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INTERPRETATIVE CLINICAL CHEMISTRY

Determination Normal Increased in Decreased in


Values
1) ALT <29 U/L 1) Hepatitis(viral 1) End stage liver disease
(SGPT) (M) hepatitis,Toxic 2) Renal—insufficiency
hepatitis,Alcoholic
<23 U/L (F)
hepatitis) 4) Infectious
mononucleosis
5)Polymyositis
2) Albumin 3.8.- 5.4g/dl 1) Dehydration I) Renal disease
2) Liver insufficiency
3) Severe malnutrition
4) Pregnancy 5) Burns
3) (ALP) 80-220 U/L 1) Intrahepatic cholestasis 1) Hypophosphatasemia
Alkaline Adults) 2) Extrahepatic cholestasis (a rare inherited disorder)
phosphatase 145- 950 IU 3) Osteoblastic disease
(Children) 4) Pregnancy
4) Amylase < 160 1) Pancreatitis 1)Extensive destruction
(Refloctron 2) Perforated peptic ulcer of pancreas.
instrument ) 3) Acute ethanol ingestion
4) Severe renal disease
5) Salivary gland disease
6) Obstruction of Pancreatic
duct
5) AST <26 U/L 1) Hepatocellular 1) End stage liver disease
(SGOT (M) destruction (viral, toxic, 2) Pregnancy
alcoholic)
<21U/L (F)
2) Myocardial infarction
3) Pulmonary infarction
4) Post-hepatic conditions
5) Musculoskeletal disease
6) Bilirubin 0.1 - 1.0 1) Haemolytic jaundice
(total) mg/dl 2) Haepatocellular
destruction(viral, toxic,
alcoholic)
3) Post-hepatic conditions
4) Neonatal physiological
hyperbilirubinemia
5) Gilbert’ disease
Determination Normal Increased in Decreased in
Values
7) Calcium 8.8 -10.2 ) Hyperparathyroidism 1)Hypoparathyrodisim
mg/dl 2) Metastatic carcinoma 2) Hypoaibuminaemia
3) Myeloma 3) Chornic renal disease
4) Sarcoidosis 4) Acute Pancreatitis
5) Thyrotoxicosis 5) Malnutrition
6) Rickets,
8) Chloride 98—107 1) Dehydration 1) Overhydration
mEq/L 2) Renal tubular disease 2) Prolonged vomiting
3) Prolonged diarrhea 3) Burns
4) Hyperparathyroidism 4) Salt losing renal disease
9) Cholesterol 150—200 1)Famililal(hereditary) 1) Hyperthyrodism
mg/dl hypercholesterolemia 2) Malnutrition
2) Nephrotic syndrome 3) Chronic anaemia
3) Biliary obstruction 4) Thyroiditis
4) Hypothyroidism 5) Severe liver
5) Pregnancy insufficiency
10) 15—130 1) Myocardial infarction 1) Physical inactivity
CPK (CK) IU (men) 2) Progressive muscular 2) Decreased muscle mass
15—110 dystrophy
IU/L 3) Dermatomyositis
(Women) 4) Convulsions
5) Surgery
11) Creatinine 0.7 – 1.5 1) Impaired renal function
mg/dl
12) Co2 21-30 1) Primary respiratory l)Primary metabolic
Content( Hco3 mEq/L acidosis acidosis2) Primary
+ H2Co3) 2) Primary metabolic respiratory alkalosis
alkalosis
13) Glucose 70—110 l)Diabetes mellitus 1) Insulinoma 2)
mg/dl 2) Endocrine Hypopituitarism 3)
disorders(Thyrotoxicosis Adrenal cortical
acromegaly,) insufficiency
3) Stress 4) Severe liver disease
4) Chronic renal failure 5) Extrapancreatic
5) Pancreatitis neoplasm 6) Ethanol
6) Drugs, Steroids, Oral ingestion 7) Drugs
contraceptives etc. (Sulphonylurea, salicylates
insulin etc )
Determination Normal Values Increased in Decreased in
14) Gamma- GT 8-33 U/L. (male) 1) Histry of ethanol 2) -
(GGTP) 7-29 U/L Hepatobiliary disease3)
(Female) History of Drug
ingestion (e.g.
Phenytoin,phenobarbital
15) LDH (LD) 140-330 U/L 1) Myocardial
infarction
2) Haemolytic disease
e.g. megaloblastie
anaemia,,sickle cell
anaemia
3) Pulmonary infarction
4) Infectious
mononucleosis
5) Hepatic disorders.
6) Progressive muscular
dystrophy
7) Malignancy i.e.
leukaemia,
lymphoma, metastatic
carcinoma
16) Lithium 0.5— 1.2 mmol/l Lithium medication
(theraputic range) given in excess
17) Magnesium 1.2—2.4 mEq/L 1) Renal disease 1) Alcoholism 2)
2) MgSO injection Malnutrition 3)
Severe diarrhea 4)
Malabsorption
18) Inorganic 2.5—5.0 mg/dl 1)Hypoparathyroidism 1)Hyperparathyroidism
(adults 2) Hypervitaminosis‘D’ (primary) 2) Vitamin D
phosphorus
4.0 —7.0 mg/dl 3) High calcium diet deficiency)
(children 4) Renal insufficiency 3)Malabsorption
4) Fanconi’s syndrome
(loss of phosphate in
urine)5) Rickets
6) Sprue steatorrhoea
7) Hyperinsulinism

