LabCorp

Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.

The presence of acetone may indicate exposure to acetone; it is also a metabolite of isopropanol and may be detected during ketoacidosis.

Ammonia measurements are mainly of use in the diagnosis of urea cycle deficiencies (any neonate with unexplained nausea, vomiting, or neurological deterioration appearing after first feeding), and they play an important part in the detection of Reye syndrome.

In Reye syndrome threefold increases in AST, ALT and plasma ammonia are required for diagnosis with/or the diagnostic liver biopsy findings. Ammonia levels increase characteristically early; plasma ammonia ≥100 μg/dL reflects severe hepatic changes.

This test allows for the detection of the presence of antibodies to glutamic acid decarboxylase, which provides early evidence of autoimmune disease activity; its measurement has been shown to be useful in assisting the physician in the prediction, diagnosis, and management of patients with diabetes.

Anti-DNase B is a blood test to look for antibodies to a substance (protein) produced by group A streptococcus. This is the bacteria that cause strep throat.

Negative anti-DNase B and ASO tests or very low titers means that it is unlikely you had a recent strep infection. This is especially true if a sample taken 10 to 14 days later is also negative. Your signs and symptoms are likely due to a cause other than a recent strep infection.

Autoimmune rheumatic diseases are conditions in which the immune system attacks the joints and certain systems. They are often difficult to diagnose, as their symptoms can be vague, vary from patient to patient, and often overlap. Laboratory testing can provide useful information, but no single test provides a definitive diagnosis for any one rheumatic disease. Diagnosis is most often based on a compilation of symptoms and signs, including clinical information and laboratory test results.

Testing for antinuclear antibodies (ANAs) using an immunofluorescence assay (IFA) is a good first approach for laboratory evaluation of patients suspected of having certain autoimmune rheumatic diseases. ANAs, a group of autoantibodies directed against diverse nuclear and cytoplasmic antigens, are associated with several autoimmune rheumatic diseases.

These include:

- systemic lupus erythematosus (SLE),

- systemic sclerosis (SSc),

- and mixed connective tissue disease (MCTD).

The ASO test is primarily used to help determine whether a recent strep infection with group A Streptococcus:

This test measures the levels of a certain type of hormone in your blood called a B-type natriuretic peptide. This test gives you information about your heart.

Providers use a BNP test to diagnose heart failure. If you already know you have heart failure, your provider may order this test to check the severity (seriousness) of your condition. They may also use this test to monitor how heart failure treatments are working. In some cases, your provider may also order it if they think you may be at higher risk of developing heart failure.

Doctors often suspect C. difficile in anyone who has diarrhea and who has other risk factors for C. difficile. 

Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), also known as Clostridioides difficile and often referred to as C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.

Determine the extent of carbon monoxide poisoning, toxicity; check on the effect of smoking on the patient; work up headache, irritability, nausea, vomiting, vertigo, dyspnea, collapse, coma, convulsions; work up persons exposed to fires and smoke inhalation.

Carbon monoxide levels are of limited value in testing for smoking, since it is cleared rapidly. The half-life of carboxyhemoglobin in individuals with normal cardiopulmonary function is one to two hours. Urinary cotinine, if available, is preferable as a test for tobacco use. Arterial blood gases may be of limited value in treatment decisions for carbon monoxide poisoning.

Carboxyhemoglobin is useful in judging the extent of carbon monoxide toxicity and in considering the effect of smoking on the patient. A direct correlation has been claimed between CO level and symptoms of atherosclerotic diseases, intermittent claudication, angina, and myocardial infarction. Exposure may occur not only from smoking but also from garage exposure, and from various motors.

A cold agglutinin test may be used to help detect cold agglutinin disease and determine the cause of a person’s hemolytic anemia. It may be used as a follow-up test after a complete blood count (CBC) shows a decrease in a person’s red blood cell (RBC) count and hemoglobin, especially if these findings are linked to an exposure to cold temperatures.

Cold agglutinin disease is a rare autoimmune disorder in which autoantibodies produced by a person’s immune system mistakenly target and destroy RBCs, causing hemolytic anemia. These autoantibodies are cold-reacting and can cause signs and symptoms related to anemia after an affected person is exposed to cold temperatures. This disease may be classified as either primary or secondary, triggered by an infection or other condition.

Copper is part of enzymes, which are proteins that help biochemical reactions occur in every cell. Copper is involved in the absorption, storage and metabolism of iron. The symptoms of a copper deficiency are similar to iron deficiency anemia. The liver makes a special protein, ceruloplasm, to transport copper and help convert iron to a form that can be used by other tissues.

Quantitation of alcohol level for medical or legal purposes; test unconscious patients; used to diagnose alcohol intoxication and determine appropriate therapy; detect alcoholism and to monitor ethanol treatment for methanol intoxication. Must be tested as possible cause of coma of unknown etiology since alcohol intoxication may mimic diabetic coma, cerebral trauma, and drug overdose.

Casein is a major allergen in milk and the main protein constituent in cheese. Milk protein or casein intolerance occurs when the body has a food-specific IgG antibody response to the protein found in milk. This is not to be confused with lactose intolerance, which occurs wheninsufficient amounts of lactase are produced by cells in the small intestine.

