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Heartlands Biochemistry Laboratory

Citalopram

Citalopram

Citalopram Therapeutic range - 50 - 110ug/L

Desmethylcitalopram may weakly contribute to pharmacological actions.

Please contact the laboratory if citalopram measurement is required for therapeutic monitoring purposes.

Citalopram is measured by LC-MS/MS.

Ethyl Glucuronide (EtG) and Ethyl Sulphate (EtS)

Ethyl Glucuronide (EtG) and Ethyl Sulphate (EtS)

Internal Interpretation Guidance for Hepatologists

EtG <250 ng/mL - Negative result. No further action required.

EtG = 250-500 ng/mL (&EtS >100 ng/mL) - Low positive result. Result may indicate previous heavy drinking (i.e. 1-3 days), previous light drinking (i.e. 12-36 hours) or recent extraneous exposure e.g. hand-sanitisers, mouthwash. 

EtG = 500-1000 ng/mL (& EtS >100 ng/mL) - Positive result. Result may indicate previous heavy drinking (i.e. previous 1-3 days) or recent light drinking (i.e. past 24 hours).

EtG >1000 ng/mL (&EtS >100 ng/mL) - High positive result. Results may indicate heavy drinking on the same day or previously (i.e. previous day or two) or light drinking on the same day.

Due to Rifaximin interference on EtS, only EtG will be used to confirm positive cases of alcohol consumption at UHB.

Please refer to links below for further sources of information for interpretation and sources of positive interference.

https://www.mayocliniclabs.com/test-catalog/Overview/63421#Clinical-and-Interpretive

Ethyl Glucuronide (EtG) and Ethyl Sulphate (EtS)

Ethyl Glucuronide (EtG) and Ethyl Sulphate (EtS)

Internal Interpretation Guidance for Hepatologists

EtG <250 ng/mL - Negative result. No further action required.

EtG = 250-500 ng/mL (&EtS >100 ng/mL) - Low positive result. Result may indicate previous heavy drinking (i.e. 1-3 days), previous light drinking (i.e. 12-36 hours) or recent extraneous exposure e.g. hand-sanitisers, mouthwash. 

EtG = 500-1000 ng/mL (& EtS >100 ng/mL) - Positive result. Result may indicate previous heavy drinking (i.e. previous 1-3 days) or recent light drinking (i.e. past 24 hours).

EtG >1000 ng/mL (&EtS >100 ng/mL) - High positive result. Results may indicate heavy drinking on the same day or previously (i.e. previous day or two) or light drinking on the same day.

Due to Rifaximin interference on EtS, only EtG will be used to confirm positive cases of alcohol consumption at UHB.

Please refer to links below for further sources of information for interpretation and sources of positive interference.

https://www.mayocliniclabs.com/test-catalog/Overview/63421#Clinical-and-Interpretive

Fibroblast growth factor 23 (FGF-23)

Fibroblast growth factor 23 (FGF-23)

Provided by referral laboratory.

Fluoxetine

Fluoxetine

Therapeutic range = 120 - 500 ug/L (sum of fluoxetine and desmethylfluoxetine)

Glucose Tolerance Test (OGTT)

Glucose Tolerance Test (OGTT)

Levels are influenced by many factors including previous carbohydrate diet, drugs, gastric emptying time and gastrointestinal surgery, as well as circulating insulin levels.

The following criteria for adults and children are based on recommendation made by the World Health Organisation and have been adopted by Diabetes UK.

 

Glucose concentration in mmol/L

Venous plasma

Capillary plasma

Diabetes mellitus

Fasting value

≥ 7.0

≥ 6.1

2h after glucose load

≥11.1

≥ 11.1

Impaired Glucose

Tolerance

Fasting Value

< 7.0

< 6.1

2h after glucose load

≥ 7.8 & <11.1

≥ 7.8

Impaired Fasting

Glycaemia

FastingValue

≥ 6.1 & <7.0

≥ 5.6 & <6.1

2h after glucose load

< 7.8

< 7.8

 

NOTE. If the fasting blood glucose concentration is in the diabetic range on more than one occasion, the oral GTT is superfluous.

The same criteria are used for pregnant patients but those fulfilling the criteria of impaired glucose tolerance and diabetes mellitus have gestational diabetes mellitus (GDM).

'Diabetic' levels of glucose are not infrequently found in stressed individuals.

