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Glucose, Fluid (GLF)

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EPIC Test Name

GLUCOSE, BODY FLUID

EPIC Code

LAB186

Specimen Requirements

fluid
Minimum Volume:2 mL
Collection:Collect specimens using standard laboratory procedures.
Transport:Room Temperature ASAP
Stability:After separation,
Room Temperature: 8 hours at 25 degrees C
Refrigerated: 72 hours at 4 degrees C
Container:FL
Processing/Storage:Separate from cellular material ASAP

Methods

Photometric assay using Hexokinase

Turnaround Time

SpecimenTurnaround TimeFrequency
fluid1 day24/7

Reference Ranges

Photometric assay using Hexokinase
All RangeUnit
Not established.mg/dL

Clinical Indications

Body fluid glucose concentrations can be used as an indicator of infection or possibly malignancy.
Glucose levels in a body fluid lower than expected indicate increased cellularity and, therefore, glycolysis occurrence. Ideally, measurements are done using the samples collected in fasting state.

Performed

Lab
Chemistry - Community
Chemistry - Downtown

Interpretative Information

Pleural fluid:
Low glucose typically <60 mg/dL can be associated with: (1) parapneumonic effusion; (2) malignancy; (3) tuberculosis; (4) rheumatoid pleuritis (lupus has normal glucose); (5) hemothorax. When <40 mg/dL and presence of infection, chest tube insertion is indicated

Peritoneal fluid:
Resutls of ascitic fluid glucose should be interpreted with consideration of serum glucose. In noninfected patients with alcohol-related cirrhosis, the mean (SD) ascitic fluid-to-serum glucose ratio was 1.04 (0.25). Ascitic fluid glucose can be used for distinguishing spontaneous bacterial peritonitis from secondary peritonitis caused by bowel perforation. Secondary peritonitis is likely indicated if 2 of the 3 following criteria are met:
1. Total protein is greater than 1 g/dL
2. Lactate dehydrogenase is greater than 225 IU/L (or greater than the upper limit of normal for serum)
3. Glucose is less than 50 mg/dL.

Pericardial fluid:
Exudates differed from transudates by higher leukocyte counts and ratios of fluid to serum lactate dehydrogenase levels. Glucose levels in fluid is significantly less in exudates. Exudates features with: specific gravity > 1.015 (90% cases), fluid total protein > 3.0 g/dL (97%), fluid to serum protein ratio > 0.5 (96%), fluid LDH ratio > 0.6 (94%), and fluid to serum glucose ratio < 1.0 (85%). None of these indicators were specific.
Amniotic fluid:
chorioamnionitis (Intraamniotic infection) is an acute inflammation of the fetal membranes due to bacterial infection, followed by an inflammatory response, resulting in labor and term or preterm birth. Chorioamnionitis may occur often during prolonged labor or following membrane rupture as bacteria gain opportunity to ascend along the lower genital tract to colonize in the uterus. Diagnosis and treatment at early stage for chorioamnionitis is critical to avoid maternal and fetal morbidity and mortality. Culture and Gram Stain are often employed for detecting infection, however, lacks sensitivity and culture results are not available in a timely enough manner for making clinical decisions. Decreased glucose concentrations are associated with positive culture results and poor prognosis.

Synovial fluid:
Normally, synovial fluid glucose concentrations are similar to fasting serum. Low synovial fluid glucose concentration is associated with septic arthritis or inflammation.

CPT

82945

LOINC

2344-0

References

Meyers DG, Meyers RE, Prendergast TW. The usefulness of diagnostic tests on pericardial fluid.
Chest. 1997;111:1213-21. doi: 10.1378/chest.111.5.1213.
Wilson JA, Suguitan EA, Cassidy WA, Parker RH, Chan CH: Characteristics of ascitic fluid in the alcoholic cirrhotic. Dig Dis Sci. 1979;24:645-8.
Runyon BA, Hoefs JC: Ascitic fluid analysis in the differentiation of spontaneous bacterial peritonitis from gastrointestinal tract perforation into ascitic fluid. Hepatology. 1984;4:447-50.
Tita AT, Andrews WW: Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010;37:339-54.
Gonzalez-Bosquet E, Cerqueira MJ, Dominguez C, Gasser I, Bermejo B, Cabero Ll: Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes. J Matern Fetal Med. 1999;8:155-8.
Margaretten ME, Kohlwes J, Moore D: Does this adult patient have septic arthritis? JAMA. 2007;297:1478-1488.

Contact Information

Chemistry - Downtown: (315)464-4460
Chemistry - Community: (315)492-5531
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