1.

Comments:

Alanine Aminotransferase see ALT, GPT, SGPT

This is the main enzyme in liver function test. It is present in liver parenchyma 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 severe burns, severe pancreatitis, infectious mononucleosis and preceding trauma. Decreased in pyridoxal phosphate deficiency.

Normal Range:

IU/L
Male: up to 40 Female: up to 31

kat/L
up to 0.67 up to 0.52

2.
Comments:

Albumin, Serum
Increased in dehydration, lipemia, non-fasting samples, or ampicillin therapy. Low levels may be due to chronic liver disease (decreased synthesis), nephritic syndrome, pregnancy, rheumatic diseases, protein-losing enteropathy or extensive burns. Malabsorption or malnutrition may also cause hypo-albuminemia.

Normal Range:

g/dl
3.5-5.0

g/L
35.0-50.0

3.
Comments:

Alkaline Phosphatase, Total

Increased during bone metabolism: puberty, healing of a fracture, primary and secondary hyperparathyroidism, osteomalacia and juvenile rickets. Also increased primarily in liver and bone diseases 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, achondroplasia, cretinism, deposition of radioactive materials in bone, vitamin B12 deficiency (pernicious anemia) and multi-nutritional deficiency of zinc or magnesium.

Normal Range:

IU/L
Adult: 100-290 Child: 180-1200

kat/L
1.67-4.84 3.0-20.04

4.
Comments:

Anti-Sperm Abs
Recommended in the assessment of infertility. Abs may be detected in serum of both sexes, seminal fluid and cervical mucus. The test reveals titre as well as type of agglutination. Titer: < 1/4 The streptolysin O antibody (ASO) test is used to provide serologic evidence of previous group A streptococcal infection in patients suspected of having a non-suppurative complication, such as acute glomerulonephritis or acute rheumatic fever. Elevated serum ASO titers are found in about 85% of individuals with rheumatic fever. Skin infections with group A streptococci are often associated with a poor ASO response.

Normal Range:

5.
Comments:

Anti-Streptolysin O-Titre

Normal Range:

IU/ml
20-200

6.
Comments:

Aspartate Aminotransferase see AST, GOT, SGOT

AST originates in the heart, liver, skeletal muscle, kidney, pancreas, spleen, and lung. High serum levels occur in chronic alcohol ingestion, Reye syndrome, myocardial infarction, hepatitis, lung diseases, malignancies and muscular disorders. In myocardial infarction, AST rises 6-8 hrs after the onset of chest pain, peaks at about 18-24 hrs and returns to normal in 3-5 days. Several commonly used drugs also contribute to elevated AST levels. These include steroids, progesterone, opiates, erythromycin, and salicylates in children. Low levels of AST result from uremia, vitamin B6 deficiency, metronidazole and trifluoperazine.

Normal Range:

IU/L

kat/L

Male: up to 37 Female: up to 31

up to 0.62 up to 0.52

7.
Comments:

Bilirubin, Total
Unconjugated Bilirubin makes up almost all of the total Bilirubin in hepatocellular failure and in Gilbert's disease. High levels of Bilirubin can be caused by hepatitis, cholangitis, cirrhosis, other types of liver disease (including primary or secondary neoplasia), alcoholism, Dubin-Johnson syndrome, biliary obstruction and infectious mononucleosis. Familial hyperbilirubinemia (Gilbert's disease) is encountered as a moderate elevation with otherwise unremarkable chemistries. Other factors which contribute to increased levels of total Bilirubin include anorexia or prolonged fasting, hematoma, and anemia. Nicotinic acid increases the formation of Bilirubin in the spleen, leading to a rise in Unconjugated Bilirubin. Low levels of total Bilirubin are associated with the chemical aminophenazone.

Normal Range:

mg/dl
up to 1.0

mol/L
up to 17.1

8.
Comments:

Blood Urea Nitrogen (BUN)

BUN is useful to evaluate kidney function and follow-up hemodialysis and other therapy. Raised levels are found in cases of renal dysfunction, dehydration, hyperplasia or carcinoma of the prostate, and in high protein diet. Although creatinine is generally considered a more specific test to evaluate renal function, the two tests are commonly used together. Corticosteroids tend to increase BUN by causing protein catabolism. Blood urea also increases with age. Low levels are found in pregnancy, with intravenous fluids, starvation and hepatocellular failure.

Normal Range:

mg/dl
7-21

mmol/L
1.17-3.50

9.
Comments:

C-Reactive Protein (CRP)

CRP is an acute phase reactant, which can be used as a test for inflammatory diseases, infections, and neoplastic diseases. Progressive increases correlate with increases of inflammation/injury. CRP is a more sensitive, rapidly responding indicator than ESR. CRP may be used to detect early postoperative wound infection and to follow therapeutic response to anti-inflammatory agents. Cutoff values for the top quintile are typically 2.5 mg/L. However, in postmenopausal women on hormone replacement therapy the cutoff is about 5 mg/L. Methodology may vary between latex and high sensitivity.

Normal Range:

mg/L
< 5.0

10.
Comments:

Calcium, Serum
Increased in hyperparathyroidism, myelomatosis, some malignancies both of bone and nonosseous as well as in vitamin D excess and sarcoidosis. Decreased in idiopathic, surgical, or congenital hypoparathyroidism, hypoalbuminemia and in renal disease. Also decreased in vitamin D deficiency, magnesium deficiency, massive blood transfusion, leprosy, anterior pituitary hypofunction, cystinosis, osteomalasia, alcoholism and hepatic cirrhosis.

Normal Range:

mg/dl
Adult: 8.5 - 10.2 Child: 8.5 - 12.0

mmol/L
2.12 - 2.55 2.12 - 3.0

11.
Comments:

Cholesterol, Total
Used to evaluate lipid status, coronary arterial occlusion, atherosclerosis and metabolic disorders. lncreased cholesterol levels are found in primary hyperlipidemia of types IIa and IIb, also in obstructive jaundice, alcoholic hepatitis, nephrotic syndrome and myxoedema. Decreased in hyperthyroidism, pernicious anaemia and malnutrition.

Cholesterol relates to coronary heart disease risk. Since premature mortality from coronary arterial disease is rampant and since cholesterol levels are available as a test which can detect a modifiable risk factor, serum cholesterol remains a critical and genuinely newsworthy topic and an important test. Normal Range:

mg/dl
Optimum: <200 Borderline: 200-240 Elevated: >240

mmol/L
<5.2 5.18-6.22 >6.22

12.
Comments:

Creatine Phosphate Kinase (CPK)

Used to test for acute myocardial infarction and for skeletal muscular damage. Raised in muscular dystrophy and cardiac infarction. Elevation after infarction starts at 4-8 hrs and peaks at 10-24 hrs. This test is sensitive to muscle stress, exercise, etc. For diagnosis of muscular dystrophy three afternoon assays on separate days are recommended. MB fraction derives from heart muscle. Serial readings may be used in assessing progress of Ml. Decreased CK may reflect decreased muscle mass. It has been reported with a number of entities, including metastatic neoplasia, patients with steroid therapy, with alcoholic liver disease and with connective tissue diseases. Overnight bed rest may lower CK 10% to 20%.

Normal Range:

IU/L
Male: 25-190 Female: 25-170

ukat/L
0.42-3.2 0.42-2.8

13.
Comments:

Creatinine, Serum
Used as a renal function test to provide a rough approximation of glomerular filtration. It is a more sensitive indicator of early failure than blood urea, and is especially of value after renal transplant. High serum levels are found in renal failure (both acute & chronic), urinary tract obstruction, shock, dehydration and reduced renal blood flow. Low serum creatinine levels are found in debilitation (due to increased age or decreased muscle mass), small stature, some complex cases of hepatic disease and in pregnancy (especially in the first and second trimesters).

