BLOOD TESTS

BLOOD TESTS(Normal Values & its importance)Dr.Satyen BhattacharyyaAssistant Professor : BIMLS,Burdwanwww.fitofine.org

HemoglobinHb is the iron containing coloring matter of RBCIf the count is low - chronic inflammation(inflammation is a body process that can result in pain swelling warmth or redness) Low hematocrit and hemoglobin counts may be signs that your medication is causing a loss of blood from your stomach and passing through your bowel. Low counts also may indicate a decrease in red blood cell production. bone marrow problem

If the count is more blood volume increase in case of smoking high altitude

Normal Count : 14 16 g/dL but it can vary from age to age At birth : 25g/dL After 3rd month : 20g/dL After 1 year : 17g/dL from puberty onwards : 14 16g/dL

it can also vary in age

Adult males : 15g/dL Adult females : 14.5g/dL

WBCWBC tests measure the number of white blood cells present. When you have an infection your body makes more white blood cells. Some medications can decrease the number of white blood cells which could increase your chances of getting an infection

Normal Values

total count(TC)- 4000 11000/cu mm of blood differential count(DC)- %Absolute volume/cu mmof bloodneutrophils50-703000-6000eosinophils2-4150-450basophils0-10-100monocytes2-6200-600lymphocytes20-301500-2700

SIGNIFICANSIf the count is less- may be due to some medications decrease count indicate more prone for infection If the count is more- disease in bone marrow disorder in immune system acute lymphocytic leukemia acute myelogenous leukemia(AML) Allergy, especially severe allergic reactions Chronic lymphocytic leukemia

Chronic myelogenous leukemia Drugs, such as corticosteroids and epinephrine Infections, bacterial or viral Myelofibrosis Polycythemia vera Rheumatoid arthritis Smoking Stress, such as severe emotional or physical stress Tuberculosis Whooping cough

Platelet count

This test measures the number of "sticky" cells or platelets that help the blood to clot (aspirin and some other medications make the platelets less "sticky"). If the number of platelets is low you could have too much bleeding. Some powerful arthritis medications in rare instances lower the platelet count.

Normal Values

2,50,000/cu mm of blood

range- 2,00,000 4,00,000/cu mm of blood

SignificanceIf the count is less- (thrombocytopenia) more bleeding TB infections and other diseaseIf the count is more- (thrombocytosis) allergic conditions hemorrhage bone fracture rheumatic fever trauma

Erythrocyte sedimentation rate (ESR)

This test also called "sed rate determines if you have inflammation. The sed rate can measure the amount of inflammation present. The test measures how fast red blood cells cling together, fall, and settle toward the bottom of a glass tube in an hour's time, like sediment. The higher the sed rate, the greater the amount of inflammation. As inflammation responds to medication, the sed rate usually goes down. This is an example of a test your doctor might order several times. Another test used to measure this is the C-Reactive Protein (CRP) test.

Normal Values by westergen method-

in males- 3-7 mm in one hour in females- 5-9 mm in one hour in infants- 0-2 mm in one hour

Significance if the count is more - (more inflammation) TB anemia malignant tumors RA Rheumatoid fever liver disease

If the count is less- allergic conditions sickle cell anemia polycythemia(increase in RBC) peptone shock severe leukocytosis

Salicylate level

This measures the amount of salicylate in the blood to find out if enough is being absorbed to reduce inflammation (salicylate is the main ingredient in aspirin and some other NSAIDs). This is a helpful test for people who are taking large doses of these medications for a long time. High salicylate levels can be harmful with or without such symptoms as ringing in the ears nausea vomiting or even fever

Muscle enzyme tests (CPK aldolase)

These tests measure the amount of muscle damage (in some rheumatic diseases damaged muscles release certain enzymes into the blood). These tests also can show how effective medication has been in reducing inflammation that causes muscle damage.

Normal Values

1.0 7.5 units/liter

Significance decrease amount signifies prone for muscle fatigue and inflammation

it is diagnostic test for fibromyalgia it signifies liver or muscle damage

Liver enzyme tests (SGOT SGPT) bilirubin alkaline

These tests measure the amount of liver damage. Certain medications used in the treatment of arthritis can damage the liver. Aspirin for example has been known in rare instances to damage the liver especially in children or in people who have had previous liver damage. Other NSAIDs can cause liver inflammation (hepatitis). Methotrexate can cause liver damage especially in people who drink alcohol.