 

 

 

 

 

 

https://pinboard.in/u:duty_biochemist/t:Diabetes/

Lipoprotein a (Lp(a)) Genotyping (LIPOAG)

Lipoprotein a (Lp(a)) Genotyping (LIPOAG)

Interpretative comments will be attached to report.

http://www.nejm.org/doi/full/10.1056/NEJMoa0902604 http://jama.jamanetwork.com/article.aspx?articleid=184063

Magnesium (urine)

Magnesium (urine)

2.4-6.5 mmol/24hr (Source: Pathology Harmony recommendations)

Mirtazapine

Mirtazapine

Therapeutic range = 30 -80 ug/L

 

Desmethylmirtazapine does not contribute to pharmacological actions.

MMA - Methylmalonic Acid

MMA - Methylmalonic Acid

Age related:   

≤65 yrs   0-280 nmol/L  

>65 yrs    0-360 nmol/L

MMA - Methylmalonic Acid

MMA - Methylmalonic Acid

Age related:   

≤65 yrs   0-280 nmol/L  

>65 yrs    0-360 nmol/L

Paroxetine

Paroxetine

Therapeutic range = 20 - 65 ug/L

Please contact the laboratory if paroxetine measurement is required for therapeutic monitoring purposes.

Paroxetine is measured by LC-MS/MS.

Paroxetine

Paroxetine

Therapeutic range = 20 - 65 ug/L

Please contact the laboratory if paroxetine measurement is required for therapeutic monitoring purposes.

Paroxetine is measured by LC-MS/MS.

Plasma metanephrines

Plasma metanephrines

Supine Reference Ranges

Normetanephrine <730 pmol/L.

Metanephrine <450 pmol/L.

3-Methoxytyramine <180 pmol/L

 

Seated Reference Ranges

Normetanephrine <1180 pmol/L.

Metanephrine <510 pmol/L.

3-Methoxytyramine <180 pmol/L

https://pinboard.in/u:duty_biochemist/t:Pheochromocytoma/

SARS-Cov2 IgG Antibodies

SARS-Cov2 IgG Antibodies

SARS-CoV2 S1 Spike IgG reference range 0-49.9 AU/mL

Anti S1 IgG interpretation see below

Anti NC IgG interpretation see below

The test panel measures response to nucleocapsid (NC) and S1 spike proteins of SARS -COV2.

Current vaccines are based on the S1 spike protein only

SARS-Cov2 IgG Antibodies

SARS-Cov2 IgG Antibodies

SARS-CoV2 S1 Spike IgG reference range 0-49.9 AU/mL

Anti S1 IgG interpretation see below

Anti NC IgG interpretation see below

The test panel measures response to nucleocapsid (NC) and S1 spike proteins of SARS -COV2.

Current vaccines are based on the S1 spike protein only

Sodium (Urine)

Sodium (Urine)

40-220 mmol/24h

Source : Abbott Diagnostics

https://pinboard.in/u:duty_biochemist/t:sodium/

Sulphonylurea Screen (Sulfonylurea Screen)

Sulphonylurea Screen (Sulfonylurea Screen)

This is a screening test for the presence of sulphonylureas in plasma or urine. As such, we will report results as Positive or Negative for the drugs listed above. All can be detected reliably at concentrations of 0.5 mg/L in urine and plasma.

http://jcp.bmj.com/content/56/9/641.full.pdf

Sweat Chloride

Sweat Chloride

Interpretation is based solely on sweat chloride concentration.

Age

Sweat Chloride concentration (mmol/L)

Interpretation

<6 months

<30

Cystic fibrosis is unlikely but requires genetic and clinical correlation

6 months and over

<40

Cystic fibrosis is unlikely but requires genetic and clinical correlation

<6 months

30-60

Intermediate result which requires further cystic fibrosis assessment

6 months and over

40-60

Intermediate result which requires further cystic fibrosis assessment

All ages

>60

Supports a diagnosis of cystic fibrosis

 

Sweat Chloride

Sweat Chloride

Interpretation is based solely on sweat chloride concentration.

Age

Sweat Chloride concentration (mmol/L)

Interpretation

<6 months

<30

Cystic fibrosis is unlikely but requires genetic and clinical correlation

6 months and over

<40

Cystic fibrosis is unlikely but requires genetic and clinical correlation

<6 months

30-60

Intermediate result which requires further cystic fibrosis assessment

6 months and over

40-60

Intermediate result which requires further cystic fibrosis assessment

All ages

>60

Supports a diagnosis of cystic fibrosis

 

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