Author Archives: د.حسام أبو فرسخ

:Normal range

(Cortisol, baseline: > 5mg/dL (>138 nmol/L*

(After Cortisol: Peak response: > 20 mg/dL (> 552 nmol/L*

Comment: This is screening test only. Normal (positive) response rules out primary and overt secondary adrenal insufficiency, but a partial ACTH deficiency is not excluded. A sub-normal response indicates decreased adrenal reserve and a diagnosis of insufficiency, either primary adrenal failure (e.g. Addison’s disease) or secondary pituitary disease, or suppression by steroid medications. To distinguish primary and secondary insufficiency, the prolonged ACTH tests and plasma ACTH measurements maybe performed. In adrenal hyperplasia, there is 3-to-5 fold increase. In adrenal Carcinoma, there is little or no response

Sample: Serum

:Normal range

6-57 pg/ml              1.3-12.5 pmol/L

Comment: Useful, along with cortisol, in the differentiation between primary and secondary adrenal insufficiency (high in primary, and low in secondary). In pituitary-dependent Cushing’s syndrome ACTH is elevated with loss of diurnal cortisol rhythm. Very high values are found in Cushing’s syndrome caused by an ectopic ACTH-secreting or corticotrophin –releasing tumor, and Addison’s disease. Low values with loss of diurnal variation occur in Cushing’s syndrome caused by an adenoma or carcinoma

Sample: EDTA, plasma, under ice

:Normal range

10-18 wk:     209 Pg/ml       46 pmol/L

26-30 wk:     430 Pg/ml       95 pmol/L

35-36 wk:     162 Pg/ml       36 pmol/L

Comment: ACTH in amniotic fluid is decreased in anencephalic fetuses. ACTH may also be of fetal origin. The relatively high concentration of ACTH in the normal fetus my reflect immaturity and hypothalamic regulation

Sample: Amniotic fluid, under ice

.It confirms the presence of adenovirus in peritoneal fluid, lavage specimen and peritoneal fluid

Normal range: Negative

Comment: Single positive antibody titers of 1: 64 may indicate past or current infection. Seroconversion or an increase in titers between acute and convalescent sera of at least fourfold is considered strong evidence of current or recent infection. Adenovirus is responsible for lower and upper respiratory tract infections, pharyngoconjunctival fever, epidemic keratoconjunctivitis, acute hemorrhagic conjunctivitis, cystitis, infantile gastroenteritis, meningitis, and disease of the immunocompromised patients (diarrhea, pneumonia and upper respiratory tract infections)

Sample: Serum

Normal range: Negative

Comment: Single positive IgA antibody titers may indicate acute infection. Tests should be performed in conjunction with IgG titers where Seroconversion or an increase in IgG titers between acute and convalescent sera of at least fourfold is considered strong evidence of current or recent infection. See also adenovirus Antibodies, IgG

Sample: Serum

Comment: Its absence is useful for confirming APC disease

Sample: tissue from colonic carcinoma

Normal range: 26-35 seconds

Comment:This is the most suitable test for monitoring heparin – therapy and evaluation of the intrinsic coagulation system. Prolonged PTT is found in liver disease, coagulation factor deficiencies especially hemophilia, Christmas disease (and sometimes in Von Willebrand’s disease), anticoagulant therapy (including heparin), DIC, lupus anticogulant, and with circulating anticoagulants. Result maybe influenced by extraneous heparin, lipemia, antistreplaser, chlorpromazine and valproic acid

Sample: Citrated whole blood

Normal range: Negative

Comment: Detects the paroxysmal nocturnal hemoglobinuria (PNH) abnormality.  PNH has been a candidate for myeloproliferative disease occurring in 55-65% of cases of myeloid metaplasia and primary myelofibrosis. Hemosiderin in urine should also be measured. CD55:CD59 ratio is a better test for diagnosing this disease

Sample: EDTA whole blood

:Normal range

(Male    : Up to 6.5 IU/L       (Up to 108 nkat/L

(Female: Up to 5.5 IU/L       (Up to 92 nkat/L

Comment: In addition to prostatic cancer, an increase is seen in Gaucher’s disease, Niemann – Pick disease, hemolytic disease, excessive destruction of platelets, advanced Paget’s disease, multiple myeloma and in metastatic cancer of the bone (especially in females)

Sample: Serum