Lactate: must be available 24 h (from NaF/EDTA plasma, stable for 24 h at RT) a day in pediatric environment; should be done whenever there is a suggestion of mitochondrial disorders (quite unspecific, mulit-organ symptoms) or hypoglycemia (in this latte case, do it from NaF/EDTA plasma together with glucose, ß-OH butyrate and FFA to differentiate glycogenosis from ß-oxidation block);
Pyruvate: should be done only when hyperlactemia or lactic aciduria has been documented; do it only from blood drawn into perchloric acid (use pre-weighed tubes to calculate dilution), do it always together with lactate from the same sample to calculate lactate/pyruvate ratio as an indication of redox status; do it together with ß-HOB/acetoacetate ratio, also from the same sample (to differentiate PDH deficiency, PCD type II from respiratory chain deficiency.
Prof. Dr. med. Thomas Deufel, Laborarzt
Direktor des Instituts für Klinische Chemie und Laboratoriumsdiagnostik
Klinikum der Friedrich-Schiller-Universität Jena, D-07740 Jena
Tel.: +49 (3641) 934031; Fax: +49 (3641) 934029
Email: [log in to unmask]
-----Ursprüngliche Nachricht-----
Von: Craig Webster [SMTP:[log in to unmask]]
Gesendet am: Dienstag, 19. Januar 1999 12:01
An: Acb-Clin-Chem-Gen
Betreff: Lactate and Pyruvate Analysis In Neonates
Over the recent 3 weeks we have had 4 requests for lactate and pyruvate
analysis. When compared with 1 request for pyruvate in the last 3 years this
seamed odd !
I must confess to have only textbook knowledge of these analytes. I would
welcome some comments from some of the more seasoned biochemists on the
utility of the above analytes. For example what are the indications for the
measurement of pyruvate. Is it unreasonable for us to insist that the
requesters document an acidosis and an elevated anion gap before preceding
to lactate analysis (we have been doing this in adults for sometime. Is it
the same situation in neonates ?)
Craig Webster
Senior Clinical Biochemist
Broomfield Hospital
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