The ischaemic lactate-ammonia test

Ann Clin Biochem 2001;38:304-310
© 2001 Association for Clinical Biochemistry


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Review Articles

Callum Livingstone,
Patrick F Chinnery and
Douglass M Turnbull

The ischaemic lactate-ammonia test is widely used for investigatingpatients with muscle pain and fatigue. It involves measuringplasma lactate and ammonia produced as a result of forearm exerciseunder ischaemic conditions in a fasted subject. Its clinicaluse is to screen patients with muscle complaints for disordersof carbohydrate metabolism, in particular to identify thosein whom further investigation may provide useful diagnosticinformation. There is a wide variety of methods described, reflectingattempts to optimize the response and hence the diagnostic valueof the test. Although it is often considered a general screeningtest for metabolic muscle disease, the situations in which itis useful are specific. Here we review the use of the test andpresent the results of an audit of its use in our departments.

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