Comparative analysis of venous blood lactate levels by automatic lactate strip kit (accusport) and by standard marbach’s enzymatic method.

Lactic acidosis is an emerging life-threatening condition that needs to be diagnosed and treated as early as possible. The complete analysis of blood lactate levels by standard method takes at least a few hours and is not available at all times. The automatic lactate strip kit (Accusport) will be more practical for diagnosis and treatment of lactic acidosis patients. This study showed the results of blood lactate determined by standard enzymatic method of Marbach compared to the lactate strip. The results showed a strong correlation between the two methods (r2=0.966). The correlation increased in the case of high blood lactate levels (r2=0.978) and decreased in normal blood lactate levels (r2=0.943). Overall lactate values measured from the strip method were lower than those from the enzymatic method. From this study we can calculate a constant factor of 0.981 which when multiplied with the value of blood lactate analysed by lactate strip then added with 0.532, the result will be equal to that from Marbach’s enzymatic method.

Serum ceruloplasmin in wilson’s disease.

Wilson’s disease is a rare inherited disease with an incidence of 1:50,000 to 1:1,000,0001. The mode of transmission of this disease is an autosomal recessive. The defects of the disease involve both an impairment in biliary copper excretion and a decreased incorporation of free copper into ceruloplasmin due to a low level or abnormal function of this alpha 2-globulin. The toxic accumulation of copper damages many tissues especially basal ganglia of brain and liver. The diagnosis of this disease is made from the family history, signs and symptoms especially from the damaged organs, the detection of Kayser-Fleischer ring, a copper deposit in cornea and the decreased level of serum ceruloplasmin below 20 mg/ml which is normally found in more than 95% of cases. In this study, we analysed the levels of serum ceruloplasmin from 23 cases of Wilson’s disease admitted in Siriraj Hospital from 1989-1998. The average value, (X+1 SD), of 1.38+3.55 mg/ml was significantly lower when compared with the value of 20.82+3.63 mg/ml from 46 normal controls. The cut off level of ceruloplasmin for Wilson’s disease in Thai patients from this study was estimated to be 13 mg/ml which is lower than the level of 20 mg/ml in standard textbook. Twenty two out of 23 cases of Wilson’s disease (95.65%) had serum ceruloplasmin levels less than 13 mg/ml while 1 out of 23 cases (4.35%) had normal level. The data strongly supported the usefulness of serum cerloplasmin analysis in the diagnosis of Wilson’s disease.