Immunoglobulin G (IgG) antibodies to specific allergens have not been proved to be involved in pathogenesis of disease. The presence of IgG against otherwise innocuous antigens (such as foods) in serum simply indicates that the individual has been exposed to antigens that are recognized as foreign entities by the immune system. The presence of food-specific IgG alone cannot be taken as evidence of allergy or autoimmune disease and only indicates immunologic sensitization by the food in question. Consequently, the quantitative IgG test should only be ordered by specialists who recognize the limitations of the test.

Immunoglobulin G (IgG) antibodies to specific allergens have not been proved to be involved in pathogenesis of disease. The presence of IgG against otherwise innocuous antigens (such as foods) in serum simply indicates that the individual has been exposed to antigens that are recognized as foreign entities by the immune system. The presence of food-specific IgG alone cannot be taken as evidence of allergy or autoimmune disease and only indicates immunologicsensitization by the food in question. Consequently, thequantitative IgG test should only be ordered by specialists who recognize the limitations of the test.

The F2-isoprostane/creatinine ratio is the "gold standard" for measuring oxidative stress and has utility in individuals who have lifestyle risks due to poor diet or smoking, a family history of cardiovascular disease, or hyperlipidemia.

Increases in neutral fat are commonly associated with pancreatic exocrine insufficiency.

Increase in stool total fats (neutral fats, soaps, and fatty acids) is likely to be associated with small bowel disease.

Folate is a water-soluble vitamin essential for cell growth and division. RBC folate determination is obtained by measuring the folate concentration in a whole blood (WB) hemolysate solution and dividing it by the patient’s hematocrit (Hct; %). 

This is an intermediary biomarker that is used to calculate Folate, RBC. There is no reference range provided by the laboratory, hence please refer to the actual "Folate, RBC" marker instead.

Folates are compounds of pteroylglutamic acid (PGA) that function as coenzymes in metabolic reactions involving the transfer of single-carbon units from a donor to a recipient compound. Folate, with vitamin B12, is essential for DNA synthesis, which is required for normal red blood cell maturation. Humans obtain folate from dietary sources including fruits, green and leafy vegetables, yeast, and organ meats. Folate is absorbed through the small intestine and stored in the liver.

This test measures the amount of G6PD in red blood cells to help diagnose a G6PD deficiency.

G6PD deficiency is an inherited condition. It is when the body doesn’t have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase).

This enzyme helps red blood cells work correctly. A lack of this enzyme can cause hemolytic anemia. This is when the red blood cells break down faster than they are made.

This test measures the amount of G6PD in red blood cells to help diagnose a G6PD deficiency.

G6PD deficiency is an inherited condition. It is when the body doesn’t have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase).

This enzyme helps red blood cells work correctly. A lack of this enzyme can cause hemolytic anemia. This is when the red blood cells break down faster than they are made.

- Aiding in the prognosis for people diagnosed with heart failure
- Risk-stratification of heart failure people
- An early indication of treatment failure and as a therapeutic target

Galectin-3 can be used in conjunction with clinical evaluation as an aid in assessing the prognosis of people with chronic heart failure. 

Galectin-3 levels >17.8 ng/mL are present in a proportion of people with NYHA class II-IV. Such elevated levels are associated with a more progressive form of heart failure resulting in an increased hazard for death or hospitalization.

This test measures the amount of histamine in the blood.

Histamine is a substance that is released from specialized cells called mast cells when they are activated, often as part of an allergic immune response.

Interleukin 8 (IL-8) is a promising marker for many clinical conditions and currently being applied by various subspecialties of medicine either for the purpose of rapid diagnosis or as a predictor of prognosis. Nevertheless, IL-8 level increased as a result of many inflammatory conditions, so careful interpretation of IL-8 level is required to make correlation with desired clinical condition's diagnosis or prognosis.

Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.

The presence of isopropanol indicates exposure which may result in intoxication and CNS depression. Ingestion of isopropanol can be fatal if patients do not receive immediate medical treatment.

Detect possible allergic responses to various substances in the environment such as animals, antibiotics, foods, grasses, house dust, mites, insects, insulin, molds, smuts, trees, and weeds; evaluate hay fever, asthma, atopic eczema, and respiratory allergy.

This test measures the level of lactic acid, also known as lactate, in your blood. Lactic acid is a substance made by muscle tissue and by red blood cells, which carry oxygen from your lungs to other parts of your body. Normally, the level of lactic acid in the blood is low.

Lactic acid levels rise when oxygen levels decrease.

Low oxygen levels may be caused by:

- Strenuous exercise
- Heart failure
- Severe infection
- Shock, a dangerous condition that limits blood flow to your organs and tissues

If lactic acid levels get too high, it can lead to a life-threatening condition known as lactic acidosis. A lactic acid test can help diagnose lactic acidosis before it causes serious complications.

M-protein is an abnormal protein produced by myeloma cells that accumulates in and damages bone and bone marrow.

