You might also wish to consider doing a urine organic acid analysis.
Compounds such as pyroglutamic acid and 4-hydroxyphenylacetic acid will
also lead to metabolic acidosis if enough accumulates within the
circulation.
Mike
Michael J. Bennett PhD, FRCPath, FACB, DABCC
Professor of Pathology and Laboratory Medicine,
University of Pennsylvania.
Evelyn Willing Bromley Endowed Chair in Clinical Laboratories and
Pathology,
Director, Metabolic Disease Laboratory
The Children's Hospital of Philadelphia, 5NW58
34th Street & Civic Center Blvd
Philadelphia, PA 19104-4399
tel 215 590 3394
fax 215 590 1998
[log in to unmask]
>>> "Griffiths Paul (RQ3) BCH" <[log in to unmask]> 08/11/08
8:59 AM >>>
Jeff,
I would agree with Jonathan that D-Lactic acidosis is very likely. We
can measure D-Lactate on a serum or Lithium Heparin sample which
should
be separated within one hour of collection, stored at 2-8 deg C and
sent
by first class post. Do not hesitate to contact me if you require
further details.
Regards
Paul
Paul Griffiths
Consultant Biochemist, Head of Department
Birmingham Children's Hospital
Tel 0121 333 9923
e-mail [log in to unmask]
________________________________
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Mascall, Gary
(Biochemistry)
Sent: 11 August 2008 13:34
To: [log in to unmask]
Subject: Re: Acetacetate and hydroxybutyrate
Birmingham Children's Hospital Clinical Chemistry department have
recently mails hot local laboratories, and gastroenterologists, as
they
now offer a service for D-lactate looking for bacterial overgrowth.
It may be worth asking them, as they did also used to offer
acetoacetate
and hydroxybutyrate levels too.
G.C. Mascall
Consultant in Clinical Biochemistry
Worcestershire Acute Hospitals NHS Trust
Tel: 01562 823424 extn 53465/53136
[log in to unmask]
________________________________
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Jonathan Kay
Sent: 11 August 2008 13:06
To: [log in to unmask]
Subject: Re: Acetacetate and hydroxybutyrate
Several laboratories in AssayFinder... (http://www.assayfinder.com/)
Would it be worth assaying D-lactate as well? I can't find a
laboratory
offering that in either AssayFinder or MetBioNet
(http://www.metbio.net/), but I know there is at least one.
Best wishes
Jonathan
On 11 Aug 2008, at 13:00, Slater Jeff (RQ8) Mid Essex Hospital wrote:
Dear Mailbase
Is there a UK lab which measures both Acetoacetate and Hydroxybutyrate
-
we have a gastric bypass patient with severe acidosis on ITU which is
not accounted for by the lactate results we are seeing - stix testing
is
not showing significant KBs which it won't if there is no
acetoacetate.
Best wishes
Jeff
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