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Written by Craig Webster on .

The Specialist Testing Department is one of five departments within the Laboratory Medicine Directorate at the Heart of England NHS Foundation Trust. The five departments are: Blood Sciences, Specialist Testing, Blood Transfusion, Cellular Pathology and Microbiology (UK Health Security Agency).
 
Within Specialist Testing there are five sections consisting of Molecular Diagnostics, Separation Science to include Tandem Mass Spectrometry, Toxicology, Cellular Science to include flow cytometry, cell separation assays and Immunology.  These offer a comprehensive Specialist Testing service to the Heart of England NHS Foundation Trust, many local General Practices and to other hospitals and Trusts.
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Cryoglobulin Testing Service

Written by Stephen Rimmer on .

Due to availability of staffing and equipment the Cryoglobulin service at Solihull Hospital has been temporarily suspended.

For further information please contact the Immunology laboratory on 42105

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Haematology Critical Telephone Values

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 The following criteria will be used to telephone abnormal haematology results;

 Haemoglobin  White Blood Cell Count

 <80 g/L normochromic and normocytic

<70 g/L microcytic and hypochromic

<70 g/L macrocytic

<50 g/L renal patients

Low result – neutropenia <0.5 x 109/L                                                                                    

High result –

White cell count >40 x 109/L or

Lymph count > 20 x 109/L

Any presence of blast cells  
 Platelets  Sickle Test

 Lower limit - <70 x 109/L

Upper limit - >1000 x 109/L

 Positive (urgent requests only)

 
All Positive Malaria Screens

 

 Clotting Studies

   G6PD Assay
 

INR - >5.0                             

PTT - >180 seconds                                                

Fibrinogen - <1.0g/L

D-Dimer results > 243 ug/mL   (GP/ Outpatients)                                                     

All Anti FXa results >1.20 iu/mL 

  ≤6.4 IU/gHb

 

 

 

 
 All CD34 Quantitation’s  All FMH Quantitation’s

 

 

 

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Changes to GAD ( Glutamic Acid Decarboxylase) assay

Written by Stephen Rimmer on .

There has been a change in the manufacturer of the kits used for detection of GAD (Glutamic Acid Decarboxylase) antibodies. The reference range has changed to negative 0- 5 IU/mL. Storage conditions within the laboratory have also changed so that the samples are stored at - 20C. There are no other changes to the assay.
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Lab Tests - Serology/Virology

Written by Caroline McKeon on .

Virology/Serology Tests  

It is important to state relevant clinical details and date of onset of symptoms on the laboratory form.

If no clinical details are clearly stated on the request form, the sample will be stored. 

 The following tests are performed at Good Hope Hospital. Some tests are performed in batches but urgent tests can be performed by arrangement with the laboratory (Ext 47313)

 

 Test:

 Turnaround:

 Comments:

 Antistreptolysin O (ASO) titre

 1 - 2 days

Min 5 - 10mls clotted blood 

 Hepatitis A IgM

 1 -2 days

 Min 5 - 10mls clotted blood 

 Hepatitis B surface antigen

 1 - 2 days

 Min 5 - 10mls clotted blood 

 Hepatitis B core antibody

 1 - 2 days

 Min 5 - 10mls clotted blood 

Hepatitis C antibody

Processed in batches weekly

Min 5 - 10mls clotted blood  

 HIV serology (combined HIV/HIV2 antibody and HIV1 p24 antigen)

 1 - 2 days

 Min 5 - 10mls clotted blood .

Informed consent must be obtained. Please state on form that this has been obtained. The form must be signed by the requesting doctor.

 Toxoplasma total antibody

 1 - 2 days

Min 5 - 10mls clotted blood 

 Syphilis serology (Treponema pallidum IgG and IgM)

 Processed in batches weekly

 Min 5 - 10mls clotted blood 

 Rubella IgG antibodies

1 - 2 days  

Min 5 - 10mls clotted blood 

 Helicobacter pylori (H.pylori)

 Processed in batches weekly

Min 5 - 10mls clotted blood  

 Varicella zoster IgG antibodies

 1 - 2 days

 Min 5 - 10mls clotted blood 

 

 

 

 

 

 

 

Rotavirus/Adenovirus:

  • Specimens:
  • 2 -3 spoons of faeces into plastic faeces container
  • Turnaround Times:
  • Performed daily.
  • Positive results are phoned immediately.

The following tests are sent to Reference laboratories. Results may take 7 - 10 days. A minimum of 5 - 10 mls of clotted blood is required.

  1. Antistaphylolysin titre
  2. Aspergillus precipitins
  3. Brucella
  4. Atypical pneumonia screen - the reference laboratory will not routinely accept these requests unless acute and convalescent sera (10-14 days apart) are sent.
  5. Enterovirus PCR
  6. Epstein-barr virus IgM
  7. Hepatitis A IgG (immunity for travellers)
  8. Legionella antibody
  9. Legionella antigen NOTE: MSU required, not blood
  10. Leptospira IgM
  11. Lymes disease (Borrelia burgdorferi antibody)
  12. Meningococcal PCR (EDTA blood)
  13. Parvovirus IgG and IgM
  14. Rickettsia antibody
  15. Rubella IgM antibodies
  16. Toxocara antibodies

For further information regarding investigations not listed, please see Heartlands Microbiology intranet page or contact the consultant Virologist on Bleep 2821.

Viral PCR :

      Specimens:

  • Respiratory swabs, genital swabs, skin swabs, mouth swabs, eye swabs, urine
  • Comments:
  • Send samples in transport media. Available from Serology department (GHH) ext 47313 or pathology reception fridge out of hours.
  • Turnaround Times: 
  • Sent to Heartlands Virology department for processing.
  • Results may take 7 - 1 0 days

RSV:

  • Specimens:
  • Nasopharyngeal aspirate
  • Respiratory swabs in Viral transport media
  • Turnaround Times:
  • Sent to Heartlands Virology department for processing

Investigation of congenital infection or intrauterine death

For diagnosis of possible congenital viral infection in a neonate send:

  • 1) CMV - if <3 months send urine for CMVPCR, if >3 months send EDTA blood for CMVPCR
  • 2) Throat swab in viral transport media
  • 3) Blood (clotted) for Rubella IgM and Toxoplasma

For diagnosis of infection as a cause of intrauterine death send maternal blood (clotted sample) for:

  1. 1) CMV IgM,
  2. 2) Rubella IgM
  3. 3) Toxoplasma serology

Blood Borne Viral loads e.g, HIV, Hepatitis C, Hepatitis B

  • Specimen:
  • 2 x EDTA bloods required per viral load
  • Comments:
  • Please specify whether quantitative or qualitative PCR is required for Hepatitis C.
  • If genotyping is required for Hepatitis C, an extra EDTA blood is required.
  • Turnaround Times:
  • 7 - 10 days

 

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