Newcastle Laboratories

Lactate and Pyruvate, blood

Clinical Background:

Disturbed lactate and pyruvate metabolism can have a wide variety of causes ranging from hypoxia to inherited disorders of the mitochondrial respiratory chain, gluconeogenesis, pyruvate metabolism ...

Disturbed lactate and pyruvate metabolism can have a wide variety of causes ranging from hypoxia to inherited disorders of the mitochondrial respiratory chain, gluconeogenesis, pyruvate metabolism and also secondary to other inherited metabolic disorders.

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Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    PCA tube (obtained from Metabolic laboratory, ext 20334; or from selected GNCH wards)

    Tube must be labelled with patient details.

    PCA tube (obtained from Metabolic laboratory, ext 20334; or from selected GNCH wards)

    Tube must be labelled with patient details.

  • Specimen Container Paediatric:

    PCA tube (obtained from Metabolic laboratory, ext 20334; or from selected GNCH wards)

    Tube must be labelled with patient details.

    PCA tube (obtained from Metabolic laboratory, ext 20334; or from selected GNCH wards)

    Tube must be labelled with patient details.

  • Minimum Volume Adult:

    0.5 - 1 mL blood

    0.5 - 1 mL blood

  • Minimum Volume Paediatric:

    0.5 - 1 mL blood

    0.5 - 1 mL blood

  • Special Requirement:

    Lactate and pyruvate measured on the same sample.

    Lactate and pyruvate measured on the same sample.

  • Transport Requirements:

    Sample transported to the laboratory in a plastic bag on ice.

    Whole blood should be frozen on receipt to the laboratory and kept frozen during transport to the RVI.

    Sample transported to the laboratory in a plastic bag on ice.

    Whole blood should be frozen on receipt to the laboratory and kept frozen during transport to the RVI.

  • Other Info:

    Hypoglycaemia is usually defined as a blood glucose of less than 2.6 mmol/l but the blood glucose of some healthy children will fall below this if they are fasted for more than 20 hours, so the res...

    Hypoglycaemia is usually defined as a blood glucose of less than 2.6 mmol/l but the blood glucose of some healthy children will fall below this if they are fasted for more than 20 hours, so the response to fasting requires careful assessment. Any child who becomes symptomatic or whose blood glucose falls below 2.6 mmol/l by 16 hours is abnormal until proved otherwise. The blood lactate should remain less than 2 mmol/l throughout the fast, but if the child is struggling the concentrations are likely to be falsely elevated. Raised lactate levels at the time of hypoglycaemia suggest a defect of gluconeogenesis. Acetoacetate and 3-hydroxybutyrate concentrations rise during the fast and are related to the free fatty acid concentration. Low ketone body levels relative to the NEFA concentration suggest a fatty acid oxidation disorder. Hyperinsulinism should be suspected if the plasma insulin level exceeds 5 IU/l at the time of hypoglycaemia with low circulating levels of non-esterified fatty acids (NEFA) and ketones. If the plasma cortisol level is less than 400 mmol/l at the time of hypoglycaemia, adrenocortical insufficiency should be considered. Glucagon stimulation tests are needed if hypopituitarism is suspected: in normal children, growth hormone levels are not always elevated at the time of fasting hypoglycaemia.

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  • Routine Contact Name:

    Duty Biochemist

  • Routine Telephone:

    Freeman: 0191 244 8889

    RVI: 0191 282 9719

    Freeman: 0191 244 8889

    RVI: 0191 282 9719

  • Routine Email:

  • Specialist Test:

    Yes

    Yes

  • Specialist Contact Name:

    Metabolic Clinical Scientist

    Metabolic Clinical Scientist

  • Specialist Telephone:

    0191 282 9685 (Consultant Clinical Scientist)

    0191 282 0334 (Metabolic Laboratory)

    0191 282 9685 (Consultant Clinical Scientist)

    0191 282 0334 (Metabolic Laboratory)

  • Specialist Email:

Availability:

Available during full access hours
Assayed weekly
Site of analysis: RVI

Turn Around:

Within 1 week

Send To:

Department of Blood Sciences

Level 3
Leazes Wing
Royal Victoria Infirmary
Queen Victoria Road
Newcastle upon Tyne
NE1 4LP

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