Normal Range:

mg/dl
Male: 0.7-1.36 Female: 0.6-1.13

mol/L
62-120 53-100

14.
Comments:

DHEA-S
DHEA sulfate is the principal adrenal androgen and is secreted together with cortisol under the control of ACTH and prolactin. DHEA-S is secreted solely by the adrenal glands. Congenital adrenal hyperplasia due to the rare deficiency of 3-beta-hydroxydehydrogenase causes decreased secretion of cortisol, aldosterone, androgens and estrogens but increased secretion of DHEA and DHEA-S, reflected in increased plasma levels and increased urinary 17-oxosteroids. High levels of DHEA-S are associated with several clinical indications such as hirsutism and amenorrhea, polycystic ovarian syndrome and Cushing`s syndrome.

Normal Range:

g/dl
Age(yrs) 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 > 75 Female 54.4-255 66.6-306 158-412 98-315 60.8-338 35.4-256 18.9-205 9.4-246 12.0-154 Male 49.5-245 133-553 210-496 163-425 110-424 44.3-321 51.7-305 33.6-140 16.2-149

mol/L

15.

Estradiol (E2)

Comments:

Estradiol is the most potent natural estrogen, derived almost exclusively from the ovaries. Measurements are frequently utilized to document hypoestrogenism in cases of delayed puberty, primary and secondary amenorrhea, and menopause. Also used in monitoring IVF patients undergoing ovulation stimulation. Increased levels are found in estrogen producing tumors, gynecomastia, post-menopausal bleeding, hepatic cirrhosis and use of oral contraceptives. Low levels indicate pituitary or ovarian malfunction and menopause.

Normal Range:

pg/ml
Follicular: Mid-cycle: Luteal: Post-Menopause: Males: 39-189 94-508 48-309 < 20-41 < 20-77

pmol/L
144-696 346-1869 177-1137 < 74-151 < 74-283

16.
Comments:

Follicle Stimulating Hormone (FSH)

FSH is a Gonadotropin secreted by the pituitary gland. Very high levels are found after puberty in primary gonadal failure, menopause, Kleinfelter`s syndrome and hypogonadism (in both sexes). Decreased in primary pituitary dysfunction. Useful, with luteinizing hormone, in investigating infertility and amenorrhea in women, and testicular dysfunction in men.

Normal Range:

mIU/ml
Follicular: 4-13 Mid cycle: 5-22 Luteal: 2-13 Post-Menopause: 20-138 Males: 1-8

17.
Comments:

Gamma Glutamyl Transferase (GGT)

A very sensitive but non-specific indicator of cellular liver damage. Increased in heavy intake of alcohol (either recent or long term), hepatitis, cardiac failure, diabetes, pancreatitis, malignancies, and biliary cirrhosis. Results are influenced by many drugs especially alcohol and barbiturates.

Normal Range:

IU/L
Male: 9-40 Female: 9-35

kat/L
0.15-0.65 0.15-0.60

18.
Comments:

Globulin
Increased in chronic liver disease and in paraproteinaemias where a specific immunoglobulin is increased. Decreased in nephrotic syndrome, malnutrition and hypogammaglobulinaemia.

Normal Range:

g/dl
2.0-3.5

g/L
20-35

19.
Comments:

Glucose, Blood
Increased in diabetes and some adrenal, thyroid and pituitary disorders. Decreased in insulin excess and in some types of glycogen storage disease. Infants with tremor, convulsions and/or respiratory distress should also have glucose level measured, especially in the presence of maternal diabetes.

Normal Range:

mg/dl
70-110

mmol/L
3.9-6.1

20.
Comments:

IgE, Total
The levels of circulating IgE in serum are extremely low compared to the other immunoglobulins. Increased in certain allergic diseases (parasitic infections, bronchopulmonary asperigillosis, certain drugs, atopic diseases, eczema), asthma (60%), hay fever (30%)) and in IgE myeloma. Decreased in some advanced neoplasms, ataxia telangiectasia, some cases of agammaglobulinemia, cases of hypersensitivity.

