There are many critics of using Clinitest tablets on faecal samples and
yet there are many labs who still use the test for reducing sugars in
faeces.
The New Zealand packaging of Clinitest states that the test is used for
the determination of urine sugar. The package insert says that the test
is for the quantitation of reducing sugars in urine - yet the only
sugar referred to is glucose. The use of the test for faecal samples is
not mentioned and not excuded in the limitations of the test.
Questions (I will collate the replies and post them to the group).
1. Are there any references either validatiing or condemning the use of
Clinitest tablets for the measurement of reducing substnaces in faeces?
2. Do laboratories follw up positive tests by carbohydrate
chromatography as advocated by Richard Mainwaring-Burton?
3. What is are the limitations of the test - flase positives - false
negatives?
4. Is their external QC available?
5. How do laborastories apply the test to faeces?
The method we use is to homogenise a faecal sample with an two volumes
of water and perform the test on 15 drops of homogenate.
cheers
Trevor Walmsley
>>> "Mainwaring-Burton Richard (RGZ)"
<[log in to unmask]> 9/6/03 11:02 pm >>>
We do a (disputed technique using clinitest) screen for reducing
sugars
in-house, and then send away positives for proper chromatography at a
centre
of excellence.
Sugar chromtography is one of the tests which, in my view, is sensible
to
centralise where one is able to see a significant number of positives,
and
provide proper advice and follow-up.
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
DA14 6LT
020-8308-3084
-----Original Message-----
From: Paul Masters [mailto:[log in to unmask]]
Sent: 09 June 2003 10:25
To: [log in to unmask]
Subject: Stool sugar chromatography
We still get a steady trickle of requests for this in children with
diarrhoea, presumably looking for lactase deficiency. Both GPs and
hospital
paediatricians obviously believe it is a worthwhile investigation, but
is
it?
Does anyone know of the evidence to support the use of this
investigation?
As there is no EQA scheme (or is there?) it is difficult to defend its
use.
Has anyone dropped it from their repertoire recently, and if so what do
they
suggest as an alternative when the clinician rings up?
Paul
Dr Paul Masters
Consultant Chemical Pathologist
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