Hi John,
Interesting that you add total protein to GP requested LFTs, you obviously trying to screen for paraproteinaemia. I estimate that you do 50,000 LFT/total protein annually for GPs, what is your pick up rate for paraprotein? and how many of these paraproteins are clinically significant and that their detection in this way will alter outcome?
BW
Mohammad
Dr. M A Al-Jubouri, MB ChB, MSc, EurClinChem, FRCP Edin, FRCPath
Consultant Chemical Pathologist
--------------------------------------------
On Thu, 7/1/16, OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) <[log in to unmask]> wrote:
Subject: Re: Gamma GT & all casue mortality
To: [log in to unmask]
Date: Thursday, 7 January, 2016, 9:12
Hi David
The core liver profile as recommended by MessersĀ
Smellie and Barth were
ALT,ALP,ALB,BIL so your right on the money there !
http://www.acb.org.uk/docs/default-source/test-profiles/LFTprofile.pdf?sfvrsn=0
We offer a hospital profile which is exactly the same
For GP's we add TP which allows the calculation of the
globulin gap and the possibility of generating an SPE if
raised.
Happy New Year to all list members
BW John
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]]
On Behalf Of David James
Sent: 07 January 2016 08:54
To: [log in to unmask]
Subject: Re: Gamma GT & all casue mortality
Nor us
Let's expand this a bit.................
How many tests in your LFT and name them
4; ALT, ALP, Bil, Alb
dj
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]]
On Behalf Of Jonathan Kay
Sent: 06 January 2016 16:33
To: [log in to unmask]
Subject: Re: Gamma GT & all casue mortality
Never had it in thereā¦
Jonathan
> On 6 Jan 2016, at 14:24, Colley, Michael <[log in to unmask]>
wrote:
>
> At the request of our Hepatologists /
gastroenterologists we have, starting today, removed GGT
from our LFT panel.
>
> We await the result.
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]]
On Behalf Of Mohammad
> Al-Jubouri
> Sent: 06 January 2016 14:21
> To: [log in to unmask]
> Subject: Gamma GT & all casue mortality
>
> Dear List members,
>
> High GGT even at upper reference limit has been
reported to be associated with risk of increased all cause
mortality as well as cardiovascular, type 2 diabetes and
cancer mortality, see this meta-analysis:
>
>
> http://www.tandfonline.com/doi/full/10.3109/10715762.2014.902055
>
> Is there enough evidence to justify its routine
measurement as part of routine LFT profile? And if elevated
what intervention the clinician could instigate to reduce
risk of mortality?
>
> I am not a fan of GGT because of its high sensitivity
and low specificity but would welcome a debate on this novel
use of GGT.
>
> Best regards
>
> Mohammad
>
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