Decreased serum calcium values are found in hypoparathyroidism, rickets, osteiomalacia and steatorrhea. A fall in serum calcium can occun in acute pancreatitis and in those forms of renal disease in which excessive proteinuria is observed. Increased serum calcium values are observed in hyperparathyroidism, hypervitamonosis D and multiple myeloma.
Uric acid is the end product of nucleoprotein metabolism. It is a low threshold excretory product. the serum uric acid level is ofter raised in gout. the determination has diagnostic value differentiating gout from non gout arthritis. uric acid levels are also increased in renal failure, uremia and leukemia.
The exocrine pancreas and salivary gland produce alpha amylase . Human amylase is termed as alpha amylase becouse of its ability to split plsaccharide 1 - 4 linkage in random manner. the end products of alpha amylase action are dextran, maltose and some glucose molecules .alpha amylase helps in the digestion of starch.
Increased activity of alpha amylase is found in , acute and chronic pancreatitis, pancreatic carcinoma, neuplastic,Hyperamylasemia, perforated peptic ulcer Intestinal obstruction, acute appendictis , burns and traumatic shock, diabetic ketoacidosis, , Reanal transplantation, acute alcoholism and due to drugs, medicinal opiates, heroin adiction.
A decreased concentration of serum amylase may be found in acute or chronic hepatocellular dammage but this is not done sensitive liver function test.
After an attack of acute pancreatitits , the serum lipase activity increases within 4 - 8 hrs., peaks at about 24 Hrs. and decreased within 8 - 14 days. Serum lipase levels remain elevated longer than those of amylase. Lipase elevations usually parallal those of amylase but increases in lipase activity may occur sooner or later than increases in amylase activity. Elevations between 2 & 50 times, the upper reference limit have been reported.
Serum lipase assays may also be of value in diagnosis of chronic pancreatitis and in obstruction of the pancreatic duct by a calculus or carcinoma of the pancreas. In acute and chronic renal disease, increased serum lipase activity is observed.
Elevated levels of blood urea nitrogen are observed in pre renal , renal and post renal conditions .
Pre renal conditions .. diabetes mellitius, dehydration, cardiac failure , hematemesis, severe burns, high fever etc..
Renal conditions.. disease of kidneys.
Post renal conditions.. inlargement of prostate, stones in the urinary tract, tumor of the bladder . Decreased values have been reported in severe liver disease, protein malnutrition & pregnency.