Normal ValuesSGPT male : upto 40 u/L female : upto 31 u/L

SGOT male : upto 37 u/L female : upto 31 u/L

Creatinine tests

These measure kidney function. Creatinine is a normal waste product of the muscles. A high level of it means that the kidneys are not working well enough to remove waste products from the body.

Normal Values

male - 0.9 1.4 mg/dL female 0.8 1.2 mg/dL

Uric Acid

These tests measure the amount of uric acid in the blood. People with gout usually have high levels of uric acid which forms into crystals that are then deposited in the joints and other tissues. However not everyone with a high uric acid level has gout.

Normal Values

male : 3.4 7.0 mg/dL female : 2.4 5.7 mg/dL

Auto immune disease

when immune system fights against his own body cells and creates auto antibodies that react against bodys own cell, then inflammatory conditions happen.the test includes are- rheumatoid factor antinuclear antibody complement human leukocyte antigen tissue typing(HLA)

Rheumatoid Factor(RF)This measures whether a certain amount of abnormal antibody called rheumatoid factor is in the blood. The majority of people with rheumatoid arthritis (a common disease of inflamed joints that can cause joint alignment problems and loss of function) have a large amount of rheumatoid factor in their blood. However up to 20 percent of adults with rheumatoid arthritis may never have any rheumatoid factor in their blood. In contrast about 85 percent of children with juvenile rheumatoid arthritis (ERA) are negative for rheumatoid factor (ERA is a group of diseases similar to rheumatoid arthritis that begin in childhood). It is important to note that having a positive rheumatoid factor will assist in the diagnosis but the test alone is not conclusive.

Method of testingLatex agglutinationELISANephelometry use LASER light to detect RF & IgE

Normal Values Latex RF greater than 1 : 40 as positive

Nephelometry lesser than 20 IU is normal

SignificanceX-Ray shows same impression in polyarthritis & RA but lab test signifies thisAlso used in Sjogrens disease to predict the development of lumphoma

Antinuclear antibody(ANA)These detect a group of autoantibodies that are found in most people with lupus and scleroderma and in a few people with rheumatoid arthritis. These autoantibodies react with antigens in the nuclei of cells. The antibodies suggest that an autoimmune illness may be present although many people test positive and have little evidence of serious disease. Specific antinuclear antibody tests are helpful in the diagnosis of certain rheumatic diseases that involve abnormalities in the immune system. The names of the following tests are abbreviations of more complicated-sounding tests. The diseases for which they are used include:

systemic lupus erythematosus (multiple-system illness may involve the skin joints kidney etc.); anti-dsDNA anti-Sm anti-Ro/SS-A and antihistone tests help confirm the diagnosis.scleroderma (a marked thickening of the skin); the anti-Scl-70 test helps confirm the diagnosis.polymyositis (inflammation of muscles resulting in muscle weakness sometimes with joint inflammation); anti-Jo-l and anti-PM-l tests may help confirm the diagnosis.Sjogren's syndrome (disorder marked by dry eyes and dry mouth); anti-Ro/SS-A and anti-La/SS-B tests may help confirm the diagnosis.mixed connective tissue disease (a syndrome with a variety of symptoms including joint inflammation and swollen fingers); the anti-Ul RNP test helps confirm the diagnosis.

Complement tests

These tests measure the amount of complement proteins circulating in the blood. Complement tests involve the reaction of antibodies with antigens. These tests usually are reserved for diagnosing or monitoring people with active lupus. Those people with lupus frequently have lower-than-normal amounts of complement especially if the kidneys are affected.

Human leukocyte antigen (HLA) tissue typing tests

These tests detect the presence of certain "genetic markers" or traits in the blood. For example B-27 is a genetic marker that nearly always is present in people with ankylosing spondylitis (a disease involving inflammation of the spine and sacroiliac joint) and Reiter's syndrome (a disease involving inflammation of the urethra eyes and joints). This test also is positive in 5 to 10 percent of the healthy population.

ReferencesEssentials of Medical Physiology by sembulingamWikipediawww.mayoclinic.org

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