Normal Range:

IU/ml
Adults: up to 100 10-15 yrs: up to 200 6-9 yrs: up to 90 1-5 yrs: up to 60 0-1 yrs: up to 15 Newborn: up to 1.5

ng/ml
240 480 216 144 36 3.6

21.
Comments:

Iron
Increased in excessive iron intake, pernicious, aplastic, and hemolytic anemias, hemochromatosis, acute leukemia, lead poisoning, acute hepatitis, vitamin B6 deficiency, Thalassemia and nephritis. Decreased in iron-deficiency anemia, remission of PA, acute and chronic infections, carcinoma, nephrosis, hypothyroidism, malignancy and autoimmune diseases. A single iron estimation is of little value as changes between serum iron and iron stores are affected by numerous physiological factors such as diurnal rhythm (high in the morning), hormonal influence (cyclic changes in women) and recent diet.

Normal Range:

g/dl
Male: 59-160 Female: 37-145

mol/L
10.6-28.7 6.6-26.0

22.
Comments:

LDH
Raised in liver disease and in recent myocardial infarction, peaking at 48-72 hrs. Also raised in megaloblastic anemia and in accelerated cell catabolism such as in certain leukemias and lymphomas.

Normal Range:

IU/L
200-480

kat/L
3.33-8.0

23.
Comments:

Luteinizing Hormone
LH, like FSH, is secreted by the anterior pituitary under the influence of Gonadotropin releasing hormone from the hypothalamus. Both hormones are therefore analyzed simultaneously. LH stimulates testosterone synthesis in the male and induces ovulation in the female. Increased levels of LH are associated with primary hypogonadism in males and with menopause, primary ovarian hypofunction, and polycystic ovarian disease in females. Also increased in precocious puberty. Decreased in failure of pituitary or hypothalamus. The test is useful in defining menstrual cycle phases and in distinguishing primary from secondary gonadal failure, menstrual disturbances and amenorrhea.

Normal Range:

mIU/ml
Male: 2-12 Follicular: 1.0-18 Luteal: 0.4-20 Mid cycle: 24-105 Post-Menopause: 15-62

24.
Comments:

Magnesium, Serum
It is the most abundant intracellular ion next to potassium. About 75% of the blood magnesium is in the RBC`s. Low levels produce muscular irritability similar to hypocalcemic tetany. High levels result in anesthesia and even cardiac arrest. Serum Mg is elevated in Addison`s disease, severe diabetic acidosis, renal failure, and when large doses of Mg antiacids are taken. It is reduced in malabsorption, pancreatitis, alcoholism hyperaldosteronism, prolonged gastric drainage and hypoparathyroidism. In magnesium deficiency, urinary Mg decreases before serum Mg. Excessive excretion is induced by diuretics.

Normal Range:

mg/dl
Child: 1.7-2.2 Adult: 1.6-2.6

mmol/L
0.70-0.91 0.66-1.1

25.

Phosphorous, Serum

Comments:

Nearly all of serum phosphorous is present as inorganic phosphate. Hyperphosphatemia is found in vitamin D hyprervitaminosis, hypoparathyroidism, and renal failure. Hypophosphatemia may be seen with rickets, hyperparathyroidism, and in Fanconi`s syndrome.

Normal Range:

mg/dl
Adult: 2.5-5.0 Child: 4-7

mmol/L
0.8-1.60 1.3-2.26

26.
Comments:

Progesterone
Progesterone is a steroid hormone that plays an important role in preparing the uterus for pregnancy and maintaining of pregnancy. This test is useful in the evaluation of infertility, monitoring progesterone replacement therapy, check luteal phase defects and evaluate patients at risk for abortion during the early weeks of pregnancy. Sample should be taken in second half of cycle, approximately day (21), to determine whether ovulation has occurred. Increased in congenital adrenal hyperplasia due to 21-Hydroxylase, 17a-Hydroxylase, and 11b-Hydroxylase deficiency, lipoid ovarian tumor, theca lutein cyst, molar pregnancy. Decreased in threatened abortion, primary or secondary hypogonadism and short luteal phase syndrome.

