{"id":208,"date":"2025-06-11T12:13:37","date_gmt":"2025-06-11T12:13:37","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=208"},"modified":"2025-08-08T13:57:53","modified_gmt":"2025-08-08T13:57:53","slug":"acid-delta-aminolevulinic","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/acid-delta-aminolevulinic\/","title":{"rendered":"Acid delta-aminolevulinic"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u0163ii generale \u2013 Acid delta-aminolevulinic (ALA)<\/strong><\/h2>\n<p>Acidul delta aminolevulinic (ALA)\u00a0este rezultatul condens\u0103rii dintre succinil \u2013 coenzima A \u015fi glicin\u0103 \u00een etapa ini\u0163ial\u0103 de sintez\u0103 a hemului, ce se desf\u0103\u015foar\u0103 la nivelul mitocondriilor.<\/p>\n<p>Excre\u0163ia urinar\u0103 a ALA poate cre\u015fte fie din cauza unor deficien\u0163e congenitale ale enzimelor implicate \u00een formarea hemului, fie ca urmare a prezen\u0163ei unor anomalii enzimatice dob\u00e2ndite (ex: induse de alcool, intoxica\u0163ia cu plumb, sarcin\u0103). Dac\u0103 activitatea enzimatic\u0103 este redus\u0103, porfirinele \u015fi precursorii acestora se acumuleaz\u0103 \u00een \u0163esuturi \u015fi determin\u0103 apari\u0163ia de simptome neuroviscerale (dureri abdominale, grea\u0163\u0103, v\u0103rs\u0103turi, constipa\u0163ie, mialgii, hipertensiune arterial\u0103, reten\u0163ie urinar\u0103, anxietate, insomnie, halucina\u0163ii, paranoia \u015fi ocazional comportament psihotic) \u015fi modific\u0103ri de laborator caracteristice fiec\u0103rui sindrom.<\/p>\n<p>ALA \u015fi <a href=\"https:\/\/www.synevo.ro\/shop\/porfobilinogen-in-urina\/\" target=\"_blank\" rel=\"noopener\" data-wpel-link=\"internal\">porfobilinogenul<\/a> sunt testele de elec\u0163ie pentru porfiria acut\u0103 intermitent\u0103. Plumbul stimuleaz\u0103 activitatea citocromului P450 \u015fi implicit a ALA-sintetazei, explic\u00e2nd astfel acumularea de ALA din s\u00e2nge \u015fi urin\u0103 asociat\u0103 cu saturnismul<sup>3<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea acidului delta aminolevulinic\u00a0 <\/strong><\/h2>\n<ul>\n<li>porfiriile acute (porfiria acut\u0103 intermitent\u0103, porfiria variegat\u0103, coproporfiria ereditar\u0103, deficitul dehidrazei acidului aminolevulinic);<\/li>\n<li>intoxicatii acute \u015fi cronice cu plumb \u015fi alte metale grele;<\/li>\n<li>tirozinemia ereditar\u0103<sup>4<\/sup>.<\/li>\n<\/ul>\n<h2><strong>Preg\u0103tirea pacientului<\/strong><\/h2>\n<div>Se va evita consumul de alcool \u015fi ingestia excesiv\u0103 de lichide pe perioada recolt\u0103rii probei.<\/div>\n<div>Pentru ob\u0163inerea unor rezultate relevante este de preferat s\u0103 se \u00eentrerup\u0103 administrarea oric\u0103rui medicament ce poate interfera cu testarea ALA cu 2-4 s\u0103pt\u0103m\u00e2ni \u00eenaintea recolt\u0103rii<sup>2<\/sup><sup>;<\/sup><sup> 5<\/sup>.<\/div>\n<div><\/div>\n<p><strong>Specimen recoltat <\/strong>\u2013 urina de 24 ore: la ora 7 diminea\u0163a pacientul urineaz\u0103 \u015fi nu re\u0163ine aceast\u0103 urin\u0103; apoi colecteaz\u0103 \u00eentr-un vas curat de 2-3 litri toate emisiunile de urin\u0103 p\u00e2n\u0103 la ora 7 diminea\u0163a\u00a0\u00een ziua urm\u0103toare, inclusiv; omogenizeaz\u0103 (prin agitare) urina recoltat\u0103; m\u0103soar\u0103 \u00eentreaga cantitate; re\u0163ine aprox. 10mL\u00a0\u00een pahar de plastic de unic\u0103 folosin\u0163\u0103 pentru urin\u0103. Proba se \u0163ine la 2-8\u00b0C\u00a0\u00een timpul colect\u0103rii \u015fi ulterior p\u00e2n\u0103 se lucreaz\u0103 efectiv. De asemenea se va evita expunerea la lumin\u0103 a probei prin acoperirea complet\u0103 at\u00e2t a recipientului de recoltare c\u00e2t \u015fi a celui de transport\/stocare cu ajutorul unei folii de aluminiu<sup>5<\/sup>.<\/p>\n<p><strong>Recipient de recoltare <\/strong>\u2013 vas de 2-3 litri \u015fi pahar de plastic de unic\u0103 folosin\u0163\u0103 pentru urin\u0103, pe care se noteaz\u0103 cantitatea total\u0103 de urin\u0103 din 24 ore<sup>5<\/sup>.<\/p>\n<p><strong>Cantitate recoltat\u0103 <\/strong>\u2013 10 mL<sup>5<\/sup>.<\/p>\n<p><strong>Cauze de respingere a probei <\/strong>\u2013 specimen care nu a fost p\u0103strat la 2-8\u00b0C; specimen care a fost expus la lumin\u0103<sup>5<\/sup>.<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare <\/strong>\u2013 este de preferat s\u0103 se lucreze imediat; dac\u0103 acest lucru nu este posibil, proba se poate stoca la 2-8\u00b0C<sup>5<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013 1 saptamana la -20\u00b0C<sup>5<\/sup>.<\/p>\n<p><strong>Metod\u0103 <\/strong>\u2013 fotometric\u0103<sup>5<\/sup>.<\/p>\n<h2><strong>Valori de referin\u0163\u0103 Acid delta-aminolevulinic<\/strong><\/h2>\n<p>&lt;6 mg\/24h.<sup>5<\/sup><\/p>\n<p>Factor de conversie: mg\/24h x 7.626 = \u03bcmol\/24h<sup>5<\/sup>.<\/p>\n<h2><strong>Interpretarea rezultatelor<\/strong><\/h2>\n<p>Valori considerabil crescute ale ALA urinar\u00a0 (&gt; 300 \u03bcmol\/24h) \u015fi PBG se \u00eent\u00e2lnesc\u00a0\u00een timpul atacului acut al porfiriei variegat\u0103,\u00a0\u00een porfiria acut\u0103 intermitent\u0103 \u015fi intoxica\u0163ia cu plumb, f\u0103r\u0103 a exclude \u00eens\u0103, coproporfiria ereditar\u0103 \u015fi porfiria cu deficit de ALA dehidraz\u0103<sup>4<\/sup>. Dup\u0103 un episod acut, \u00een porfiria variegat\u0103 valorile ALA revin la normal, spre deosebire de porfiria acut\u0103 intermitent\u0103 \u015fi coproporfiria ereditar\u0103.<\/p>\n<p>Anumite afec\u0163iuni, cum ar fi: porfiria acut\u0103 hepatic\u0103 ereditar\u0103 \u2013 faza latent\u0103, intoxica\u0163ia cronic\u0103 cu plumb \u2013 forma subclinc\u0103, ingestia de alcool, hepatopatii induse de etanol sau medicamente, tirozinemia tip I, diverse tipuri de anemii, intoxica\u0163ii cu anumiti compu\u015fi organici halogena\u0163i, sarcina sunt asociate cu cre\u015fteri u\u015foare sau moderate ale ALA.<\/p>\n<p>Pentru o evaluare corect\u0103 at\u00e2t a porfiriilor c\u00e2t \u015fi a celorlalte afec\u0163iuni caracterizate prin cre\u015fteri ale ALA, determinarea valorilor metabolitului \u00een urin\u0103 trebuie completat\u0103 cu informa\u0163ii privind porfobilinogenul, uro- \u015fi coproporfirina, porfirina plasmatic\u0103, protoporfirina eritrocitar\u0103 liber\u0103 etc<sup>4<\/sup>.<\/p>\n<p><strong>Limite \u015fi interferen\u0163e<\/strong><\/p>\n<p>Determinarea ALA trebuie facut\u0103 \u00een dinamic\u0103, deorece o singur\u0103 testare nu poate oferi dec\u00e2t\u00a0informa\u0163ii limitate indiferent de valorile ob\u0163inute.<\/p>\n<ul>\n<li>Medicamente<\/li>\n<\/ul>\n<p><strong>Cre\u015fteri<\/strong>: acidul valproic, aminoglutetimida, barbituricele, carbamazepina, clorpropamida, danazolul, dapsona, diclofenacul, difenilhidantoina, fenilbutazona, glutetimida, griseofulvina, meprobamatul, novobiocinul, penicilina, primidona, sulfonamidele si tolbutamidul.<\/p>\n<p><strong>Sc\u0103deri:<\/strong> cisplatinul<sup>1<\/sup>.<\/p>\n<p><strong>Bibliografie<\/strong><\/p>\n<div>1. Frances Fischbach. Effects of the Most Commonly Used Drugs on Frequently Ordered Laboratory Tests. In A Manual of Laboratory and Diagnostic Test. Lippincott Williams &amp; Wilkins, USA, 7 Ed., 2004, 1227-1228.<\/div>\n<div>2. Frances Fischbach. Urine Studies. Urine Porphyrins and Porfobilinogen. In A Manual of Laboratory and Diagnostic Tests. Lippincott Williams &amp; Wilkins, USA, 7 Ed., 2004, 266-268.<\/div>\n<div>3. Jacques Wallach. Boli metabolice si ereditare. In Interpretarea testelor de diagnostic. Editura Stiintelor Medicale, Romania, 7 ed., 2001, 727-734.<\/div>\n<div>4. Lothar Thomas. Porphyria. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-BooksVerlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 452-455.<\/div>\n<div>5. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/div>\n<div>6. ARUP Laboratories. Test Directory: Porphyrins, Urine. <a href=\"https:\/\/www.aruplab.com\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">www.aruplab.com<\/a> 2010. Ref Type: Internet Communication.<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Informa\u0163ii generale \u2013 Acid delta-aminolevulinic (ALA) Acidul delta aminolevulinic (ALA)\u00a0este rezultatul condens\u0103rii dintre succinil \u2013 coenzima A \u015fi glicin\u0103 \u00een etapa ini\u0163ial\u0103 de sintez\u0103 a hemului, ce se desf\u0103\u015foar\u0103 la nivelul mitocondriilor. Excre\u0163ia urinar\u0103 a ALA poate cre\u015fte fie din cauza unor deficien\u0163e congenitale ale enzimelor implicate \u00een formarea hemului, fie ca urmare a prezen\u0163ei [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[63,35],"product_tag":[],"class_list":["post-208","product","type-product","status-publish","product_cat-teste-biochimice-pentru-tulburari-ereditare-de-metabolism","product_cat-teste-de-biochimie","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=208"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=208"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=208"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}