Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (998 page)

   Monitoring therapy for DKA.

   Investigating the differential diagnosis of any patient presenting to the emergency department with hypoglycemia, acidosis, suspected alcohol ingestion, or an unexplained increase in the AG.

   In pediatric patients, the presence or absence of ketonemia/urea is an essential component in the differential diagnosis of inborn errors of metabolism.

   Key parameter monitored during controlled 24-hour fasts.

   Interpretation

Increased In

   Alcoholic ketoacidosis

   Lactic acidosis (shock, renal failure)

   Liver disease

   Infections

   Phenformin and salicylate poisoning

   Limitations

   Not detectable by common tests for ketone bodies

   The nitroprusside test (Acetest) may give false-negative readings because it does not detect BHB.

IMMUNOGLOBULIN A (IgA)

   Definition