INTERPRETATIVE CLINICAL CHEMISTRY Determination 1) ALT (SGPT) Normal Values <29 U/L (M) <23 U/L (F) Increased

in 1) Hepatitis(viral hepatitis,Toxic hepatitis,Alcoholic hepatitis) 4) Infectious mononucleosis 5)Polymyositis 1) Dehydration Decreased in 1) End stage liver disease 2) Renalinsufficiency

2) Albumin

3.8.- 5.4g/dl

I) Renal disease 2) Liver insufficiency 3) Severe malnutrition 4) Pregnancy 5) Burns 1) Hypophosphatasemia (a rare inherited disorder)

3) (ALP) Alkaline phosphatase 4) Amylase

80-220 U/L Adults) 145- 950 IU (Children) < 160 (Refloctron instrument )

1) Intrahepatic cholestasis 2) Extrahepatic cholestasis 3) Osteoblastic disease 4) Pregnancy 1) Pancreatitis 2) Perforated peptic ulcer 3) Acute ethanol ingestion 4) Severe renal disease 5) Salivary gland disease 6) Obstruction of Pancreatic duct 1) Hepatocellular destruction (viral, toxic, alcoholic) 2) Myocardial infarction 3) Pulmonary infarction 4) Post-hepatic conditions 5) Musculoskeletal disease 1) Haemolytic jaundice 2) Haepatocellular destruction(viral, toxic, alcoholic) 3) Post-hepatic conditions 4) Neonatal physiological hyperbilirubinemia 5) Gilbert disease

1)Extensive destruction of pancreas.

5) AST (SGOT

<26 U/L (M) <21U/L (F)

1) End stage liver disease 2) Pregnancy

6) Bilirubin (total)

0.1 - 1.0 mg/dl

Determination 7) Calcium

Normal Values 8.8 -10.2 mg/dl

Increased in ) Hyperparathyroidism 2) Metastatic carcinoma 3) Myeloma 4) Sarcoidosis 5) Thyrotoxicosis 1) Dehydration 2) Renal tubular disease 3) Prolonged diarrhea 4) Hyperparathyroidism 1)Famililal(hereditary) hypercholesterolemia 2) Nephrotic syndrome 3) Biliary obstruction 4) Hypothyroidism 5) Pregnancy 1) Myocardial infarction 2) Progressive muscular dystrophy 3) Dermatomyositis 4) Convulsions 5) Surgery 1) Impaired renal function 1) Primary respiratory acidosis 2) Primary metabolic alkalosis l)Diabetes mellitus 2) Endocrine disorders(Thyrotoxicosis acromegaly,) 3) Stress 4) Chronic renal failure 5) Pancreatitis 6) Drugs, Steroids, Oral contraceptives etc.

Decreased in 1)Hypoparathyrodisim 2) Hypoaibuminaemia 3) Chornic renal disease 4) Acute Pancreatitis 5) Malnutrition 6) Rickets, 1) Overhydration 2) Prolonged vomiting 3) Burns 4) Salt losing renal disease 1) Hyperthyrodism 2) Malnutrition 3) Chronic anaemia 4) Thyroiditis 5) Severe liver insufficiency 1) Physical inactivity 2) Decreased muscle mass

8) Chloride

98107 mEq/L

9) Cholesterol

150200 mg/dl

10) CPK (CK)

15130 IU (men) 15110 IU/L (Women) 0.7 1.5 mg/dl

11) Creatinine

12) Co2 21-30 Content( Hco3 mEq/L + H2Co3) 13) Glucose 70110 mg/dl

l)Primary metabolic acidosis2) Primary respiratory alkalosis 1) Insulinoma 2) Hypopituitarism 3) Adrenal cortical insufficiency 4) Severe liver disease 5) Extrapancreatic neoplasm 6) Ethanol ingestion 7) Drugs (Sulphonylurea, salicylates insulin etc )

Determination 14) Gamma- GT (GGTP)

Normal Values 8-33 U/L. (male) 7-29 U/L (Female)

Increased in 1) Histry of ethanol 2) Hepatobiliary disease3) History of Drug ingestion (e.g. Phenytoin,phenobarbital 1) Myocardial infarction 2) Haemolytic disease e.g. megaloblastie anaemia,,sickle cell anaemia 3) Pulmonary infarction 4) Infectious mononucleosis 5) Hepatic disorders. 6) Progressive muscular dystrophy 7) Malignancy i.e. leukaemia, lymphoma, metastatic carcinoma

Decreased in -

15) LDH (LD)

140-330 U/L

16) Lithium 17) Magnesium

0.5 1.2 mmol/l Lithium medication (theraputic range) given in excess 1.22.4 mEq/L 1) Renal disease 2) MgSO injection 1) Alcoholism 2) Malnutrition 3) Severe diarrhea 4) Malabsorption 1)Hyperparathyroidism (primary) 2) Vitamin D deficiency) 3)Malabsorption 4) Fanconis syndrome (loss of phosphate in urine)5) Rickets 6) Sprue steatorrhoea 7) Hyperinsulinism

18) Inorganic phosphorus

2.55.0 mg/dl (adults 4.0 7.0 mg/dl (children

1)Hypoparathyroidism 2) HypervitaminosisD 3) High calcium diet 4) Renal insufficiency

Determination

Normal Values

Increased in

Decreased in

19) Potassium

3.85.0 mEq/l

1) Renal glomenrular disease 2)Adrenal cortical insufficiency 3) Excessive intravenous therapy 4) Diabetic ketoacidosis 1) Dehydration2) Loss of hypotonic gastrointestinal fluids 3) Diabetes insipidus4) Salt poisoning5) Skin losses (burns excessive sweating) 1) Dehydration2) Myeloma (lgG, IgA) 3) Sarcoidosis 4) Chornic inflammation

1) Hyperaldosteronism 2) Renal tubular disease 3) Diuretic therapy 4) Gastro-inlestinal loss 5) Malnutrition 6) Metabolic alkalosis 1) Salt losing nephritis2) Gastrointestinal loss 3) Adrenal insufficiency 4) Diuretic therapy

20) Sodium

133153 mEq/L

21) Total Proteins

68 g/dl

1) Overhydration 2)Renaldisease (Protein losing) 3) Hepatic insufficiency 4) Malnutrition 5) Agammaglobunemia 6) Malignancy

22) Triglycerides

< 160 mg/dl (M) < 140 mg/dl (F)

1) Diabetes mellitus 1) Malnutrition 2) Nephrotic 2) Congenital abeta syndrome lipoproteinemia 3) Excessive alcohol intake 4) Familial hypertriglyceridemia 5) Pregnancy ) Gout 2) Renal failure3) Leukaemia 4) Polycytheniia 5) Keto acidosis 6) Lactate excess (after ingestion) 7) Chronic lead nephropathy 1) Renal tubular defect (Fanconis syndrome,Wilsons disease) 2) Administration of ACTH

23) Uric acid

3.07 mg/dl (M) 2.5 6.0 mg/dl (F)

24) Urea BUN = urea/ 2.14

1545 mg/dl 8-22 mg/dl

1) Pre-renal conditions (diabetes mellitus, shock, congestive heart failure etc.) 2) Impaired renal function3) Postrenal conditions4) Gastrointestinal bleeding5) High protein diet6) Drugs Corticosteriods tetracyclines etc.

1) Severe liver insufficiency 2) Overhydration 3) Pregnancy (third trimester) 4) Malnutrition (Particularly decreased protein intake)

Reference: Interpretative clinical chemistry by Bernard E. Statland . Note : All enzyme normal ranges are at 30 C