Clinical Chemistry

Background

We have come a long way from those test tubes and bunsen burners you played with in school. These tests include the routine glucose levels to cutting edge cancer screening tests for prostate cancer. In addition, the pathologist has now moved into the realm of molecular biological testing, screening patients for mutations of susceptibility genes for different cancers like breast cancer.

Albumin, Ischemia-Modified

alpha fetoprotein (AFP)

B-Natriuretic peptide (BNP)

BRCA1 and BRCA2

CA15-3

CA19-9

CA-125

Calcium

Carbohydrate-deficient transferrin (CDT)

Cardiac Enzymes

Catecholamines

CCP (Anti-Cyclic Citrullinated Peptide)

CEA

Coenzyme Q10

Copper

C-reactive protein (CRP)

Cystatin C

Cytokines

Digoxin

Early Prostate Cancer Antigen (EPCA)

Electrolyte Panel (sodium, potassium, chloride,bicarbonate)

Folate (Folic Acid)

GGT (Gamma glutamyltransferase)

Her2-neu

Homocysteine

HCG

Iron

Lipid Panel

Liver Panel

Newborn Screening

Pregnancy Laboratory Testing (Triple Test)

PSA (Prostate Specific Antigen)

Testosterone

Thyroid Panel

Tumor Markers

Urinalysis

OUTLINE

Interfering Diseases or Substances that Alter Levels

Commonly Used Terms

Internet Links

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INTERFERING DISEASES OR SUBSTANCES THAT ALTER LEVELS CHARACTERIZATION

GADOLINIUM MRI CONTRAST AGENTS

Gadolinium Magnetic Resonance Contrast Agents Produce Analytic Interference in Multiple Serum Assays

William L. Roberts, MD, PhD Am J Clin Pathol 2004;121:282-292 Abstract quote

Gadolinium magnetic resonance contrast agents are known to interfere with some clinical chemistry tests, particularly colorimetric assays for serum calcium.

We studied the effects of 4 agents, gadodiamide, gadoversetamide, gadopentetate dimeglumine, and gadoteridol, for interference with multiple serum assays. Gadodiamide and gadoversetamide produced clinically significant negative interference with colorimetric assays for serum angiotensin-converting enzyme, calcium, and zinc. These agents produced clinically significant positive interference in magnesium and total iron binding capacity assays and both positive and negative interference in iron assays. Gadopentetate dimeglumine produced a negative interference with iron assays, and gadopentetate dimeglumine and gadoteridol produced negative interference with a colorimetric zinc assay.

Caution should be exercised when using colorimetric assays for angiotensin-converting enzyme, calcium, iron, magnesium, total iron binding capacity, and zinc in serum samples from patients who have recently received magnetic resonance contrast agents. In general, gadodiamide and gadoversetamide are more likely to produce a clinically significant interference than gadopentetate dimeglumine and gadoteridol. Likewise, certain analytic methods are more prone to interference, while others not affected.

Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.

Commonly Used Terms

Basic Principles of Disease
Learn the basic disease classifications of cancers, infections, and inflammation

Commonly Used Terms
This is a glossary of terms often found in a pathology report.

Diagnostic Process
Learn how a pathologist makes a diagnosis using a microscope

Surgical Pathology Report
Examine an actual biopsy report to understand what each section means

Special Stains
Understand the tools the pathologist utilizes to aid in the diagnosis

How Accurate is My Report?
Pathologists actively oversee every area of the laboratory to ensure your report is accurate

Got Path?
Recent teaching cases and lectures presented in conferences

Internet Links

Last Updated August 11, 2005

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Interfering Diseases or Substances that Alter Levels
Commonly Used Terms
Internet Links

INTERFERING DISEASES OR SUBSTANCES THAT ALTER LEVELS	CHARACTERIZATION
GADOLINIUM MRI CONTRAST AGENTS
Gadolinium Magnetic Resonance Contrast Agents Produce Analytic Interference in Multiple Serum Assays William L. Roberts, MD, PhD	Am J Clin Pathol 2004;121:282-292 Abstract quote Gadolinium magnetic resonance contrast agents are known to interfere with some clinical chemistry tests, particularly colorimetric assays for serum calcium. We studied the effects of 4 agents, gadodiamide, gadoversetamide, gadopentetate dimeglumine, and gadoteridol, for interference with multiple serum assays. Gadodiamide and gadoversetamide produced clinically significant negative interference with colorimetric assays for serum angiotensin-converting enzyme, calcium, and zinc. These agents produced clinically significant positive interference in magnesium and total iron binding capacity assays and both positive and negative interference in iron assays. Gadopentetate dimeglumine produced a negative interference with iron assays, and gadopentetate dimeglumine and gadoteridol produced negative interference with a colorimetric zinc assay. Caution should be exercised when using colorimetric assays for angiotensin-converting enzyme, calcium, iron, magnesium, total iron binding capacity, and zinc in serum samples from patients who have recently received magnetic resonance contrast agents. In general, gadodiamide and gadoversetamide are more likely to produce a clinically significant interference than gadopentetate dimeglumine and gadoteridol. Likewise, certain analytic methods are more prone to interference, while others not affected.