrenal hyperplasia. Lack of the C-21- hydroxylase enzyme (the most common defect) causes an increase in 17- hydroxyprogestrone (> 15 nmol/l) and deficiency of both 11-deoxycortisol and cortisol. Also used in the investigation of infertility, being a precursor of oestrogens and androgens which are reduced when the level of 17-hydroxyprogesterone is abnormally low

Sample: Serum

Methotrexate

:Normal range

 1-2wk after dose: <2.3 nmol/L

 72hrs after dose: < 100

If it exceeds these levels, then higher doses of leucovorin or extended rescue nmol/L

 1-2wk after dose : <2.3

 72hrs after dose: < 100

If it exceeds these levels, then higher doses of leucovorin or extended rescue

Comment: anti-neoplastic agent used in the treatment of many solid tumours, non-Hodgkin’s lymphoma and juvenile acute lymphoblastic leukaemia. Also used for some cases of psoriasis

Sample: Serum, state time of last dose