Page 139 - Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022

Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022
14 MOH-AMM Scientific Meeting 2022 in conjunction with 23 NIH Scientific Conference Abstract Book
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severe normocytic normochromic anaemia, leucocytosis with neutrophilia and marked
rouleaux formation. The patient was treated as septic shock secondary community-acquired
pneumonia and severe anemia in ward. In view of severe anaemia, both protein quantitation
and profiling of Transferrin were requested. Profiling of Transferrin isoform was determined
using Carbohydrate-Deficient Transferrin (CDT) analysis. Transferrin quantitation showed low
value of 1.17 g/L and Transferrin isoform showed presence of additional peak appearing
anodic to Sialo 0-tf, which represent immunoglobulin (Ig) or monoclonal interferences. This
monoclonal peak was further identified using serum protein electrophoresis and
immunofixation analysis. Presence of IgG Lambda paraproteinaemia was discovered with
concentration of 60.38 g/L. An additional Serum free light chain test was carried out and the
result showed low ratio level of Kappa to Lambda of 0.02.
CONCLUSION: Monoclonal proteins may be incidental findings at CDT CZE and may indicate
malignant or premalignant conditions. Therefore, it should be reported regardless of its
concentration to the ordering physician.

ID 182 DISTRIBUTION OF ARYLSULPHATASE A LEVELS IN PLASMA OF PATIENTS WITH LACTIC
ACIDOSIS

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Affandi Omar , Salina Abdul Rahman , Fatimah Diana Amin Nordin , Balqis Kamarudin , Nur Jannaim Muhamad ,
2
Fatin Nurin Najma Latif , Julaina Abdul Jalil 1
1 Inborn Errors of Metabolism & Genetic Unit, Nutrition, Metabolism & Cardiovascular Research Centre (NMCRC),
Institute for Medical Research, National Institutes of Health
2 Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, Malaysia

INTRODUCTION: Lactic acidosis is one of many clinical presentations related to mitochondrial
disorders (MD). Current laboratory diagnosis is based on skin biopsy which is invasive to the
patients. Arylsulphatase A (ARSA) functions as a lysosomal enzyme also known to be related
with metachromatic leukodystrophy (MLD) and Parkinson’s Disease (PD). However, there is
little information about the relationship of ARSA level in patients with lactic acidosis. Here,
we investigated the ARSA level potentiality to be used as an MD fluid biomarker.
METHODS: Plasma ARSA level was measured in 31 high-risk patients with high lactate and 40
healthy controls. We compared the plasma ARSA level among the groups using Mann-
Whitney U test and assessed its correlation using Spearman’s rho correlation coefficient.
RESULTS: Plasma ARSA level was not correlated with gender, organomegaly presentation and
seizures (p>0.05). Patients with high lactate had lower plasma ARSA level (median = 110
nmol/ml/hour; min, max value = 35.93, 347.33) than the control group (median = 177
nmol/ml/hour; min, max value = 107.58; 326.76) (p<0.05). In the high-risk patients with lactic
acidosis, plasma ARSA was negatively correlated to lactate level (r=-0.486) and alkaline
phosphatase (r=-0.463) while positively correlated to age group (r=0.465). High level of
lactate anion might act as inhibitor to ARSA and reduce the capabilities of ARSA.
DISCUSSION/CONCLUSION: In summary, reduction in plasma ARSA in patients with lactic
acidosis, were associated with MD. Therefore, these results suggest that ARSA level is a
potential biomarker for patients suspected with MD.

ID 183 IMPACT OF GLUCOSE TOWARDS ARYLSULPHATASE A ACTIVITY IN PLASMA

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Fatimah Diana Amin Nordin , Affandi Omar , Salina Abdul Rahman , Balqis Kamarudin , Nur Jannaim Muhamad ,
2
Fatin Nurin Najma Latif , Julaina Abdul Jalil 1
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