Biopsy Case Studies

Abstract. An unknown blue copper (#32) was measured by iodometry with sodium thiosulfate. The procedure from the lab handout Iodometric Determination of Copper was followed. The thiosulfate was standardized by titrating KIO3 with starch in acidic conditions to produce triiodide. Starch is the indicator for iodine having the appearance of a blue complex; starch was added before the endpoint in order for the endpoint to be sharp since there is low concentration of iodine. After the thiosulfate was standardized, the unknown copper titration was performed. Sodium acetate was added to the copper analyte before titration to increase the pH to 3. The pH is raised to 3 because a low pH would produce extra triiodide, and a high pH would produce

Positive ANA titer (1:1280); elevated antibodies against double-stranded DNA; low C3 level (73 mg/dl); all else (platelets, direct/indirect Coombs tests/anti-phosopholipid Abs) normal.

Progressive hepatolenticular disease, or more commonly known as Wilson’s Disease, is a rare autosomal recessive genetic disorder of copper metabolism that is characterized by hepatic and neurological disease. While there is no cure for Wilson’s Disease, there are several treatments that can effectively manage the symptoms. The predominant form of treatment for Wilson’s Disease is heavy metal toxicity medication which utilize copper chelators to prompt the organs in the body to release copper into the bloodstream and excreted via urine after kidney filtration or zinc to reduce copper absorption (Ala et. al, 2007). Medications for Wilson’s Disease include penicillamine, trientine, and zinc acetate. Besides medications, other current therapeutic

If your hs-CRP level is 3.0 mg/L or higher, your risk of developing heart or blood vessel disease is high.

The level of pre-albumin is (from 0.2 to 0.3 g /L). In the liver disease the levels of pre-albumin decreased because decrease the synthesis. Due to it has short half-life. Pre-albumin was considered useful to determine the drug that causes hepatotoxicity.

Therefore, proteins upset the balance when they leave through the kidneys. Since you are negative for protein in the urine, you definitely don’t have kidney issues. Your liver function can also be measured by a urinalysis because of bilirubin, and uribilinogen. When your body breaks down old red blood cells they form bilirubin, which goes through the liver. That bilirubin is then converted to urobilinogen, which is 0.0 in your analysis.

Choice “D” is the correct answer. The combination of neurological symptoms, Kayser–Fleischer rings a low ceruloplasmin level, paradoxically low free serum copper level (which is carried by ceruloplasmin) and high urinary copper excretion is supportive of a diagnosis of Wilson's disease. The mainstay of therapy for Wilson disease is the use of chelating agents and medications that block copper absorption from the gastrointestinal (GI) tract. Zinc and penicillamine are lifelong medications for patients with Wilson disease.

Hemoglobin Electrophoresis was performed to support and give a more defined result of what the problem was. Hemoglobin Electrophoresis measures the different types of hemoglobin’s in the blood. This occurs by an electrical current being passed through the hemoglobin in a blood sample causing different types of hemoglobin to separate and form bands. The different bands include Hgb (hemoglobin) A1, Hgb A2, Hgb F, Hgb S and Hgb C. The most common type of Hemoglobin found in health children and adults is Hgb A1 which makes up 95% - 98% of the total hemoglobin. Hgb F is found in

According to Pagana and Pagana (2014), the normal range of CRP for children is less than 10.0 mg/L where as my patient’s CRP level was 11.5 mg/L (p. 184). The infections in patient’s right ankle and oral lesions most likely have triggered the liver to produce CRP during an acute inflammatory process. However, a CRP test can only detect the presence of an inflammatory illness, but not the cause or the location of the illness. Compared to ESR, the CRP test is more sensitive and responds more rapidly in an acute inflammatory change. Even though the levels of CRP increase earlier and more intensely during an inflammatory process, they decrease rapidly and return to normal levels before the ESR normalizes when the infection has been resolved (Pagana and Pagana,

A hematocrit and hemoglobin value can provide with an indirect measurement for levels of RBC’s in the blood and how much hemoglobin there is in the blood. My patients Hct was 29.3L on 10/25 which is higher than a few days prior which was 24.5L but lower than admit day 10/17 32.3L. A low level of RBC’s can indicate anemia or hemorrhage but not immediately after, not until the blood volume is replaced with fluids (Pagana et. al. 2014). However, in her case low levels of H&H are also a consequence of hemodialysis. The patients Hgb was 9.1L on 10/25 but 10.5L on admit 10/17 her lowest being 10/21 at 7.9L. This value can also indicate anemia due to decrease of RBC’s which is also an indicator of the rapid blood loss through hemodialysis or through

Ceruloplasmin is a serum ferroxidase that carries more than 90 % of copper in plasma and plays an important role in iron homeostasis as well as antioxidative functions [105]. Ceruloplasmin best known as copper binding protein, found in the plasma of vertebrate species, and is mainly synthesized by the liver [106]. After ceruloplasmin was originally isolated from plasma by Holmberg and Laurell [107], this protein quickly became the subject of many investigations concerning its function, molecular structure and the physical properties of the copper ions bound to it [106, 108-111]. The ceruloplasmin gene was identified on the human 3q25 chromosome with a molecular weight of ~132 kDa [112]. The molecule is composed of six compact domains, with large loop insertions, and is characterized by the presence of three types of spectroscopically distinct copper sites.

The first is whether or not the patient has polycythemia. This can be determined by a complete blood count to evaluate the hemoglobin, hematocrit, and red blood cell concentration. Diagnosis of Polycythemia Vera includes a hemoglobin level greater than 18.5 g/dl (16.5 g/dl in women) and genetic testing for JAK2 mutations (The Editors of Encyclopædia Britannica, 2014). Erythropoietin levels are a secondary determinate (The Editors of Encyclopædia Britannica, 2014) and in Primary polycythemias tend to be normal or low, as the issue pertains more to precursor over-sensitivity to erythropoietin as opposed to an overabundance of erythropoietin. In secondary polycythemias, this level would be expected to be elevated.

Low serum albumin levels are usually associated with acute glomerulonephritis, the normal albumin levels for Patient B implies that acute glomerulonephritis could be eliminated from list of conditions provided. Thus suggested for both Patient B and Patient N there were no leakage of the serum albumin in the urine. Nevertheless, (McClatchey, 2002) identified that low albumin levels may also signify impaired liver function. Conditions such as hepatic cirrhosis and chronic hepatic cirrhosis can also be dismissed because of the normal level of albumin in blood. This implies that no anomalies were present thus signifying accurate results.

Sensitivity: probability that the test results will be positive when the disease is present (true positive rate, expressed as a percentage); Specificity: Probability that the test results will be negative when the disease is present (true negative rate, expressed as a percentage); Positive Predictive value (PPV: probability that the disease is present when the test is positive); Negative Predictive value (NPV: probability that the disease is present when the test is negative) and accuracy is the ratio of the true positive and true negative on all patients. Result was considered significant at a P value of 400ml/24hrs). Oliguria was found in 25% of severe preeclampsia cases as shown in Table (1).