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Hello Jonathan Yes, this was part of the reason for including TP but what really swayed it was work done by the immunologists in Cardiff on missing patients with hypogammaglobulinaemia if calculated globulin is not provided. There's a cut off on the all Wales LIMS below which there's a message generated suggesting a check of immunoglobulins. Best regards Gethin -----Original Message----- From: Avril Wayte (BCUHB - Pathology) Sent: 07 January 2016 10:16 To: Jonathan Kay Cc: [log in to unmask]; Gethin Roberts (Hywel Dda UHB - Consultant Clinical Biochemist) Subject: RE: Gamma GT & all casue mortality Morning Jonathan Gethin is really the person to ask as he was directly involved at that time. Thanks Avril Mrs Avril Wayte Consultant Clinical Scientist Ysbyty Gwynedd, Bangor Clinical Director for Biochemistry, BCUHB RCPath Assistant Registrar 01248 384262 -----Original Message----- From: Jonathan Kay [mailto:[log in to unmask]] Sent: 07 January 2016 09:57 To: Avril Wayte (BCUHB - Pathology) Cc: Jonathan Kay; [log in to unmask] Subject: Re: Gamma GT & all casue mortality Morning, Avril. We took total protein out of all defined groups a few decades ago. Every so often I'd ask our haematologists if there was any value in earlier detection of paraproteins, and they always agreed there wasn't. How did that discussion go in Wales? Or was there a different reason? Thanks Jonathan > On 7 Jan 2016, at 09:28, Avril Wayte (BCUHB - Pathology) <[log in to unmask]> wrote: > > In Wales, following our standardisation process, all LFT profiles across all labs and all platforms is as follows: > > Bilirubin umol/L ref range <21 > Total Protein g/L ref range 60-80 > Albumin g/L ref range 35-50 > Calculated globulin > ALP U/L adult ref range 30-130 > ALT U/L ref range <41 > > AST and/or gamma GT extra requests if required. > > Hope this helps. This was achieved following the hard work of Gethin Roberts, and more latterly Catherine Bailey and Rachael Still (and standardisation team). > > Kind regards > > > Avril > > Mrs Avril Wayte > Consultant Clinical Scientist > Ysbyty Gwynedd, Bangor > Clinical Director for Biochemistry, BCUHB > RCPath Assistant Registrar > 01248 384262 > > > -----Original Message----- > From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) > Sent: 07 January 2016 09:13 > To: [log in to unmask] > Subject: Re: Gamma GT & all casue mortality > > Hi David > The core liver profile as recommended by Messers 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 there... > > 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 >> > > > ------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. > ACB Web Site > http://www.acb.org.uk > Green Laboratories Work > http://www.laboratorymedicine.nhs.uk > List Archives > http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html > List Instructions (How to leave etc.) > http://www.jiscmail.ac.uk/ > > > This message contains confidential information and is intended only for the individual named. 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