Determination Normal Values Increased in Decreased in


19) Potassium 3.8—5.0 mEq/l 1) Renal 1)
glomenrular disease Hyperaldosteronism
2)Adrenal – cortical 2) Renal tubular
insufficiency disease
3) Excessive 3) Diuretic therapy
intravenous therapy 4) Gastro-inlestinal
4) Diabetic loss 5) Malnutrition
ketoacidosis 6) Metabolic
alkalosis
20) Sodium 133—153 mEq/L 1) Dehydration2) 1) Salt losing
Loss of hypotonic nephritis2)
gastrointestinal Gastrointestinal loss
fluids 3) Diabetes 3) Adrenal
insipidus4) Salt insufficiency
poisoning5) Skin 4) Diuretic therapy
losses (burns
excessive sweating)
21) Total Proteins 6—8 g/dl 1) Dehydration2) 1) Overhydration
Myeloma (lgG, 2)Renaldisease
IgA) 3) Sarcoidosis (Protein losing)
4) 3) Hepatic
Chornic insufficiency
inflammation 4) Malnutrition
5)
Agammaglobunemia
6) Malignancy
22) Triglycerides < 160 mg/dl (M) 1) Diabetes mellitus 1) Malnutrition
2) Nephrotic 2) Congenital abeta
< 140 mg/dl (F)
syndrome lipoproteinemia
3) Excessive alcohol
intake
4) Familial hyper-
triglyceridemia
5) Pregnancy
23) Uric acid 3.0—7 mg/dl (M) ) Gout 2) Renal 1) Renal tubular
failure3) Leukaemia defect (Fanconi’s
2.5 – 6.0 mg/dl (F)
4) Polycytheniia syndrome,Wilson’s
5) Keto acidosis disease)
6) Lactate excess 2) Administration of
(after ingestion) ACTH
7) Chronic lead
nephropathy
24) Urea 15—45 mg/dl 1) Pre-renal 1) Severe liver
conditions (diabetes insufficiency
mellitus, shock, 2) Overhydration
BUN = urea/ 2.14 8-22 mg/dl congestive heart 3) Pregnancy (third
failure etc.) 2) trimester)
Impaired renal 4) Malnutrition
function3) Post- (Particularly
renal conditions4) decreased protein
Gastrointestinal intake)
bleeding5) High
protein diet6) Drugs
Corticosteriods
tetracyclines etc.

Reference: Interpretative clinical chemistry by Bernard E. Statland .

Note : All enzyme normal ranges are at 30 C