Normal Range:

ng/ml
Follicular: 0.27 - 2.61 Luteal: 3.28 - 38.63 Post-menopause:< 0.2-0.82 Pregnant female: 1st Trim: 12.26-81.8 2nd Trim: 11.11-81.4 3rd Trim: 39.3-387.8 Male: < 0.2-3.37

nmol/L
0.9-8.3 10.4-122.8 < 0.7-2.7 40.9-272.7 37.0-271.3 131.0-1292.7 < 0.7-11.2

27.
Comments:

Prolactin
Prolactin (PRL) is secreted by the anterior pituitary gland. It functions to initiate and maintain lactation. Prolactin levels are elevated in cases of pituitary tumors, diseases of the hypothalamus, hypothyroidism, and ectopic tumors. Other causes of elevated prolactin include chronic renal failure, pregnancy and breast trauma/stimulation. In males, infertility or impotence may be caused by hyperprolactinemia.

Normal Range:

ng/ml
Male: up to 19 Female: up to 24

mIU/L
up to 621 up to 529

28.
Comments:

Protein, Total, Serum

Used to evaluate nutritional status and to investigate edema. Serum protein levels are increased in hyperimmunoglobulinemia (polyclonal or monoclonal gammopathies), dehydration, SLE, granulomatous diseases and paraproteinemia. Decreased in nephrotic syndrome, severe liver disease, acute burns, malabsorption syndrome, pregnancy, malnutrition and hypogammaglobulinemia.

Normal Range:

g/dl
6.6-8.7

g/L
66-87

29.
Comments:

Testosterone, Total
Total testosterone measurements have traditionally been used to help screen for hirsutism. Serum concentrations of testosterone in both sexes during the first week of life average about 25 ng/dL. Conditions such as hypogonadism, hypopituitarism, orchiectomy, estrogen therapy, and some cases of Klinefelter`s syndrome are associated with decreased levels of testosterone. Levels increase from puberty to adult values, and are related to pubertal stage rather than chronological age.

Normal Range:

ng/ml
Male: < 1 yr.: 0.12-0.21 1-6 yrs.: 0.03-0.32 7-12 yrs.: 0.03-0.68 13-17 yrs.: 0.28-11.1 > 17 yrs.: 2.8-8.0 Female: 0.06-0.82

nmol/L
0.42-0.72 0.10-1.12 0.10-2.37 0.98-38.5 9.9-27.8 0.22-2.9

30.
Comments:

Thyroid Stimulating Hormone (3rd Generation)

Thyroid stimulating hormone (TSH), or thyrotropin, is a glycoprotein synthesized and secreted by the thyrotropes of the anterior pituitary gland. Third generation TSH assays are useful in separating euthyroid and hyperthyroid serum TSH levels in the low ranges, and in distinguishing marked suppression (<0.01 IU/mL) characteristics of thyrotoxicosis from nonthyroid illness and from subclinical hyperthyroidism. These assays are also useful in monitoring optimal TSH suppression in patients treated with T4.

Normal Range:

mIU/L
Adult: 0.27-4.64 Child: 0.27-15.0

31.
Comments:

Thyroxine (T4), Free

Free T4 is a small part of total T4. FT4 is usually low in hypothyroidism and increased in hyperthyroidism. Thyroxine test is of particular value in determining thyroid status in patients with an abnormal TBG level such as during pregnancy, estrogen or androgen therapy, use of contraceptive pills, or a congenitally abnormal TBG level.

