Ahai Luvai

The Newcastle upon Tyne Hospitals NHS Foundation Trust · Department of Laboratory Medicine

Background: Vitamin B12 status is assessed primarily by total serum B12 using competitive binding methods. The lack of availability of a standard material, and high-level reference measurement procedure affects the trueness of B12 results. This results in variation between methods. This study aimed to determine the reference intervals for vitamin...

Objectives To validate a nurse-led process using electronic health records to identify those at risk of Familial Hypercholesterolaemia (FH) for genetic diagnosis in primary care. Design Those at risk of FH were identified using searches developed and refined locally and implemented in primary care by a trained nurse; they were invited for further...

Background: Harmonization of reference intervals for analytes that have a sound calibration and metrological traceability is a widely recommended practice. The UK Pathology Harmony has recently harmonized reference intervals for calcium and albumin. In this study, we have determined the reference intervals for calcium and albumin on the UK's most...

Familial dysbetalipoproteinemia (type III hyperlipoproteinemia) is a potentially underdiagnosed inherited dyslipidemia associated with greatly increased risk of coronary and peripheral vascular disease. The mixed hyperlipidemia observed in this disorder usually responds well to appropriate medical therapy and lifestyle modification. Although there...

Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce...

Methods: We studied a reference population of healthy adult subjects and measured free thyroxine and TSH by the four most commonly used analytical platforms used in the UK. Subjects were excluded if they were >65 years or had positive thyroid peroxidase antibodies. We also performed a systematic literature review of thyroid hormone reference inter...

Introduction: Laboratories are recommended to determine their own local reference intervals (RIs) to embrace the variations in local populations. We have assessed local RIs for thyroid function tests using two different approaches to selection of reference populations and also searched the literature for studies using the Advia Centaur methods. M...

Background Patients with end-stage renal failure (ESRF) exhibit a chronic elevation of serum cardiac troponin (cTn) concentration. In order to facilitate the diagnosis of myocardial infarction (MI) in these patients, it is necessary to distinguish an increased cTn concentration due to an acute event, from that being a manifestation of chronic eleva...

Macrocomplexes between immunoglobins and aspartate aminotransferase (macro-AST) may result in persistently increased AST concentration. The presence of macro-AST in patients has been implicated in unnecessary investigations of abnormal liver function tests. We report the case of a 44-year-old female who presented to the rheumatology clinic with a 1...

Variegate porphyria is an autosomal dominant acute hepatic porphyria characterized by photosensitivity and acute neurovisceral attacks. Hepatocellular carcinoma has been described as a potential complication of variegate porphyria in case reports. We report a case of a 48-year-old woman who was diagnosed with hepatocellular carcinoma following a br...

Phenylketonuria (PKU), is an autosomal recessive condition affecting the amino acid metabolism. The UK National newborn screening programme was commenced in 1969 and PKU is one among the five conditions included in the screening programme. We present the case history of two siblings of a family with a delayed diagnosis of PKU. This case history hig...

A 27 year old man was referred to the clinic for further evaluation after he developed sudden left sided facial droop, right sided visual loss, and slurred speech. Two months previously he had elective corneal transplantation of the left eye. At the age of 22 years he had experienced an episode of sagittal sinus thrombosis for which he had received...

Rosuvastatin is a new generation HMG-CoA reductase inhibitor which exhibits some unique pharmacologic and pharmacokinetic properties. It has low extrahepatic tissue penetration, low potential for CYP3A4 interactions and substantial LDL-C lowering capacity and therefore has distinct advantages. We conducted a Medline literature search to identify ro...

This case based discussion focuses on a lady with hypercholesterolaemia following an acute admission for severe sepsis. We will discuss the assessment, differential diagnosis and management of secondary hyperlipidaemia. Case History A 52 year old lady with unusually elevated cholesterol is referred to the lipid clinic a few weeks after an acute adm...