Author Archives: د.حسام أبو فرسخ

:Normal range

:a.m 7-10

6.2-19.4mg/dL 171-536 nmol/L

 :p.m 4-8

2.3-12.3mg/dL 64-340 nmol/L

Comment: Cortisol excess and deficiency are at the center of several major disease processes, which require laboratory testing for diagnosis. Random measurements of serum cortisol are often useless. Even in patients with cortisol excess or deficiency, the many factors influencing cortisol can result in cortisol values, which overlap the reference range. Diagnostically useful cortisol measurements require standardized testing protocols in which one or more pre analytic variables are held constant

(Sample: Serum (a.m, p.m

(Normal range: 9-53 mg/24 hrs (248-1462 nmol/24 hrs

Comment: The diagnosis of Cushing syndrome (CS) requires evidence of cortisol hyper secretion. While serum cortisol levels fluctuate unpredictably and are strongly dependent on concurrent cortisol- binding globulin (CBG) levels, a 24-hour urine specimen integrates the cortisol production for an entire day and is not affected by CBG. Urinary cortisol reflects the portion of serum-free cortisol filtered by the kidney, and correlates well with cortisol secretion rate

Sample: 24 hr Urine

Normal range: < 320 nmol/L

(Comment: Increased in porphyria (see porphyrins

Sample: 24 hr Urine, in dark container

Comment: In Wilson, also in primary biliary cirrhosis, Indian childhood cirrhosis

Sample: Tissue sections (Paraffin blocks) & Cytology

(Normal range: 65-165 μg/dL (10-26 mmol/L

Comment: Nearly all serum copper is found bound to ceruloplasmin and both change proportionally. Increased levels are found in the last trimester of pregnancy, chronic leukemias, lymphomas in relapse, many anemias, age, infections & inflammatory conditions and Fanconi’s syndrome. It is also raised by oral contraceptives. Deficiency is associated with Wilson’s disease, nephrosis, cystic fibrosis, Menke’s syndrome, chronic diarrhea, hyper alimentation, iron deficiency anemia, malnutrition and infancy

Sample: serum

(Normal range: Up to 40 μg/24 hrs (up to 0.63 mmol/ 24 hrs

Comment: Copper poisoning can occur through chronic inhalation of copper fumes and /or dusts that are typically associated with industrial work. Urine copper is elevated in Wilson’s disease, chronic active hepatitis, biliary cirrhosis, proteinuria, and rheumatoid arthritis. Decreased urinary levels are found in protein malnutrition

Sample: 24hr Urine, 5-10 ml 10% HCL

Normal range: Negative

Comment: To detect irregular antibodies in Rh negative patient’s serum. Abnormal proteins and cold auto agglutinins may interfere and cause delays in interpretations

Sample: serum

Comment: To determine the quantitative variations in peripheral blood cell population e.g. WBC, RBC, Hb, HCT, MCV, MHC, MCHC, Platelets

Sample: EDTA whole blood

(Normal range: 10-40 mg/dL (0.1-0.4 g/L

Comment: Quantitation of C4 is used to detect individuals with congenital deficiency or those with autoimmune disease such as lupus erythematous (SLE), rheumatoid arthritis, serum sickness, certain glomerulonephritides, chronic hepatitis, cryoglobulinemia, immune complex disease, and hereditary angioedema. C4 levels are sensitive indicators of SLE and proliferative glomerulonephritis disease activity. C4 maybe increased with autoimmune hemolytic anemia

Sample: Serum, in ice

(Normal range: 90-180 mg/dL (0.9-1.8 g/L

Comment: Quantitation of C3 is used to detect individuals with a congenital deficiency or those with immunologic disease in whom complement is consumed at an increased rate. These include chronic hepatitis, certain chronic infections (including hepatitis C virus associated cryoglobulinemic vasculitis), immune complex disease, post streptococcal and membranoproliferative glomerulonephritis, and others. It is especially useful to assess disease activity in lupus erythematous SLE

Sample: Serum, in ice