Biochemistry

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Adults (Alinity immunoassay):

Female: <1.9 nmol/L

Male aged 18-49 years: 8.3 - 30.2 nmol/L

Male aged >50 years: 7.7 - 24.8 nmol/L

Adults (mass spectrometry):

Female: <1.9 nmol/L

Male: 7.0-27.0 nmol/L

Paediatrics:

Reference for mass spectrometry reference ranges: 

• Kushnir et al (2010). Liquid Chromatography–Tandem Mass Spectrometry Assay for Androstenedione, Dehydroepiandrosterone, and Testosterone with Pediatric and Adult Reference Intervals. Clinical Chemistry 2010:56;1138–77.

Provided by Reference Laboratory

For children and young adults with ALL, please refer to your protocol directed guidance. The guidelines below apply to azathioprine/6-mercaptopurine immunosuppression.

TGN therapeutic range 235-450 pmol/8x10E8 RBC

*(TGN <235). TGN below the therapeutic range. Question adherence. Consider dose incrementing if the patient is adherent. If the MeMP/TGN ratio is >11, consider changing therapy to 25% of the target thiopurine dose with 100 mg allopurinol.

*(TGN 235-450). TGN within the therapeutic range. The patient is appropriately dosed. If the patient is not responding to therapy, consider alternative immunosuppressant  therapies. Where MeMP > 5700, there is an increased risk of hepatotoxicity, in such patients consider changing therapy to 25% of the target thiopurine dose with 100mg allopurinol.

*{TGN >450). TGN above the therapeutic range. Dose reduction is advisable if TGN levels are above 550, depending on clinical situation. If patient is not responding to therapy, consider alternative immunosuppressant  therapies.

For 6MMP, therapeutic range is <5700 pmol/8x10E8 RBC

Repeat TGN measurement 4 - 6 weeks after any change in therapy. 

No reference ranges applicable. Results must be interpreted with thyroglobulin antibodies (TgAb). 

Successfully treated post-thyroidectomy patients should have an undetectable serum thyroglobulin. Elevations in thyroglobulin post-thyroidectomy for DTC can indicate recurrence of disease or metastasis. Thyroglobulin analysis is most sensitive when TSH is not suppressed ie, any small thyroid remnants of disease present should produce measurable thyroglobulin.

Interpretation of results also depends on factors such as whether the patient is on T4/T3 replacement.

Higher levels may be seen in the newborns and in the third trimester of pregnancy.

Benign elevations of thyroglobulin see with:

• Grave's disease
• Hashimoto's disease
• Adenomas

Multiple Daily Dosing

Pre dose (trough) blood sample 15 mins before dose < 2mg/L

Post dose (peak) blood sample 1 hour after dose 5 - 10mg/L

N.B. Ranges and comments DO NOT apply to Renal patients

Once Daily Dosing

Pre dose (trough) < 1 mg/L

Please refer to Antibiotic guidelines on the HEFT website for further information (http://pharmacy/?page_id=922)

For diagnostic purposes, the test findings should always be assessed in conjunction with the patient’s medical history, clinical examinations, and other findings

60-80 g/L

(Source : Pathology Harmony Recommendations)

A toxicology screen is qualitative result and as such, an interpretative report will be issued.

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