Laboratory parameters of the 1st order – obligatory laboratory tests.
- Small blood count
- Differential blood count
- Ferritin – in suspected iron deficiency anemia [↓↓]Note: Ferritin can be measured elevated as a so-called acute phase protein in the context of infections, liver cirrhosis, tumor disease or other inflammatory processes.
- Inflammatory parameters – CRP (C-reactive protein) or ESR (blood sedimentation rate).
- 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).
- Electrolytes – calcium, sodium, potassium, phosphate.
- Total protein, albumin
- Fasting glucose (fasting blood glucose), HbA1c if necessary; oral glucose tolerance test (oGTT).
- HbA1c
- Thyroid parameters – TSH, (fT3, fT4) – if hyper- or hypothyroidism (hyper- or hypothyroidism) is suspected.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH), and gamma-glutamyl transferase (gamma-GT, GGT); alkaline phosphatase, bilirubinNote: chronic hepatitis C virus infection may be associated with normal transaminases and cholestasis parameters.
- Renal parameters – urea, creatinine, possibly cystatin C or creatinine clearanceNote: Cystatin C, is the better parameter for determining renal function; a normal serum creatinine value may already hide a significant restriction of renal function!
- LDL
- Uric acid
- Folic acid
- Vitamin B12
- Zinc
- Test for occult (non-visible) blood in stool – for iron deficiency/stool irregularities.
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Electrophoresis
- Total IgE, specific IgE if necessary, prick testing, epicutaneous testing – if allergy is suspected.
- Antinuclear antibodies (ANA) – e.g. due toautoimmune diseases.
- Anti-mitochondrial antibodies (AMA) – eg due toautoimmune diseases.
- Hepatitis serology (anti-HAV IgM, HBsAg, anti-HBc, anti-HCV), bile acids, anti-mitochondrial antibodies (AMA), perinuclear antineutrophil cytoplasmic antibodies (pANCA), antinuclear antibodies (ANA), smooth muscle antibodies (SMA), soluble liver antigen antibody (SLA), liver-kidney microsomal antibodies (LKM) – for pathological liver values.
- Parathyroid hormone, phosphate, Ca 2+, fT3, fT4, 25-OH-cholecalciferol, TSH receptor AK (TRAK), thyroperoxidase AK (TPO-AK) – in suspected endocrine disease.
- Alpha-fetoprotein (AFP) – in the case of liver cirrhosis/hepatic space-occupying lesion.
- Porphyrins (metabolic diagnostics).
- Tryptase – detection of mast cell involvement in allergic reactions.
- PTH (parathyroid hormone) – in disorders of calcium metabolism, suspected hyper- or hypoparathyroidism, renal insufficiency, nephro- and urolithiasis, malabsorption syndrome, osteopathy.
- Transglutaminase antibodies or endomysium antibodies (EMA) and total IgA in serum – as celiac disease screening; in case of IgA deficiency: genetic test (DNA analysis)/detection of celiac disease-associated HLA-DQ gene constellation, this allows with very high certainty the exclusion of celiac disease.
- HIV antibodies if necessary also lues serology;
- 5-HIES (5-hydroxyindoleacetic acid) in urine – due tocarcinoid diagnostics.
- Histamine in urine – elevated in: Mastocytosis and mastocytoma, type 1 hypersensitivity reactions, CML, carcinoid, polycythaemia vera.
- Bone marrow biopsy and cytology – for suspected leukemia (blood cancer), for example.
- Paraproteins
- Skin biopsy – tissue removal from the skin.
- Pathogen detection from the affected skin area.