Aspergillus species are ubiquitous environmental molds that grow on organic matter and aerosolized conidia (conidia is a spore produced by various fungi at the tip of a specialized hypha).

Aspergillus is a genus of molds that includes several hundred species that grow in nutrient-depleted environments.

Humans inhale hundreds of conidia per day without adverse consequences, except for a small minority of people for whom infection with Aspergillus causes significant morbidity (the condition of suffering from a disease or medical condition). 

The clinical manifestations of aspergillosis are determined by the host immune response to exposure with the spectrum ranging from a simple allergic response to local lung disease with mycelial balls to catastrophic systemic Aspergillus infection.

Melanocyte-Stimulating hormone (MSH) characterizes a group of hormones made by the pituitary gland, hypothalamus, and skin cells. MSH is essential for preserving the skin from ultraviolet rays, the development of pigmentation, and controlling appetite. 

Detecting methanol in cases of accidental ingestion, or intentional ingestion by potential suicide victims or alcoholics.

The presence of methanol indicates exposure which may result in intoxication, central nervous system (CNS) depression, and metabolic acidosis. Ingestion of methanol can be fatal if patients do not receive immediate medical treatment.

MPO levels are associated with an increased risk for:

- Cardiovascular disease

- Myocardial infarction

NT-proBNP is a diagnostic screening tool to differentiate between people with normal and reduced left ventricular systolic function.

A rubella blood test checks to see if you have antibodies to the rubella virus. Antibodies are proteins your immune system makes to help fight infections and keep you from getting sick. They're targeted to specific germs, viruses, and other invaders. Your doctor can tell a lot from the type of antibodies that you have in your blood.

Rubella, also called German measles or 3-day measles, isn't a problem for most people. It causes a mild fever and rash that go away in a few days. Most kids get vaccinated for it with the MMR (measles-mumps-rubella) or MMRV (which also includes chickenpox) shots.

But when you're pregnant, rubella can be very serious. If you get it in the first 4 months, your baby could have eye, hearing, or heart problems or be born too soon.

Sirolimus is often referred to by the brand name Rapamune.

Sirolimus is an immunosuppressant drug used in the prophylaxis of organ rejection in patients receiving transplants.

Sirolimus can be used in combination with ciclosporin, tacrolimus or mycophenolate.

Sirolimus levels are measured in order to establish the correct dose, maintain therapeutic levels and ensure that toxic levels are avoided.

S stercoralis has a complex lifecycle that begins with maturation to the infective filariform larva in warm, moist soil. The larvae subsequently penetrate exposed skin and migrate hematogenously to the lungs, from where they ascend the bronchial tree and are swallowed. Once in the small intestine, filariform larva matures into the adult worms that burrow into the mucosa. Gravid female worms produce eggs that develop into noninfectious rhabditiform larvae in the gastrointestinal tract and are eventually released in the stool. The time from dermal penetration to appearance of Strongyloides in stool samples is approximately 3 to 4 weeks.

The marker “Testost., F+W Bound” stands for Testosterone Free and Weakly Bound. Free and weakly bound testosterone, also referred to as bioavailable testosterone, is thought to reflect an individual’s biologically active, circulating testosterone. It includes free testosterone and testosterone that is bound to albumin. It does not include sex hormone binding globulin-bound testosterone.

Thyroid-binding globulin (TBG) is produced in the liver and is the primary circulating (transport) protein that binds thyroid hormones3,5,3’-triiodothyronine (T3) and thyroxine (T4) and carries them in the bloodstream.

Toxoplasma gondii is an obligate intracellular protozoan parasite that is capable of infecting a variety of intermediate hosts including humans. Infected definitive hosts (cats) shed oocysts in feces that rapidly mature in the soil and become infectious.

Valproate is an alternative drug in the treatment of complex partial seizures but may be considered for initial therapy in patients with partial and secondarily generalized seizures.

Valproic acid is used as an anticonvulsant to treat certain types of seizures, to prevent migraine headaches and to treat various psychiatric illnesses such as bipolar disorder and aggression. Drugs that compete for protein-binding sites with valproic acid can increase the concentration of valproic acid. Therapeutic drug monitoring is useful to optimize dose. Measurement of the free concentration is useful if toxicity is suspected.

Varicella-zoster virus (VZV), a herpes virus, causes 2 distinct rash-associated diseases:

1) chickenpox (varicella) and 2) herpes zoster (shingles).

Chickenpox is a highly contagious, though typically benign, disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure. Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome.

Shingles is an extremely painful condition typically occurring in older nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.

Zinc Transporter 8 Autoantibodies

- ZnT8 antibody distinguishes type 1 and type 2 diabetes mellitus.

- ZnT8 antibody identifies relatives of diabetic patients at most risk for developing diabetes.

- ZnT8 antibody predicts the future need for insulin treatment in adult-onset diabetic patients.

- ZnT8 antibody predicts the future development of diabetes mellitus in women with gestational diabetes.

Detects zinc transporter 8 autoantibodies (ZnT8), an autoimmune diabetes marker that is instrumental in the diagnosis of new-onset type 1 diabetes