Laboratory parameters of the 1st order – obligatory laboratory tests.
- Small blood count
- Differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Calprotectin or lactoferrin (fecal inflammatory parameters) – if chronic bowel disease or chronic inflammatory bowel disease (eg, Crohn’s disease, ulcerative colitis) is suspected.
- Pancreatic parameters – amylase, elastase (in serum and stool), lipase.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – if myocardial infarction (heart attack) is suspected.
- Test for occult (not visible) blood in the stool.
- Pregnancy test (quantitative HCG)
Laboratory parameters 2nd order – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification.
- Dysbacteria analysis of the stool (intestinal flora analysis).
- Stool examination for enteropathogenic germs, fungi, parasites and worm eggs (here: lamblia).
- Adrenal parameters – ACTH, aldosterone, renin.
- Serological examination – if bacterial, viral or parasitic infections are suspected.
- Tumor markers – depending on the suspected diagnosis.
- Celiac disease screening – transglutaminase antibody or endomysium antibody (EMA) and total IgA in serum; in case of IgA deficiency: molecular genetic testing – genetic test (DNA analysis)/detection of celiac disease-associated HLA-DQ gene constellation, this allows with very high certainty the exclusion of celiac disease.
Further notes
- Recurrent abdominal pain in children: Minimal program to exclude organic causes:
- Determination of fecal calprotectin (calprotectin in stool),
- Determination of transglutaminase antibodies (anti-tTG), and.
- Examination for lambliae in the stool.
The three laboratory parameters achieve a hit rate for an underlying organic disease in the range of 88%.
