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
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.
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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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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DISCLAIMER: This e-mail and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. Any views or opinions expressed are those of the author and do not represent the views of Poole Hospital NHS Trust unless otherwise explicitly stated. The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. Unless the Information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed.