A question has been posed and I would welcome views of the informed.
A GP has a patient with Glycogen Synthase deficiency - now aged 27 -
diagnosed as a young boy when he had recurrent hypoglycaemic episodes. He's
apparently reasonably well now but has asked for guidance on alcohol intake.
Would any experts care to comment?
Thanks
Joe Begley
Dr JP Begley
Clinical Biochemistry
Poole Hospital
Longfleet Road
Poole BH15 2JB
Tel: 01202 442155
Fax: 01202 448454
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-----Original Message-----
From: Mascall, Gary (Biochemistry)
[mailto:[log in to unmask]]
Sent: 07 March 2005 10:57
To: [log in to unmask]
Subject: Re: discordant paediatric urea/creat
This rings a bell.
I'd check with your Pharmacy about the Dexamethasone
solution used, as some of them contain Creatinine too. We got caught out by
this a year or so ago.
Gary
G. C. Mascall
Consultant in Clinical Biochemistry
Worcestershire Acute Hospitals NHS Trust.
[log in to unmask]
<mailto:[log in to unmask]>
Tel: 01562 823424 extn 53464/53136
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of TICKNER TREVOR (RM1)
Norfolk & Norwich University Hospital
Sent: 05 March 2005 10:41
To: [log in to unmask]
Subject: Re: discordant paediatric urea/creat
Can anyone help with the opposite situation.
Patient child age 2. Post op for removal of foreign body
from oesophagus.
Creatinine 1269 umol/l; Urea 3.6 mmol/l.
Previous day (pre-op) creatinine 17, Urea 3.5
On admission (one day earlier still) creatinine 13, urea 7.6
3 months ago creatinine 27, urea 5.4
9 months ago creatinine 29, urea 5.4.
Method Vitros 950 (creatinine amidohydrolase, sarcosine
oxidase, peroxidase)
I have not been able to ascertain (as yet) the details of
the anaesthetic other than it was a GA and dexamethasone was given.
Clinical situation - child well and eating!
Any thoughts, known interferences that could lead to such an
elevation?
Thanks,
Trevor Tickner
Norwich
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Mohammad Al-Jubouri
Sent: 04 March 2005 11:46
To: [log in to unmask]
Subject: Re: discordant paediatric urea/creat
There are few reasons for disproportionate rise in urea
compared to creatinine:
1. Pre-renal causes: hypovolaemia, sepsis, adrenocortical
crisis.
2. G.I bleed, causes increased protein load.
3. Increased protein catabolism
4. Increased protein load.
5. Low cardiac output, causes renal hypoperfusion.
I would suspect that this patient was moderately dehydrated.
regards
Mohammad
Chris Lovell-Smith <[log in to unmask]> wrote:
I've been asked for an explanation (which I can't supply)
for raised urea (11mmol/L) with creatinine of 65umol/L in a one-year old
child suffering from gastroenteritis; clinically assessed as mildly
dehydrated initially. Samples were taken after some iv and oral rehydration.
Hct at same time around 0.35. No obvious analytical interferences.
many thanks
Dr Chris Lovell-Smith
Clinical Leader and Chemical Pathologist
Otago Diagnostic Laboratories, Dunedin Hospital, Dunedin,
NZ.
Phone 64 3 474 7925 Fax 64 3 474 7637
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