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  HDL CHOLESTEROL PEG/CHOD-PAP Method (Courtesy: Tulip Group of Companies) For the determination of HDL cholesterol in serum or plasma (for in vitro diagnostic use only). Summary Lipoproteins are the proteins which mainly transport fats in the bloodstream. They can be grouped into chylomicrons, very low density lipoproteins (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL). Chylomicrons and VLDL transport mainly triglycerides, though VLDLs also transport some amount of cholesterol. LDL carries cholesterol to the peripheral tissues where it can be deposited and increase the risk of arteriosclerotic heart and peripherial vascular disease. Hence, high levels of LDL are atherogenic. HDL transports cholesterol from the peripherial tissues to the liver for excretion, hence, HDL has a protective effect. The measurement of total and HDL cholesterol and triglycerides provide valuable information for the risk assessment of coronary heart diseases. Principle When the seru

  Clinical Chemistry 481 Causes of Monoclonal Gammopathies ¾ Multiple myeloma ¾ Waldenstrom’s macroglobulinemia ¾ Benign idiopathic monoclonal gammopathy ¾ Heavy chain diseases ¾ Collagen disorders, autoimmune diseases ¾ Certain lymphomas ¾ Cirrhosis liver ¾ Neoplasms of colon, prostate, breast, female genital tract, stomach and lungs ¾ Myeloproliferative disorders-CML, polycythemia, myelofibrosis, erythrimic myelosis, erythroleukemia, other acute leukemias ¾ Aberrations in lipid metabolism ¾ Diabetes mellitus. Interfering Factors 1. Low levels of albumin occur normally in all trimester’s of pregnancy. 2. Bromosulfalein may cause a false elevation. Therefore, a serum protein test should not be done within 48 hours following a BSP test. 3. See appendix for complete listing of drugs that interfere with total protein levels. SERUM CHOLESTEROL Cholesterol (CHOD/PAP Method) (Courtesy: Tulip Group of Companies) For the determination of cholesterol in serum or plasma (for in vitro diagnostic

  2. Contrast media 24 hours before measurement may cause an altered reaction. 3. A high fat meal may cause decreased bilirubin levels by interfering with the clinical reactions. 4. Air bubbles and shaking of the specimen may cause decreased levels. 5. Foods (carrots, etc.) and drugs increase the yellowish hue in the serum. 6. Refer to the Many drugs can interfere with Bilirubin tests for a listing of the many drugs that may interfere with testing for bilirubin. 7. Hemolyzed blood will falsely elevate bilirubin level. Comments 1. In severe obstructive jaundice with formation of biliverdin, low results for the degree of jaundice will be obtained since biliverdin does not react with the diazo reagent and cannot be determined. 2. An unusual source of otherwise unexplained elevated serum bilirubin has been described following 48 hours fasting. A normal bilirubin value from 0.68 mg% may rise to the abnormal range at 1.87 mg%. Icterus Index The icterus index is a measure of the degree of ict