Bone Panel – Ca, PO4, ALP, Albumin
Code:
BONE
Sample Type:
Serum (Gold Top)
Minimum volume: 2 mL
Ref Ranges/Units:
Ca – 2.20 – 2.60 mmol/L
PO4 – 0.8 – 1.5 mmol/L
ALP – 30 – 130 U/L
Total protein 60 – 80 g/L
Albumin 35 – 50 g/L
Ca results <1.8 mmol/L and >3.5 mmol/L will be phoned to the requesting clinician.
PO4 results <0.3 mmol/L will be phoned to the requesting clinician.
Turnaround:
Same Day (60 minutes from receipt for Urgent Samples).
Special Precautions/Comments:
Additional Information:
Panel of tests to investigate bone disease (defects in bone turnover and mineralization).
Albumin – Measured for calculation of the adjusted calcium.
Calcium – adjusted for albumin concentration. Adjusted calcium cannot be calculated at extremes of albumin. A raised calcium may indicate excess bone resorption (e.g. primary hyperparathyroidism) or malignancy (e.g. erosion of bone, multiple myeloma). A low calcium may indicate rickets/osteomalacia or vitamin D deficiency.
Phosphate (PO4) – low phosphate may indicate rickets/osteomalacia or vitamin D deficiency.
Alkaline phosphatase (ALP) – enzyme found in bone, liver, intestine and placenta. Bone ALP is a marker of bone formation and is therefore higher in children than adults. Increased ALP in the presence of hypocalcaemia and hypophosphatemia may indicate rickets/osteomalacia. An isolated increased ALP may be suggestive of Paget’s disease. ALP is also increased in pregnancy.
Total protein – increased total protein may warrant a myeloma screen.
Second line tests may include: parathyroid hormone (PTH), magnesium and 25-Vitamin D
South of Tyne & Wear Pathology Centre
