Author Archives: د.حسام أبو فرسخ

:Normal range

Total alkaline phosphatase: up to 290 u/l

Liver fraction: up to160 u/l

Bone fraction: up to 150

Intestine fraction: up to 5 u/l

Comment: Alkaline phosphatase is released into the circulation from a variety of tissue primarily liver, bone, intestine and placenta. Each has varying properties of heat stability

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Bone isoenzymes is increased in osteoblastic activity (& growth), and decreased in osteopenia due to genetic hypophatasemia, cretin hypothyroidism, chronic nutritional deficiency, vitamin B12 deficiency and pernicious anemia

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Liver isoenzyme (Fraction I) is increased in hepatic congestion, Vasculitis, pregnancy, and (Fraction II) in parenchymal cell damage

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Intestinal isoenzyme is increased in intestinal disease and in some individuals with blood type “O” or “B”, and particularly after meals

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Placental fraction appears in maternal serum in 3rd trimester

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Regan isoenzymes frequently detected in neoplastic disease

Sample: Serum

:Normal range

 (Adult: 100-290 u/l       (1.67-4.84 mkat/L

 (Child : 180-1200 u/l     (3.0-20.04 mkat/L

Comment: Increasedduring bone metabolism: puberty, healing of afracture, primary and secondary hyperparathyrodisim, osteomalacia and juvenile rickets. Also increased primarily in liver and bone disease and metastatic carcinoma in bone. It is also released from the intestines and placenta. For more specific differentiation, the measurement of isoenzymes is needed. Hepatotoxic drugs may influence result positively. Decreased in hypothyroidism, scurvy, gross anemia, kwashiorkor, achondrolasia, cretinism, depsion of radioactive materials in bone, vitamin B12 deficiency (pernicious anemia) and multi- nutritional deficiency of zinc or magnesium

Sample: Serum

:Normal range

Erect         : 111-860 Pmol/L

Supine       : 28-444 Pmol/L

Comment: Useful the in investigation of patients with suspected primary Conn’s syndrome and secondary hyper- or hypo- aldosteronism

Without hypertension: decreased in Addison’s disease, isolated aldosterone deficiency, syndrome of hypo-aldosteronism due to renin deficiency. With hypertension: decreased with excess secretion of deoxycorticosterone, coticosterone, Tirne’s syndrome (25%), diabetes mellitus and acute alcoholic intoxication (increased during hangover). High sodium intake will tend to suppress serum aldosterone, whereas low sodium intake will elevate serum aldosterone

(Sample: Serum, (erect, supine

(Normal range: 2-8 U/L   (33-133 nkat/L

Comment: Of diagnostic use in muscular dystrophy and other muscular disorders. Increased levels are found in liver disease, polymyositis, gangrene trauma, hemolysis, and in malignancies, and after myocardial infarction. Decreased in hereditary fructose intolerance

Sample: Serum

Normal range: Negative

Comment: Used in the quantitation of alcohol level for medical or legal purposes, to test unconscious patients, and to diagnose alcohol intoxication and for the determination of appropriate therapy

Alcohol intoxication maybe possible cause of coma and also may mimic diabetic coma, cerebral trauma, and drug overdose. Ethanol is absorbed rapidly from the GI tract. Peak blood levels usually occur within 40-70 minutes on an empty stomach. Food in the stomach can decrease the absorption of alcohol. The half-lives and effectiveness of certain drugs such as barbiturates are increased in the presence of ethanol

Sample: EDTA whole blood, serum

Normal range: Negative

Comment:Increased in renal proteinuria, glomerulonephritis, diabetic, SLE, cystic kidney, malignancy, amyloidosis, sarcoidosis, sickle cell disease, renal transplant rejection, multiple myeloma, degenerative and irritative conditions of the lower urinary tract, heavy metal poisoning, strenuous exercise, pyrexia, exposure to cold, congestive heart failure, hypertension, arteriosclerosis, pregnancy and postural proteinuria

Positive results from reagent strips maybe confirmed by repeat samples collected at different times of the day. Alkaline or highly buffered urine may cause false positive results

Sample: Urine

Normal range: 3.5-5.2 g/dl   35-50 g/L

Comment:Increasedin dehydration, lipemia, non-fasting samples, or ampicillin therapy. Low levels may be due to chronic liver disease (decreased synthesis), nephrotic syndrome, pregnancy, rheumatic disease, protein- losing enteropathy or extensive burns. Malabsorption or malnutrition may also cause hypo-albuminaemia

Sample: Serum

Normal range: 1.1-2.2 ratio

Comment: Ratio indicates whether the levels of albumin or globulin exceed each other

Sample: Serum

:Normal range

(M: up to 40 IU/L(up to 0.67 mkat/L

(F: up to 31 IU/L (up to 0.52 mkat/L

Comment: This is the main enzyme in liver function test. It is present in liver paranchyma and is thus elevated in hepatocellular damage – primarily from toxic necrosis – viral hepatitis and circulatory failure. Moderate increase occurs in cirrhosis, preeclampsia, fatty liver, chronic alcohol abuse, filariasis sever burns, sever pancreatitis, infectious mononucleosis and preceding trauma. Decreased in pyridoxal phosphate deficiency

Sample: Negative

:Normal range

Blood, umol/L*

Newborn: 235-700

Infants: 100-619

Children: 150-600

Adults: 200-600

Urine, umol/L*

Infants: < 183

Children: 43-367

Adults: 200-1040

Comment: Look amino acid

Sample:Urine,spot urine, plasma,(lithium heparin) separate immediately