Normal Range:

ng/dl
Euthyroid: 0.93-1.7

pmol/L
12-22

32.
Comments:

Triglycerides
Used to evaluate turbid samples of serum, chylomicronemia, hyperlipidemia and some cases of diabetes mellitus. Increased in familial pre-beta hyperlipidemia (Fredrickson type IV) and familial lipoprotein lipase deficiency (Fredrickson type IIb). Elevations in TG levels can also be a result of some primary disease states or conditions. These include obesity, impaired glucose tolerance, eruptive or planar xanthomas, viral hepatitis, alcoholism, biliary cirrhosis, acute and chronic pancreatitis, acute myocardial infarction, essential hypertension, hypothyroidism, glycogen storage types I, II, and VI, Thalassemia major and stress. Decreased in hypo- and a-B-lipoproteinemia. Also low in chronic obstructive lung disease, brain infarction, hyperthyroidism, malnutrition, lactosuria, intestinal lymphangiectasia. Non-Fasting samples will give elevated results without pathological significance.

Normal Range:

mg/dl
Optimum: < 150 Borderline: 150-190 Elevated: > 190

mmol/L
< 1.7 1.7-2.15 > 2.15

33.
Comments:

Triiodothyronine, Free (FT3)

Used to assist in the diagnosis of hyperthyroidism.The formation of triiodothyronine (T3) results from conversion of thyroxine (T4) to T3 in peripheral tissues. T3 is also synthesized by the follicular cells of the thyroid gland. Raised in hyperthyroidism, often before the thyroxine level is elevated. Lowered in hypothyroidism and in chronic illness. Of value when the concentration of thyroxine binding globulin is raised as in pregnancy, or when taking contraceptive pills or other estrogens. FT3 is about 0.2-0.5% of total T3.Free T3 is largely unaffected by variations in carrier proteins.

Normal Range:

pg/dl
Euthyroid: 1.8-4.6

pmol/L
2.8-7.1

34.
Specimen: Comments:

Urea, Serum
Serum Used to evaluate kidney function. Serum urea levels increase in low renal perfusion, acute or chronic intrinsic renal disease, post-renal obstruction to urine flow and high protein diet. Decreased levels are associated with low protein diet, acromegaly, pregnancy and severe liver damage.

Normal Range:

mg/dl
15-45

35.
Comments:

Uric Acid, Serum

Uric acid is associated with hyperlipidemia, obesity, hypertension, arteriosclerosis, diabetes mellitus, hypoparathyroidism, sarcoidosis, and liver disease. Increased in gout, renal failure, alcohol excess, high purine dietary intake, acute leukemias, lymphoma, polycythemia vera, toxemia of pregnancy, psoriasis, starvation and in chemotherapy or radiotherapy of large tumors. Decreased in Wilson`s disease, Fanconi`s syndrome, some malignancies, xanthinuria, SIADH, purine, and nucleoside phosphorylase and low-purine diet. The combination of low uric acid and low sodium may also be found in instances of liver disease.

Normal Range:

mg/dl
Male: 3.0-7.0 Female: 2.5-6.0

mol/L
180-420 150-360

36.
Comments:

VDRL
This is a rapid slide test that gives a good indication of syphilitic infection. Several biological false positives, for example SLE and RA, could be excluded by negative TPHA or FTA-Abs tests. VDRL and RPR are generally positive within 1-3 weeks after the chancre appears. Titers in primary syphilis are >1:32 and in late syphilis they are variable. Titers usually decline after treatment. Negative

Normal Range:

37.
Comments:

Widal Test
S. typhi and S. paratyphi A, B, and C typically give rise to a systemic infection characterized by the clinical picture of typhoid or parathyroid fever. They are transmitted between people via direct fecal-oral contact or indirect fecal-oral contact through contaminated food or drinking water. Only rising O (and H) antibody titres (four fold increase) are significant in diagnosis of typhoid and paratyphoid disease. Both titres are raised after previous clinical or latent infection but generally only the H antibody persists. Significant titers are usually > 1/160. S. typhi O: Negative S. typhi H: Negative S. paratyphi AO: Negative S. paratyphi BO: Negative S. paratyphi CO: Negative S. paratyphi AH: Negative S. paratyphi BH: Negative S. paratyphi CH: Negative

Normal Range: