Bupa Cromwell Hospital Laboratory Guide (type:pdf size:1.67MB)

Transcription

Laboratory Guide 2015
Valid from 1st January 2015
TAP2547/20-11-14/V2
Bupa Cromwell Hospital
Laboratory Guide 2015
Valid from 1st January 2015
TDL Customer Charter
We are committed to being the most helpful pathology service in the UK. Our goal is always
to provide an extraordinarily high level of service to our customers, who request pathology
services from us, for their patients. This is a philosophy shared by all Sonic Healthcare
Pathology practices. We are medically led, and patients are our first concern. We look to
improve our operational expertise, and we strive to provide professional leadership within
our specialities.
We promise to provide easy access to our pathology services
• We will always provide a friendly, helpful service.
• Our automated laboratory departments operate 24 hours a day, 7 days a week,
and we aim to achieve, or improve, our published turnaround times.
• Our medical consultants and laboratory teams are available to provide additional clarification,
advice or information for tests or results.
We promise to help you
• We invest in technical and operational excellence, with an extensive test repertoire,
to ensure access to a leading-edge laboratory service.
• We return results using the reporting method choice, in an as organised and safe way
as possible.
We promise to support the communities we work in
• We do our utmost to provide a service, even during extreme external disruptions
beyond our control.
• We are committed to our staff’s continued professional development.
• We have an organised programme to provide young people with work experience.
• We support our local community.
We promise to listen
• We acknowledge customer issues, and try to resolve them promptly and consistently.
• If our delivery has been adversely affected, we will address and review our procedures so that our
service reaches the highest standards.
• We actively ask for feedback so that we can continue to improve our service.
Complaints policy
It is the aim of the company to maintain its core values. Two of these core values are:
• Commit to service excellence.
• Be enthusiastic about continuous improvement.
Where a doctor or patient needs to raise a complaint about service levels they should contact
Cyril Taylor, Director of Laboratory Compliance, or Annette Wilkinson, Director of Service at
[email protected] giving details of the complaint.
The information forwarded will be treated as confidential and investigated by the above persons.
This process will link into Quality Management procedure for incident investigation. Corrective and
preventative actions will be introduced where indicated
Contents
PAGE
Index of Bupa Cromwell Hospital Profiles
2-3
Helpful Information for using the laboratory at the Bupa Cromwell Hospital
4-12
Quality Assurance
13-14
Special sample taking instructions
15
Bupa Cromwell Hospital Screening Profiles CP1 – CP12
16-17
18
Lp-PLA2 (PLAC®) Test
Biochemistry
19-24
Haematology 25-27
Microbiology and Swab guide
28-30
Endocrinology
31-35
Reproductive Health
36-39
TDL Andrology
40-44
STI Detection: Testing and Detection Information
45-52
Immunology: General/Infectious Immunology/Serology
53-58
Tropical Immunology
59-60
Virology: Immune Status Testing
61
Hepatitis Testing and Hepatitis Profiles
62-65
HIV Testing
66-67
General
68-69
Special Assays by PCR/Nucleic Acid Amplification
70
Tumour Markers 71-74
Genetics – Cytogenetics /Molecular Genetics
75-94
In-Vivo Tests: General/Antibiotic Assays/Therapeutic Drug Assays
95-96
Vitamins, Nutrition and Lifestyle97-98
Omega 3/6
99
Allergy
100-108
Cytology/Histopathology 109-116
Screening for Drugs of Abuse / Alcohol
117
Occupational Health
118-120
Alphabetical Index
121-141
TDL Referral Labs
142
Forms
Downs Risk Profile (1st & 2nd Trimester)
Leukaemic Studies Request Form (Cytogenetics / Molecular Genetics)
Genetic Request Form
143
1
Index of TDL Profiles
BUPA CROMWELL HOSPITAL SCREENING PROFILES
CP1
CP2
CP3
CP4 CP5
CP6
CP7
CP8
CP9
CP10
CP11
CP12
PAGE
Bupa Cromwell Full Blood Count 16
Bupa Cromwell Haematology Profile 16
Bupa Cromwell Biochemistry Profile 16
Bupa Cromwell Haematology and Biochemistry Profile16
Bupa Cromwell Thyroid Profile 16
Bupa Cromwell Admission Profile
16
Bupa Cromwell Executive Screen 16
Bupa Cromwell Female Premier Screen 17
Bupa Cromwell Male Premier Screen 17
Bupa Cromwell Cardiovascular Risk Profile 17
Bupa Cromwell Pre-Angioplasty Screen 17
Bupa Cromwell Diabetic Profile17
TDL SPECIFIC PROFILES
Alcohol Profiles
Allergy Screens Amenorrhoea Profile Anaemia Profile Andropause Profile
Antenatal Profile Autoantibody Profiles Azoospermia Profile
Bone Screens 117
100-103
31, 35
25, 27
31, 34
25, 27
53, 57
80
19, 24
Calprotectin / Elastase Profile
53, 57
CHANGE Cardiovascular Risk Profiles
20, 24 Chest Pain Profile Chlamydia (Species Specific) Antibody Profile 20, 24 53, 57
Chronic Fatigue Syndrome Profile Clotting Profiles Coeliac/Gluten Sensitivity Profiles Deep Vein Thrombosis (DVT) Profile (Pre-travel screen) Diabetic Profiles Drugs of Abuse / Alcohol Screens Enteric Organism Rapid Antigen Detection Entovirus Screen Epstein-Barr Virus Profile 53, 57
25, 27
53-54, 56
25, 27, 56, 59-60
20, 24
117
59-60
68-69
70
Erectile Dysfunction Profile
Female Hormone Profile 31, 34
31, 34
First Trimester Antenatal Screening Bloods
Food Handler Screens
Genetic Profiles Haematology Profile
31, 35
119-120
93
25, 27
2
PAGE
Hepatitis Profiles
62
Hirsutism Profile 31, 35
HIV Profiles 45, 51, 62, 66, 70
HRT Profile 31, 35
Impotence Profile 31, 34
Infertility Male Profile
31, 34, 43
Iron Overload Profile 21, 23, 84, 93
Iron Status Profile 21, 23
Jewish Carrier Screen 93
Lipid Profile 21, 23
Liver Function Tests 21, 23
Male (cause of) Recurrent Miscarriage Profile
43
Male Genetic Reproductive Profile
43, 93
Menopause Profile 32, 35
Metabolic Syndrome Profile 32, 35
Mineral Screen 97-98
Myeloma Screen 21, 23
Natural Killer Profile
26-27
Needle Stick Injury Profile 119-120
Neurological Viral Screen 68-69
Osteoporosis Screen 21, 24
Pituitary Function Profile
32, 35
Pneumonia (Atypical) Screen 68-69
Polycystic Ovary Syndrome Profile 32, 35
Post-Travel Screens 59-60
Pre-Travel Screen 25, 27, 56, 59-60
Prostate Profile 71
Recurrent Miscarriage Profile
Respiratory Viral Screen Rheumatology Profiles Rickettsial Species Antibodies Profile STI / Sexual Health Profiles
Thrombotic Risk/Miscarriage Profile
Thyroid Profiles Torch Screen
Trace Metal Screen Tropical Screen Urea and Electrolytes Viral Screen Profile Vitamin Screens Von Willebrand Profile Personal Profile (Doctor’s own) are available on request.
Sports/Performance
43, 93
68-69
55, 58
55, 59
91-92
97-98
26-27, 93
32, 34
55, 68-69
98, 118
59-60
22-23
68-69
97-98
26-27
3
Helpful information
The Laboratory Guide is designed to give the Bupa Cromwell Hospital an easy-to-use reference
for the most regularly requested services, pathology profiles and tests. If you are not able to find
details for tests and services, please contact the laboratory on 020 7460 5565 or Freeset 7064.
We continue to develop a wide range of test and patient services and our aim is to offer
commitment to customer service, strong working relationships and help and support for referring
doctors and their practices.
All services can be arranged by contacting the laboratory on 020 7460 5565, or for
more information visit www.tdlpathology.com.
PHLEBOTOMY SERVICE AT BUPA CROMWELL HOSPITAL
This service is provided by the Bupa Cromwell Hospital and is available to all outpatient clinics.
The phlebotomy area is situated in the outpatient department on the ground floor.
Monday to Friday: 8.00am – 8.00pm, Saturday: 8.00am – 2.00pm
LABORATORY HOURS
The Laboratory is located at 1-3 Pennant Mews. Laboratory hours are:
Monday to Friday: 8.00am – 8.00pm, Saturday: 8.00am – 2.00pm
An emergency Out of Hours Service is available seven days per week. Our on-call staff can be
contacted via switchboard on 020 7460 2000 or Freeset 7064.
CLINICAL INFORMATION, REQUIREMENTS AND
DELIVERY OF SAMPLES TO THE LABORATORY
• The responsibility of labelling specimens lies with the person taking the samples.
• The responsibility of providing appropriate clinical information lies with the person
requesting the tests.
• All specimens must be enclosed within a self sealing plastic transport bag.
• Wire staples are dangerous and should not be used on any request forms or specimen bags.
Pathology samples must be delivered to the laboratory using the Pneumatic Tube System within
the main hospital building. There are points of access to this delivery system strategically
positioned around the hospital.
RED carrier must be used ONLY for transporting Pathology Specimens and reference made
to the hospital operating procedures before sending samples to the laboratory.
4
Ensure all specimens and forms are labelled with given Name, Surname, DOB, Date and Time of collection.
Unique Hospital number is required for BT samples. Turnaround times are quoted as working days.
Helpful information
Specimen exceptions which must not be sent to the laboratory in the Pneumatic
Tube System are:
• Specimens from non-repeatable
procedures (e.g., bone marrow, CSF, etc.)
Specimens from patients known or
suspected to have:
• Blood Culture and Temperature
labile specimens
• Transmissible spongiform
encephalopathy (e.g. CJD)
•Tissue / Histopatholoy specimens
•Tuberculosis
• Bone marrow specimens
• Severe Acute Respiratory Syndrome (SARS)
• Cerebro-spinal fluid (CSF)
• Infection with a Hazard Group 4 organism
(includes Viruses causing haemorrhagic
fever, e.g. Ebola, Lassar fever)
•Specimens / Blood Products containing
more than 30ml fluid
• All urgent specimens
• Exposure to biological warfare organisms
such as Anthrax, Plague, Smallpox,
Botulism, Tularaemia
All samples should be forwarded to the laboratory AS SOON AS POSSIBLE after
sample taking. If the Pneumatic Tube System is out of action all samples will be
delivered to the hospital.
5
Helpful information
SEMEN ANALYSIS
Semen needs specialist handling within the laboratory. For this reason all requests for Semen
Analysis should be made by appointment. Practices or patients should contact TDL Andrology
on 020 7025 7940 or 020 7307 7373 to make an appointment and confirm instructions for
sample collection. Appointments for andrology should be made between the following hours:
Monday to Friday 8.00am – 5.00pm Saturday 9.00am – 3.00pm
1. Patients must abstain from ejaculation for at least 2 days but not longer than 5 days
before the test.
2. Ideally semen samples should be produced at TDL’s Patient Reception, 76 Wimpole
Street, unless there are exceptional circumstances. If this is not possible the fresh
sample must arrive at the laboratory within 60 minutes of production. This must be
pre-arranged with the laboratory. Please contact TDL Andrology on 020 7025 7940
for special instructions. Refer to Andrology, see page 40.
PATIENT REQUEST FORM
To comply with good clinical practice it is important that there is one request form for
each patient’s request, and specimens and form are correctly and fully labelled, to include
3 unique patient identifiers:
• First name, Surname, Date of Birth
• Time and Date of Collection of Samples
• Bupa Cromwell Hospital Medical
Record Number (MRN)
• Type of Sample and anatomical site,
where appropriate (eg swabs)
• Department within the hospital
• Relevant clinical information
• Requesting clinician
• Relevant details of medication
• Contact details for urgent results
• High Risk Samples should be identified
and packed separately
If additional tests are required for a sample already received please contact the laboratory with
your request for specific further analysis. Samples are stored within timeframes according to
their discipline. Laboratory staff will advise on the ability to undertake further testing.
6
Helpful information
REQUESTS FOR ADD ONS
The majority of samples received in the laboratory are kept for up to a week.
If sample type and volume allow for further testing additional tests can be added by telephoning
020 7460 5565.
Please specify the test details to be added, together with Patient NAME and Hospital number.
UNLABELLED SAMPLES
All samples should be clearly labelled with the patient’s correct name, MRN,
date of birth and date of sample. In the event this is not so:
a) Where possible the sample taker will be contacted immediately and informed of the
situation and invited to send another appropriately labelled sample.
b) The request for the test will be entered in the computer and the facts of the situation
will be recorded.
c) Under no circumstances will laboratory staff label samples on the instruction
of the requesting doctor.
7
Helpful information
BLOOD TRANSFUSION
Hours of service are as for routine pathology with emergency requests handled by on call staff.
All specialist testing will be undertaken by the North London Transfusion Centre in Colindale
and will be co-ordinated via the laboratory.
Request Form Criteria
Labelling requirements for request forms includes all the information required on the
sample as well as:
• The patient’s clinical details including reason for request of test and / or blood components
• Date and time of blood product request (if required)
• Requesting Clinician
• Blood Product requests should comply with the guidelines stated in the Hospital
Blood Transfusion Policy
• All samples for blood transfusion MUST carry a full name, hospital number, date of birth,
date and time taken, and signature of sample taker. Addressographs (Pre-printed labels)
are NOT ACCEPTABLE.
8
Helpful information
TEST
SAMPLE
TYPE
NOTES
TURNAROUND TIME
Blood
group and
antibody
screen
(G & S)
1xBT
A full tube is recommended. The sample MUST
be properly labelled and accompanied by a
properly completed form. Strongly recommended
for all patients likely to be transfused in the near
future. G & S samples are kept for 7 days and can
be converted to a crossmatch if the sample is
still valid (see below).
1 working day.
Crossmatch
Carried
out on
a G & S
sample
A previously tested G & S sample can be used or a Optimum 24 hours. If a valid
fresh sample may be required (see sample validity G & S is in the laboratory 2
table below or contact the laboratory for advice).
hours is sufficient.
Please request routine work as early as possible.
Emergency
Crossmatch
1xBT
Please request routine work as early as possible.
40 minutes, but more notice
if possible. Request must be
confirmed by telephone call.
Direct
Antiglobulin
test (DAT)
1xBT
Labelling is important, (e.g. twins).
24 hours, but more notice if
possible. Request must be
confirmed by telephone call.
BT
BT
BT
Sample validity for use for blood transfusion
IF THE PATIENT WAS TRANSFUSED
WITHIN THE LAST
THE SAMPLE MUST HAVE BEEN BLED
WITHIN THE LAST
3 to 14 days
24 hours
15 to 28 days
72 hours
29 days and over
<7 days
(taken from BCSH (2004) Guidelines for pre-transfusion compatibility procedures in blood transfusion
laboratories. Transf. Med., 14, 59-73)
The Hospital Blood Issue Fridge is located in a secure room in the basement,
near Main Theatres, which can be accessed by hospital staff ID Access Cards.
Unit of blood not transfused within 30 minutes of removal from the blood bank fridge
can be returned to the issue fridge and documented.
If blood units remained at room temperature for more than 30 minutes after removal
from the blood bank fridge they MUST NOT be transfused and the laboratory should be
contacted to quarantine the blood component. For timescales related to the transfusion
of blood components refer to the Hospital Transfusion Policy.
Under no circumstances should the blood be stored in a domestic fridge or left at
room temperature.
9
Helpful information
HIGH RISK SPECIMENS AND LABELLING
The labelling of specimens which contain or may contain Hazard Group 3 pathogens
is a requirement of the Health & Safety Commission and allows special safety procedures
to be taken to prevent infection in laboratory workers.
HAZARD GROUP 3 CONTAINS
Hepatitis B virus
Brucellosis bacillus
Anthrax bacillus
Dysentery bacillus (Shigella dysenteriae)
Hepatitis C virus
HIV 1+2 Abs
Mycobacterium tuberculosis and most other mycobacterium species
E. Coli verocytotoxigenic strains (eg. 0157:H7)
Paratyphoid A, B & C bacilli
Typhoid bacillus
A yellow warning label with ‘HIGH RISK’ written in red must be attached to both
specimen and request form. These should be clearly labelled as urgent, preferably
with a fluorescent marker. The samples when identified are prioritised.
RESULTS SERVICE
Turnaround times for results are shown in this guide. Quoted turnaround times are in working
days from the time of receipt of sample.
Urgent requests will be dealt with as a priority. For urgent samples we recommend that
Red Sample Bags are used. These are provided by the laboratory and allow requests to be
handled as priority.
Where test results may suggest the need for urgent clinical assessment of the patient, the
laboratory will contact the referring clinician. This procedure is part of the laboratory critical
value policy.
It is not policy for the laboratory to give or send patients their pathology results unless there
is specific instruction from the referring clinician to do so.
TDL WEBSITE: WWW.TDLPATHOLOGY.COM
Our website contains comprehensive information on the range of tests and services we provide.
The website is updated monthly with services and test information, including sample types,
turnaround times, special instructions and information.
INTRODUCING TDL E-VIEW. Registered users can view results online. This is a secure log-on/
password protected look-up system with a cumulative results reporting function that can be
accessed using an existing internet connection.
10
Helpful information
CONSULTANT ADVICE AND OPINION
Each department in the laboratory is consultant led. For doctors wanting clinical advice
or professional support, TDL consultants can be contacted via the laboratory. Contact the
consultant Haematologist to make arrangements for venesections for Haemochromatosis
and polycythaemia.
TDL MEDICAL CONSULTANT
MEDICAL DIRECTOR
Professor Michael Patton
BIOCHEMISTRY
Dr Paul Holloway
IMMUNOLOGY
Dr Scott Pereira
FRCP, FRCPCH
FRCPath
FRCPath
Dr Anne Tarn
Dr Suranjith Seneviratne
MRCPath
MRCP, FRCPath
HAEMATOLOGY /
BLOOD TRANFUSION
Dr Marie Scully
MRCP, FRCPath
Dr Adrian Bloor
FRCP, FRCpath
Dr Simon Jowitt
FRCPath
Dr Denise Darby
MRCP, FRCPath
Professor Carel le Roux
FRCPath
Dr Gilbert Weiringa
PhD MRCPath
MICROBIOLOGY
Dr Michael Kelsey
FRCPath
Dr Julie Andrews
FRCPath
Dr Edward Kaczmarski
FRCPath
VIROLOGY
Dr Mark Atkins
FRCPath
CYTOLOGY
Dr Colin Clelland
FRCPath
Dr Mary Falzon
MRCS, LRCP, FRCPath
GENETICS: MOLECULAR/
CYTOGENETICS
Professor Michael Patton
FRCP, FRCPCH
Consultant Clinical Geneticist
11
Helpful information
WHO TO ASK FOR HELP
Direct Tel: 020 7460 5565 Freeset: 7064
Direct Fax: 020 7835 0361
Heads of Pathology Team at the Bupa Cromwell Hospital
Tel: 020 7460 5565
Laboratory Manager
Swati Shukla
Main Laboratory
Noel Smith
Blood Transfusion
Ishmael Carboo
Specimen Reception
Robert Stanton
Heads of Laboratory Departments at The Doctors Laboratory
Tel: 020 7307 7373
12
Andrology
Dr Sheryl Homa
Cytology
Margaret Morgan
Immunology/Virology
Kushen Ramessur
Molecular Genetics
Dr Stuart Liddle
Cytogenetics
Terry Ballard
Microbiology
Massimo Bonaiti
Director of QMG
Jan Stewart
CEO
David Byrne
Group Laboratory Director Tim Herriman
Laboratory Service Compliance Director
Cyril Taylor
Director of Sales/Service
Annette Wilkinson
Director of TDL Genetics Dr Lisa Levett
Quality assurance
The Doctors Laboratory is committed to providing doctors with pathology of the highest
quality. The quality of results is of fundamental importance and the laboratory operates to
stringent technical and administrative standards.
Internal quality assurance is achieved by strict adherence to standard operating procedures for all analytical
processes. TDL participates in all recognised National External Quality Assessment Schemes. These
schemes are subscribed to by all NHS and private laboratories. Results are subjected to strict internal and
external quality control. Details of the laboratories to whom TDL refers specialist testing are available from
TDL Referrals. These laboratories are CPA accredited or of equal accreditation status. Details of the tests
that are referred are given on the TDL website. QA is administered by TDL’s Quality Management Group
(QMG) who also adhere to regulatory and accreditation requirements.
BIOCHEMISTRY: UKNEQAS, WEQAS, RIQAS, BIORAD for
ACE
ACTH (with PTH)
AFP / CEA & HCG
Antibiotics (Gentamicin, Vancomycin and Amikacin)
Anti-Hbs Detection
Ammonia
Amniotic AFP
Cardiac Markers
Clinical Chemistry
CRP & Ultra-Sensitive CRP
Cyclosporin and Tacrolimus
Diagnostic Serology Exanthem
Diagnostic Serology Hepatitis
Drugs of Abuse
Ethanol
GFR
Glucose /Glucometer
Glycated Haemoglobins
Guildford Peptides
Haematinics
Healthcontrol Therapeutic Drugs Screen (TDM)
Hepatitis A (with B and C)
Hepatitis B Serology
Hepatitis C Serology
HIV Serology
Homocysteine
HTLV
Immunity Screen
Lipase
Lipid Investigations
NT-Pro BNP
Paediatric Bilirubins
Parasitology
Peptide Hormones
PSA
PTH, ACTH and hCT
Rubella IgG Serology
Salicylate and Paracetamol
Specific Proteins
Steroid Hormones
Syphillis Serology
Thyroglobulin Surveys
Thyroid Hormones
Total IgE
Toxoplasma IgG / M Serology
Tumour Markers
Toxoplasma IgM Serology
Toxoplasma IgG Serology
Trace Elements
Urine Chemistry
HAEMATOLOGY: UKNEQAS for
Automated Differential Leucocyte Count
Blood Film Morphology
Coagulation (Including PoCT Coagulation)
Flow Cytometry
Full Blood Count
Haematology
Haematology Analysis
Malaria
Parasite Films
Reticulocyte
Sickle Screening
Thrombophilia Screening
13
Quality assurance
TDL GENETICS: CEQAS, ISFG, EMQN, UKNEQAS, ECAT for
Constitutional Clinical Cytogenetics (Rounds for Amniocentesis,
CVS, Solid Tissue, Blood, Array CGH)
QF-PCR Aneuploidy Detection
Chlamydia & Gonorrhoea detection by PCR
Cystic Fibrosis
Cytochrome P450 2D6 genotyping
Duchenne / Becker Muscular Dystrophy
Hereditary Haemochromotosis (C282Y + H63D) genotyping
+ reporting
HLA Class I (HLA-A, HLA-B, HLA-C) Tissue Typing (low resolution)
HLA Class II (HLA-DRB1, HLA-DQB1) Tissue Typing (low resolution
HLA-B27 Tissue Typing
HLA-B57*01 Tissue Typing
Human Papillomavirus DNA
Paternity Testing
Prader-Willi and Angelman Syndromes
Spinal Muscular Atrophy
Thrombophilia (Factor II & Factor V)
Y Microdeletion PCR Assay
BoBs Rapid Aneuploidy detection
HLA+ Disease Typing
MICROBIOLOGY: UKNEQAS, QCMD for
AAFB for Microscopy + Mycobacterium Culture
Antimicrobial Susceptibility
Clostridium Difficile + MRSA Screening
Faecal Parasitology
Faecal Haemoglobin EQA scheme
General Bacteriology
Molecular detection of Mycobacteria
Mycology
Urinary Antigen: Legionella
WEQAS Urinanalysis scheme
IMMUNOLOGY
UKNEQAS – General Immunology for:
Autoimmune Serology ANCA / GBM Antibodies
Bullous Dermatosis Antibodies
Coeliac Disease Antibodies
Allergen Specific IgE Antibodies
New General Autoimmune Serology
Anti-Phospholipid Antibodies
Nuclear and Related Antigens
AMH
IGRA TBQ
Intristic factor
Islet Cell Antibodies (Diabetic Marker)
14
EUROQAS:
Allergy for specfic IgE
UKNEQAS – Infectious Immunology for:
HIV Serology / POCT
Immunity Screen – VZV, Parvo Viruse, EBV
Chlamydia Detect
Varicella Zoster (IgG) Serology
Parasite Serology
Chlamydia & Gonnorhoea (NAAT/PCR)
RIQAS Scheme:
Syphilis Serology
EBV
HSV Serology
ENDOCRINOLOGY: UKNEQAS for
Steroid Hormones
Peptide Schemes 1 to 4
Thyroid Scheme
Allergens Scheme
SHBG
Prostate Specific Antigen
Tumour Markers
PTH
Specific IgE / Total IgE
AFP / CEA
CYTOLOGY: EQA, TEQA for
NHSCSP (EQA for Gynaecological Cytopathology)
NHSCSP (TEQA for PAP stain)
Hologic Imager stain (TEQA)
ANDROLOGY: UKNEQAS for
Semen Analysis Scheme
Special instructions for samples
1
Contact the laboratory for special sample tubes/
containers/instructions.
2
Confirmation of not negative drug screens by
GCMS may take up to 5 days.
3
Clinical history essential and protect from light.
4
Send to the laboratory without delay.
5
Do not send sample to the laboratory between
Friday noon and Monday morning.
6
Contact the Referrals Department before taking
and sending sample to the laboratory.
7
Sample should be separated and frozen if
sending overnight.
8
DRP Form required. DRP Form can be found
at the back of the guide.
9
Clinical history must be provided.
10 Contact the laboratory for special stability tubes
for lymphocyte subsets – or take an EDTA sample
and ensure same day delivery to the laboratory,
Monday to Friday noon (do not send sample
between Friday noon and Monday morning).
11 Patient consent required. Consent Form can be
found at the back of this guide.
12 Please provide one sample for each person
being tested.
PRE-TRAVEL SCREEN (DVT)
FBC
Factor II Prothrombin Gene
Factor V Leiden
Anticardiolipin
TAT
Antibodies
Profile
content
5
Turnaround
time
DAYS
DVT1
9
A A B 14 Provide details of travel history.
15Ammonia
Sample: EDTA plasma only. Full tubes and tightly
stoppered. On ice, centrifuged and analysed
20-30 mins post venepuncture (or plasma can be
frozen). If haemolysed gives falsely high results.
Patient: Fasting. Avoid smoking.
16Lactate
Sample: Fluoride oxalate plasma only.
On ice and separate from cells 15-30 mins,
analyse promptly. Handle with care as sweat
contains large amounts of lactate. No tourniquet.
Patient: Rest 30 mins prior to test.
17 Homocysteine
Should be spun and separated with 1 hour of
venepuncture.
18 Citrate Samples
Samples should be double spun and separated
and frozen within 4-8 hours of sample taking,
if a delay is expected with transportation to
the laboratory, samples must be transported
as frozen.
19 Must include patient’s age, height and weight.
20 Sample types: FCRU or PCR swab or TPV
or Semen.
21 Urine cytology container, ideally first catch,
mid-morning specimen.
Profile panel information
Profile
name
13 Protect from light.
Code
Sample requirements
Reference to sample taking and
special handling instructions (see above)
22 Must be fresh.
30 Collect sample at end of exposure.
33 Sample must be labelled by hand with first
name, family name and date of birth detailed
on sample and form. Do not use labels other
than the tube label.
34 Samples must arrive in the laboratory on the same
day of sample taking or contact the laboratory.
35 Patient should be fasting and resting for 30 mins
before sample taking. Samples need handling
urgently.
36 Renin: Sample collected either upright /active
or resting /supine (3 hrs lying).
37 Provide sample time and date of collection.
15
Bupa Cromwell Screening Profiles CP1-CP12
CP1
BUPA CROMWELL
FULL BLOOD
COUNT
CP4
Full Blood Count
BUPA CROMWELL
HAEMATOLOGY
AND BIOCHEMISTRY
PROFILE
Full Blood Count
ESR
CP1
A
CP2
BUPA CROMWELL
HAEMATOLOGY
PROFILE
Full Blood Count
ESR
CP2
A
CP3
BUPA CROMWELL
BIOCHEMISTRY
PROFILE
Sodium
Glucose
Potassium
Cholesterol/
Triglycerides
Chloride
HDL/LDL
Bicarbonate
Ferritin
Urea
Creatinine
Bilirubin
Alkaline Phosphatase
AST
ALT
Gamma GT
Total Protein
Albumin
Globulin
Calcium
Phosphate
Urate
Sodium
Potassium
Chloride
Bicarbonate
Urea
Creatinine
Bilirubin
AST/ALT
Gamma GT
Total Protein
Albumin
Globulin
Calcium
Phosphate
Urate
Glucose
Cholesterol/Triglycerides
HDL/LDL
Ferritin
CP5
BUPA CROMWELL
THYROID PROFILE
FT3
FT4
TSH
CP5
B
CP6
BUPA CROMWELL
ADMISSION PROFILE
CP4
Hep B sAg
Syphilis IgG/IgM
CP6
A A B B
CP7
BUPA CROMWELL
EXECUTIVE SCREEN
CP4
FT4
TSH
FT3
CP7
CP4
A A B B
A A B B
CP3
B
16
Bupa Cromwell Screening Profiles CP1-CP12
CP8
BUPA CROMWELL
FEMALE PREMIER
SCREEN
CP9
CP4
Amylase
Iron
TIBC
C-Reactive Profile
Blood Group
TSH
FSH
Oestradiol
Homocysteine
B12/Folate
BUPA CROMWELL
MALE PREMIER
SCREEN
CP10
CP4
Amylase
Iron
TIBC
C-Reactive Profile
Blood Group
Homocysteine
Ferritin
B12/Folate
TSH
CP4
hcCRP
Homocysteine
Fibrinogen
Lipoprotein (a)
CP10
A A B B C C G Hepatitis A Profile
Hep B sAg
Hep C Abs
HIV 1&2 Abs
Hepatitis A Profile
Hep B sAg
Hep C Abs
HIV 1&2 Abs
Rubella
CP11
Urine for m/c/s
Stool for o/c/p, culture
and sensitivity
FOB
CP11
A B C
AFP
C199
CEA
PSA
Thin Prep PAP
AFP
C125
C153
C199
CEA
CP8
A A A B B B B G RU RF TPV
BUPA CROMWELL
PRE-ANGIOPLASTY
SCREEN
CP4
Clotting Profile
CK/LDH
Hep B sAg
Tropical Screen
Autoantibody Profile
Rheumatoid Factor
Syphilis IgG/IgM
Viral Screen
Urine for m/c/s
Stool for o/c/p, culture
and sensitivity
FOB
Tropical Screen
Autoantibody Profile
Rheumatoid Factor
Syphilis IgG/IgM
Viral Screen
BUPA CROMWELL
CARDIOVASCULAR
RISK PROFILE
CP12
DIABETIC
PROFILE
Glucose
HbA1C
U/E’s
Lipids
FT4/TSH/FT3
CP9
A A A B B B B G RU RF CP12
A B G
17
Lp-PLA2 (PLAC®) Test
The PLAC test measures the amount of lipoprotein-associated phospholipase (Lp-PLA2) in blood.
Lp-PLA2 is an enzyme primarily associated with low density lipoprotein (LDL). LDL carries Lp-PLA2 to
the coronary artery walls where it activates an inflammatory response. If present, this causes plaque to
become more prone to rupture. Because this enzyme is associated with causing inflammation of coronary
artery walls, high levels of Lp-PLA2 would therefore seem to indicate an increased risk of heart attack or
stroke. Given that the majority of heart attacks and strokes are caused by plaque rupture and thrombosis,
individuals with high levels of Lp-PLA2 might benefit from more aggressive management with lipid
lowering agents, therapeutic intervention and/or lifestyle modification.
Traditional inflammatory markers, such as hsCRP, and CRP, whilst recognised as being useful systemic
inflammatory markers are not as sensitive for identifying inflammation of the coronary artery walls.
As a result, the PLAC Test, which is measuring levels of Lp-PLA2, serves as a specific independent
coronary marker.
• Lp-PLA2 is independent of traditional cardiovascular risk factors.
• Lp-PLA2 is an enzyme produced in the plaque itself and its measurement is therefore more specific
than other inflammatory markers.
• Increases in Lp-PLA2 levels are not caused by traditional risk factors.
• Imaging tests whilst able to assess the anatomical state of blood vessels, cannot identify plaque
that is vulnerable to rupture.
Lp-PLA2 levels should help to identify hidden risk of cardiovascular event that might be missed by more
conventional risk factors (eg cholesterol levels, blood pressure, family and smoking history). Lipid levels
alone cannot provide a great deal of information on the status of the artery wall whereas Lp-PLA2 is
a direct measure of artery wall enzyme activity, independent of other cardiovascular markers. It is not
intended that the PLAC Test should replace blood lipid testing or other traditional risk factors identified
for cardiovascular disease. It provides an additional independent risk marker.
The PLAC test is recommended for patients with known CVD disease, or for patients with moderate/
intermediate risk for CVD including, but not limited, to two or more of the following risk factors:
• Family history of CVD
• Diabetes
• Obesity
• Metabolic Syndrome / Chronic Kidney Disease
• Smoking
• Gender/Age (male > 55 / female > 45)
• High Cholesterol • On lipid lowering treatment
• High blood pressure
• High saturated fat diet / physical inactivity
Risk Levels are reported quantitatively as Low, Medium or High
Low < 151 nmol/min/ml
Medium 152 – 194 nmol/min/ml
High > 195 nmol/min/ml
High levels of Lp-PLA2 are consistently linked to higher risk of heart attack and stroke in multiple
population based studies*. Individuals with an elevated PLAC Test result who have two or more other risk
factors are at 2 or 3 times the risk of a cardiac event. An elevated PLAC test is an actionable tool, and
may indicate a need for further investigation, more aggressive therapy, including treatment to lower LDL
Cholesterol levels. Lipid lowering agents including statins are proven to reduce cardiovascular events.
Knowing that there is active disease, rather than just risk, may create a greater sense of urgency for
patients to become more compliant with treatment recommendations.
*DiaDexus Bibliography (http://www.plactest.com/healthcare/index.html)
http://www.plactest.com/healthcare/annotated-bibliography.html
18
Ensure all specimens and forms are labelled with given Full Name, Surname, DOB, Date and Time
of collection. Turnaround times are quoted as working days.
Biochemistry
TEST
5 HIAA
Albumin
Alcohol (Legal) Police Blood Sample
Alcohol (Medical) [Do not use alcohol swab
prior to sample taking]
Alcohol (Urine)
Aldolase
Alpha 1 Antitrypsin Genotype – PI*M, PI*S, PI*Z
Alpha 1 Antitrypsin (Serum)
Alpha 1 Antitrypsin (Stool)
ALT (Alanine Aminotransferase)
Aluminium
Amino Acid (Serum/Plasma)
Amino Acid Quantitative (Urine)
Ammonia
Amylase
Angiotensin Converting Enzyme
CHANGE Antimullerian Hormone (Elecsys/Roche)
Apolipoprotein A1 (12 hrs fasting)
Apolipoprotein B (12 hrs fasting)
Apolipoprotein E
Arsenic (Blood)
Arsenic (Urine)
AST (SGOT)
Bence-Jones Protein
Beta 2 Microglobulin (Serum)
Beta 2 Microglobulin (Urine)
Bicarbonate
Bilirubin (Direct/Conjugated)
Bilirubin (Total/Indirect/Conjugated)
Bilirubin (Urine)
Bismuth
BNP (NT-pro BNP)
Bone Screen
Bone Screen (Bloods only)
C Reactive Protein
C Reactive Protein (High Sensitivity)
Cadmium (Blood)
Cadmium (Urine)
Calcium
Calcium (24 hr Urine)
Calcium/Creatinine Ratio
CODE
SAMPLE REQS
TAT
RU5H
ALB
LALC
PU 1
B
Police Sample
5 days
4 hrs
3 weeks
ALCO
G 1
4 hrs
UALC
ALDO
ALP
GENE
A1AT
A1AF
ALT
ALUM
AMIN
UAAQ
AMMO
AMY
ACE
AMH
APOA
APOB
APOE
ARS
ARSE
AST
RBJP
B2MG
UB2M
HCO3
DBIL
BILI
UBIL
BISM
BNP
BONE
BON2
CRP
HCRP
CADM
URCD
CA
UCA
CACR
RU
B
B
A 9
B
RF
B
K
B
RU
A (Frozen) 15
B
B
B
B
B
B (fasting)
A or H
RU 30
B
1 x 30mls (RU)
B
RU
B
B
B
RU
B
B
B CU
B
B
B
A or H
RU 30
B
PU
RU B
4 hrs
5 days
4 hrs
3 weeks
1 day
10 days
4 hrs
7 days
7 days
7 days
4 hrs
4 hrs
4 hrs
4 hrs
3 days
3 days
5 days
5 days
5 days
4 hrs
5 days
2 days
3 days
4 hrs
4 hrs
4 hrs
1 day
5 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
5 days
5 days
4 hrs
4 hrs
4 hrs
Key: See page 15 for sample taking and special handling instructions.
19
Biochemistry
TEST
Carbohydrate Deficient Transferrin (CDT)
Cardiac Enzymes (not chest pain)
CHANGE Cardiovascular Risk Profile 1
Ceruloplasmin
Chest Pain Profile
Chloride
Cholesterol
Cholesterol (Familial Hypercholesterolaemia)
Cholinesterase (Blood)
Cholinesterase (Serum/Pseudo)
Chromium (Blood)
Chromium (Urine)
Citrate (Urine)
CK (MB Fraction)
Cobalt (Blood)
Cobalt (Serum)
Cobalt (Urine)
Copper (Serum)
Copper (Urine)
Creatine Kinase (CK, CPK)
Creatinine
Creatinine (Urine)
Creatinine Clearance
Crosslaps (Serum DPD)
Cyclosporin (Monoclonal)
Deoxypyridinoline (DPD) – Serum
Deoxypyridinoline (DPD) – Urine
Diabetic Profile 1
Diabetic Profile 2
Electrolytes
Electrolytes (Urine)
ELF/Enhanced Liver Fibrosis
Faecal Fat (1 Day Collection)
Faecal Urobilinogen
Ferritin
Fibrotest (Liver Fibrosis)
Fructosamine
Gall Stone Analysis
Gamma GT
Globulin
Glucose
Glycosylated HB
20
CODE
SAMPLE REQS
CDT
CENZ
PP10
PP11
CERU
CPP
CL
CHO
3 days
B 4
4 hrs
B
3 days
B B
3 days
B B B C 34
1 day
B
STAT
B
4 hrs
B
4 hrs
B
See Genetics section, page 83
5 days
H
3 days
B
5 days
A
5 days
RU 30
CU (Frozen)
5 days
4 hrs
B
5 days
A
5 days
B
5 days
RU 30
5 days
B
CU
5 days
4 hrs
B
4 hrs
B
CU
4 hrs
4 hrs
B CU
4 days
B
1 day
A
4 days
B
EMU
4 days
8 hrs
A G
2 days
A G RU
4 hrs
B
CU
4 hrs
6 days
B
LF 6
5 days
RF
5 days
4 hrs
B
2 weeks
B 3 days
B
STONE
10 days
4 hrs
B
4 hrs
B
4 hrs
G
6 hrs
A
CHRC
CHPS
CHRO
URCR
UCIT
CKMB
COB
COBB
COBA
COPP
URCU
CKNA
CREA
UCR
CRCL
SDPD
CYCL
SDPD
DPD
DIAB
DIA2
ELEC
UELE
ELF
TFFA
FURO
FERR
FIBT
FRUC
RSTA
GGT
GLOB
RBG
GHB
TAT
Biochemistry
TEST
Haemochromatosis HFE common mutations
C282Y+H63D
HbA1c
HDL Cholesterol
Homocysteine (Quantitative)
IgG Subclasses
Immunoglobulin E – Total
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Immunoglobulins (IgG, IgM, IgA)
Iron
Iron Binding Capacity
Iron Overload Profile
Iron Status Profile
Lactate (Plasma)
Lactate Dehydrogenase (LDH)
Lead (Blood)
Lead (Urine)
Lipase
Lipid Profile
Lipoprotein (a)
Lithium (take 12 hrs after dose)
Liver Fibrosis (Enhanced Liver Fibrosis ELF)
Liver Fibrosis Fibrotest
NEW
CODE
SAMPLE REQS
TAT
HMD
A 3 days
GHB
HDL
HOMO
IGSC
IGE
IGA
IGG
IGM
IMM
FE
TIBC
IOP
ISP
LACT
LDH
LEAD
URPB
LIPA
LIPP
LPOA
LITH
ELF
FIBT
A
B
B 17
B
B
B
B
B
B
B
B
A A B 9
B
G 16
B
A
RU
B
B
B
B
B
B 6 hrs
4 hrs
1 day
4 days
1 day
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
3 days
4 hrs
1 day
4 hrs
5 days
5 days
4 hrs
4 hrs
4 hrs
4 hrs
6 days
2 weeks
Liver Function Tests
LFT
Lp-PLA2 (PLAC) Test (see page 18)
Magnesium (Serum)
Magnesium (Urine)
Manganese (Serum)
Mercury (Blood)
Mercury (Urine)
Methaqualone
Microalbumin (Urine)
Myeloma Screen
Myoglobin (Serum)
Nickel (Serum)
Nickel (Urine)
NMP22 (Bladder tumour)
Osmolality (Serum)
Osmolality (Urine)
Osteoporosis Screen
Oxalate (Urine)
PLA2
MG
URMG
MANG
MERC
URHG
METQ
UMA
MYEL
SMYO
NICK
NICU
NMP
OSMO
ROSM
OPS
UOXA
9
B
4 hrs
B
B
PU
B
A or H
RU 1
RU
RU
A B G RU
B
B
RU
J 1
B
RU
B B
PU
2 days
4 hrs
1 day
5 days
5 days
5 days
5 days
4 hrs
3 days
4 hrs
5 days
5 days
4 days
1 day
1 day
4 days
5 days
21
Biochemistry
TEST
Phencyclidine (PCP)
Phosphate
Phosphate (24 hr Urine)
NEW PLAC Test (Lp-PLA2) (see page 18)
Porphyrin (Blood)
Porphyrins (Faeces)
Porphyrins Screen (Total: Urine, Stool, Blood)
Porphyrins Screen (Urine)
Potassium
Pregnancy (Serum) [Quantitative]
Pregnancy Test (Urine)
Procalcitonin
Propoxyphene
Protein (Urine)
Protein/Creatinine Ratio (Urine)
Protein Electrophoresis
Protein Total (Blood)
Renal Stone Analysis
Salicylates
Selenium (Blood)
Selenium (Serum)
Silver (Blood)
Silver (Urine)
Sodium
Thiopurine Methyl Transferase
Total IgE
Transferrin
Triglycerides
Troponin T
Tryptase
Urate (Uric Acid)
Urea
Urea (Urine)
Urea and Electrolytes
Urea Electrolytes (Urine)
Uric Acid (Urine)
Uric Acid (Serum)
22
CODE
SAMPLE REQS
TAT
DUST
PHOS
UPH
PLA2
PORP
FPOR
PORS
RPOR
K
QHCG
PREG
PCAL
DPRO
UPRT
UCPR
PRTE
PROT
RSTA
SALI
SELR
SELE
SILV
USIL
NA
TPMT
IGE
TRAN
TRI
TROT
STRY
UA
UREA
UURE
U/E
UELE
UURI
UA
RU
B
PU
B
A 3
RF 3
A RU, RF 3
RU 3
B
B
RU
B (Frozen) 4,7
RU
CU
RU
B
B
STONE
B
A or H
B
B
RU
B
A 5
B
B
B
B
B
B
B
CU
B
CU
CU
B
5 days
4 hrs
4 hrs
2 days
15 days
15 days
15 days
15 days
4 hrs
4 hrs
4 hrs
1 day
5 days
4 hrs
4 hrs
2-4 days
4 hrs
10 days
4 hrs
4 days
4 days
5 days
5 days
4 hrs
5 days
1 day
1 day
4 hrs
4 hrs
5 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
Urobilinogen (Urine)
UURO
RU
1 day
Vitamin B12 (Active)
Vitamin D (25-OH)
VMA
B12
VITD
UVMA
B
B
PU 1
1 day
4 hrs
5 days
Biochemistry
LIPID PROFILE
UREA AND ELECTROLYTES
Triglycerides
Cholesterol
HDL Cholesterol
LDL Cholesterol
Sodium
Potassium
Chloride
Bicarbonate
Urea
Creatinine
TAT
LIVER FUNCTION TESTS
TAT
4
4
HOURS
HOURS
LIPP B
IRON STATUS PROFILE
Iron
Total Iron Binding Capacity
Ferritin
B
Iron Status Profile
Haemochromatosis
Mutation
H63D/C282Y)
TAT
4
3
HOURS
TAT
HOURS
DAYS
ISP FBC and ESR
Biochemistry Profile
Immunoglobulins
(IgA, lgG, IgM)
Bence-Jones Protein
AMI
A: Myoglobin
B: Cardiac Troponin
C: CK-MB
10
C
3
DAYS
A B G RU A A B 9
B
TAT
MYEL IOP
B
Multiples of the AMI
cutoff limit
MYELOMA SCREEN
TAT
4
Unstable angina with
minor myocardial damage
D: Cardiac Troponin
A
2
1
0
4
HOURS
LFT IRON OVERLOAD PROFILE
20
TAT
U/E B
5
Bilirubin
ALT
AST
Total Protein
Alkaline Phos
Albumin
Globulin
Gamma-GT
D
0
1
AMI Decision Limit
URL (Upper Reference limit)
2
4 12 16
hrs hrs hrs
3
4
5
6
7
14
Days after onset of AMI
Kinetic Characteristics for Chest Pain Markers
BeginningPeak
Duration
Myoglobin
12–24 hours
7–14 days
24–36 hours
Troponin
CKMB
0.5–2 hours
4–8 hours
3–8 hours
5–12 hours
12–24 hours
10–18 hours
23
Biochemistry
BONE SCREEN
(BLOODS ONLY)
BONE SCREEN
24 hour urinary calcium
24 hour urinary phosphate
Total Protein
TAT
AlbuminGlobulin
4
Calcium
HOURS
Total Protein
Albumin
Globulin
Calcium
Vitamin D (25 OH)
HOURS
TAT
4
DAYS
OPS CARDIOVASCULAR RISK PROFILE 2
CHANGE
2015
TAT
3
Cholesterol
Triglycerides
HDL Cholesterol
LDL Cholesterol
Apolipoprotein A
Apolipoprotein B
Lipoprotein (a)
Fibrinogen
hsCRP
Homocysteine
CHANGE
2015
TAT
3
DAYS
DAYS
PP10 PP11
B B B C 34
B B CHEST PAIN PROFILE
DIABETIC PROFILE 1
DIABETIC PROFILE 2
Glucose
Glycosylated Hb
Myoglobin
CK MB Fraction
Troponin T
Glucose
Glycosylated Hb
Microalbumin
TAT
TAT
HOURS
DAYS
8
STAT
2
DIAB CPP 24
4
B B
CARDIOVASCULAR RISK PROFILE 1
B TAT
B Cholesterol
Triglycerides
HDL Cholesterol
LDL Cholesterol
Apolipoprotein A
Apolipoprotein B
Lipoprotein (a)
hsCRP
Calcium
Albumin
Phosphate
Serum Crosslaps
(DPD)
Vitamin D (25 OH)
BON2 BONE B CU OSTEOPOROSIS SCREEN
A G
DIA2 A G RU
Haematology
All citrate samples C sent by post or with an overnight delay must be double spun and sent frozen.
TEST
CODE
SAMPLE REQS
TAT
Activated Protein C Resistance
Anaemia Profile
Antenatal Profile
Antithrombin Ill
APTT/KCCT
Atypical Antibody Screen (handwritten tube label)
B12 (Active)/Red Cell Folate
Blood Film Examination
Blood Group †
CD3/CD4/CD8
CD5 T+B Cells
CD16
CD19 B Cells
CD20
CD25
CD56
CD69/CD16/CD56 (NK Cells)
Coagulation Profile 1
Coombs (Direct Antiglobulin Test)
(Handwritten tube label)
D-Dimers
Direct Antiglobulin Test (Coombs)
DVT/Pre-travel Screen (see profile)
Erythropoietin
ESR
Factor V Leiden
Factor VII Assay
Factor VIII Assay
Factor IX Assay
Factor X Assay
Factor XI Assay
Factor XII Assay
Factor XIII Assay
Fibrinogen
Folate (Red Cell)
Folate (Serum)
Full Blood Count
APCR
ANAE
ANTE
A111
KCCT
AASC
B12F
FILM
ABO
LYSS
CD5
CD16
CD19
CD20
CD25
CD56
CD69
CLPF
CLOT
C (Frozen) A A B
A A 33 B B B G
C (Frozen) 4,9,18
C 18
A 22,33
A B
A
A 22,32
A 10/Chex
A 4
A 4
A 4
A 10/Chex
A 10/Chex
A 4
H 5,34
C 18
A C 18
3 days
2 days
3 days
3 days
4 hrs
2 days
2 days
4 hrs
2 days
1 day
1 day
1 day
1 day
2 days
2 days
1 day
2 days
4 hrs
4 hrs
COOM
A 22,33
2 days
DDIT
C 1 day
COOM
DVT1
ERY
ESR
FX2
FX5
FAC7
FAC8
F1X
FX
FX1
FX11
FA13
FIB
RBCF
FOLA
FBC
4,18
4
2 days
A 22,33
A A B
B
A
A 9
A 9
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen)9,18
C 4,18
A
B
A
9
5 days
4 days
4 hrs
5 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
4 hrs
2 days
1 day
4 hrs
†The tube’s own label must be completed by hand. This must correspond with same name and date of birth
details as given on the request form. Do not affix additional computerised or hand written labels.
25
Haematology
All citrate samples C sent by post or with an overnight delay must be double spun and sent frozen.
26
TEST
CODE
SAMPLE REQS
TAT
G6PD
Haematology Profile
Haemoglobin
Haemoglobin Electrophoresis
HFE gene (Haemochromatosis) –
common mutations C282Y + H63D
Hughes Syndrome
INR
Leishmania Blood Film
Lupus Anticoagulant and Anticardiolipin Abs
Lupus Anticoagulant only
Lymphocyte Immunophenotyping (Leukaemia)
Lymphocyte Subsets (CD3/CD4/CD8)
Malarial Parasites
Microfilaria Blood Film
Miscarriage/Thrombotic Risk Profile
PAI1 4G/5G Polymorphism
Paul Bunnell (Monospot)
Plasma Viscosity
Platelet Count
Pre-Travel Screen (DVT)
Protein C
Protein S Free Ag
Prothrombin Time
Prothrombin Time + Dose
Reticulocyte Count
Sickle Cells
Thalassaemia Screen
Thrombotic Risk Profile
Viscosity (Plasma)
Vitamin B12 (Active) / Red Cell Folate
Von Willebrand Profile
G6PD
PP3
HB
HBEL
A
A
A
A
5 days
4 hrs
4 hrs
4 days
HMD
A 9
3 days
HOMO
LUPA
PTIM
LEIF
LUPA
LUPC
LYPT
LYSS
MALP
MICF
PROP
NK1
PAIP
PAUL
VISC
PLTS
DVT1
PRC
FPRS
PTIM
PT+D
RETC
SICK
THSC
PROP
VISC
B12
B12F
FVWF
B B C 4,18
C 18
A
B C 4,18
C C 18
A 4,5
A 10/Chex
A 4,9,14
A
A A B C C C 18
A A H 10
A
A or B
A 4
A
A A B 9
C (Frozen) 4,9,18
C (Frozen) 4,9,18
C 18
C 18
A
A
A
A A B C C C 18
A 4
B
A B
C (Frozen) 4,12
1 day
2 days
4 hrs
8 hrs
2 days
2 days
5 days
2 days
STAT
STAT
5 days
2 days
10 days
8 hrs
3 days
4 hrs
5 days
3 days
3 days
4 hrs
4 hrs
4 hrs
4 days
4 days
5 days
3 days
1 day
2 days
5 days
17
Haematology
HAEMATOLOGY PROFILE
COAGULATION PROFILE 1
FBC + 5 part Diff
ESR
COAGULATION PROFILE 2
Prothrombin Time
APTT
Fibrinogen
FBC + 5 part Diff
Prothrombin Time
APTT
Fibrinogen
TAT
TAT
HOURS
HOURS
HOURS
CLPF
CLOT
4
4
PP3 ANAEMIA PROFILE
PRE-TRAVEL SCREEN (DVT)
FBC + 5 part Diff
ESR
Iron, TIBC
Ferritin
B12 (Active)
Folate (RBC)
TAT
2
4
A C 18
C 18
A
TAT
FBC
Factor V Leiden
Anticardiolipin
TAT
Antibodies
VON WILLEBRAND PROFILE
Von Willebrand Factor
Von Willebrand Activity
(Ristocetin Cofactor)
Factor VIII Assay
TAT
5
5
DAYS
DAYS
DAYS
ANAE
DVT1
FVWF
C 4,12
A A B 9
A A B
THROMBOTIC RISK PROFILE
ANTENATAL PROFILE
NATURAL KILLER PROFILE
FBC + 5 part Diff
Blood Group and Rh Type
Atypical Antibody Screen
Haemoglobin electrophoresis
Syphilis IgG/IgM
Glucose
FT4/TSH
Rubella Antibodies (IgG)
Toxoplasma (IgG/IgM)
Hepatitis B sAg
Hep C Abs
Varicella Zoster IgG (Immunity)
HIV 1 & 2 Abs
FBC
Coagulation Profile
Antithrombin III
Factor V Leiden gene
Factor II Prothrombin gene
MTHFR gene
Fibrinogen
Lupus Anticoagulant
Protein C
Free Protein S Ag
Anticardiolipin Abs
CD3
CD4
CD5
CD8
CD16
CD19
CD56
CD69
TAT
3
DAYS
TAT
5
DAYS
PROP
A A B C C C 18
Please ensure the blood
group (EDTA) tube label is
HANDWRITTEN. Do not affix
a secondary label.
TAT
2
DAYS
ANTE
A A 33 B B B G
NK1
A A H 10
27
Microbiology
Please refer to the website (www.tdlpathology.com) for a list of factors that may affect microbiology test
performance and for special instruction for sample collection, transportation and handling.
TEST
CODE
Blood Culture
Chlamydia trachomatis by PCR (Swab)
Chlamydia trachomatis by PCR (Thin Prep)
Chlamydia trachomatis by PCR (Urine)
Chlamydia trachomatis by PCR (Semen)
Clostridium Difficile Toxin
Cryptococcal Antigen
Cryptosporidium
CSF for Microscopy and Culture
Faecal Occult Blood/FOB (immunochemical/FIT)
Fluid Culture
Fluid for Crystals
Food Microbiology
Fungal ID + Sens
Group B Strep
Gonorrhoea by Culture
HVS (inc. Mycoplasma + Ureaplasma)
IUCD for Culture
Legionella Urine Antigen
MRSA (Rapid PCR) one swab per site
MRSA Culture one swab per site
Mycology/Skin Scrapings
Mycoplasma/Ureaplasma Culture
Nail Clippings
Pleural Fluid for Culture
Pneumococcal Antigen
Pneumocystis Examination
Rapid Strep (incl. m/c/s)
Rotavirus in Stool
BCUL
SPCR
TPCR
CPCR
UPCR
CLOS
CRYC
CRPO
CSF
FOB
FLUD
FLU2
FOOD
FUID
GBS
GONN
HVS
IUCD
LEGA
MRSA
MRSW
SKSC
MYCS
SKSC
FLUP
PNAG
PCYS
RAPS
ROTA
Schistosoma (Urine)
USCH
Sellotape Test
Semen Analysis
Semen Culture
Skin Scrapings/Mycology
Specific Gravity (Urine)
Sputum for Routine Culture
Sputum for TB Culture (AFB)
SELL
SPCU
SKSC
USG
SPU1
SPU2
SAMPLE REQS
TAT
2x BC 5 days +
PCR
2 days
TPV
5 days
FCRU
2 days
Semen
5 days
RF*
2 days
Serum or CSF
1 day
RF
2 days
CSF
2-3 days
RF
1 day
SC
2-7 days
SC
1 day
Submit sample
10 days
Fungal sample/STM
14 days
2x STM
3 days
STM
2-3 days
STM
2-3 days
Send Device
10 days
RU
1 day
Blue Micro Swab
4 hrs
Blue Micro Swab
2 days
Submit Sample
3-4 weeks
RU,Swab
2-3 days
Nail clippings
3-4 weeks
SC
2 days
RU
1 day
BAL*
1 day
STM**
2 days**
RF
8 hrs
Mid-morning
8 hrs
terminal urine
Send Sample***
1 day
see Andrology page 40
Semen
2-3 days
Send Sample
3-4 weeks
RU
8 hrs
SC
2-3 days
SC
up to 8 weeks
4
* Not performed on formed stool specimens.
** Do not use a black swab for RAPS. Use Blue only. Rapid antigen is reported within 4hrs with full culture to follow.
*** Use clear Sellotape only and attach to slide.
28
Microbiology
TEST
CODE
Stool for OCP and Culture
Stool for OVA Cysts & Parasites
Swab for Culture (Any Site)
Synovial Fluid (For Crystals)
TB (pleuralfluid)
TB Culture
TB Culture (Urine)
SPAR
OCP
SWAB
FLU2
TBCU
SPU2
TBUR
TB Slopes – Confirmation and Sensitivity
TBSL
Tissue for culture
Ureaplasma/Mycoplasma Culture
Urine (Microscopy Only)
Urine for Microscopy and Culture
TISS
MYCS
UMIC
UCEM
SAMPLE REQS
TAT
RF
RF
STM
SC
SC
SC
3x EMU
TB slope
(LJ medium-green) 6
Tissue sample
RU,Swab
RU
RU
2-3 days
1 day
2-3 days
1 day
up to 8 weeks
up to 8 weeks
up to 8 weeks
up to 8 weeks
up to 7 days
2-3 days
1 day
1-2 days
* BAL: Induced sputum or bronchoalveolar larage
GROUP B STREPTOCOCCUS (GBS)
GBS is recognised as the primary cause of bacterial infection in new-born babies, resulting in disease
at birth and up to 3 months of age. GBS is a normal body commensal. Normally GBS is harmless and
needs no treatment. However, for a pregnant woman, positive for GBS at the time of delivery, intravenous
antibiotics are effective against GBS infection that can affect new-born babies. 2 Blue culture swabs (low
vaginal and rectal) should ideally be taken from 35 weeks.
29
Microbiology
Swabs: Types and Codes
Patient Request Forms AND Swabs should be labelled with the body site from which the sample was
taken. This is important. The swab site determines the appropriate culture media required to target the
most likely pathogens.
SITE
CODE
SAMPLE TYPE
Culture Swabs
Cervical SwabCERS
Blue Micro Swab
Eye SwabEYES
Blue or Orange Micro Swab
Ear SwabEARS
GonorrhoeaGONN
Blue Micro Swab
High Vaginal SwabHVS
Blue Micro Swab
Nasal SwabNASS
Oral SwabORSW
Blue Micro Swab
Penile SwabPENS
Orange Micro Swab
Rectal SwabRECG
Blue Micro Swab
Skin SwabSKIS
Blue Micro Swab
Throat Swab THRS Blue Micro Swab
Urethral SwabURES
Orange Micro Swab
Vaginal SwabVAGS
Blue Micro Swab
Vulval SwabVULV
Blue Micro Swab
Wound SwabWOUS
Blue Micro Swab
Blue Micro/Transwab
are multipurpose, culture
swabs in transport medium
Orange Micro/Transwab
are small, thin wire culture
swabs in transport medium
PCR swabs are also
known as DRY SWABS
Female/Purple DRY
PCR swab
Male/Blue DRY PCR swab
MRSA by Culture
MRSW Blue Micro Swab x 1 – state site
MRW2 Blue Micro Swab x 2 – state sites
MRW3
Blue Micro Swab x 3 – state sites
MRW4
MRW5
RAPID MRSA by PCRMRSA
Blue Micro Swab x 1 – state site
MRS2
Note: This PCR
methodology uses
MRS3
culture swabs
MRS4
MRS5
PCR Swabs/Not Culture
(First Catch Urine or Thin Prep Vial can also be used as alternative sample types for these tests).
Chlamydia
Chlamydia/Gonorrhoea
Herpes Simplex I/II
SPCR
SCG
HERS
PCR Dry Swab (Blue / Purple)
DL12 (7 STIs by PCR)
Viral Eye Swab
Viral Skin Swab
DL12
VPE
VPSK
PCR Dry Swab (Blue – Thin wire)
PCR Dry Swab (Blue – Thin wire)
H1N1 Swabs
Swine H1N1 FluH1N1
Blue (Thin wire) PCR Dry Swab x 2 (nose and throat)
Double Bagged and marked as High Risk
30
Endocrinology
TEST
17 Hydroxyprogesterone
ACTH (Adreno Corticotrophic Hormone)
Aldosterone
Alpha Feto Protein
Amenorrhoea Profile
Andropause Profile
Androstenedione
Antimullerian Hormone [Elecsys/Roche]
CHANGE
(see page 34)
Beta HCG (Quantitative)
BNP (NT-pro BNP)
C Peptide
Calcitonin
Catecholamines (Plasma)
Catecholamines (Urine)
Cortisol
Cortisol (Urine)
DHEA
DHEA Sulphate
Dihydrotestosterone
Down Syndrome Risk Bloods only
(Risk to be calculated by clinician)
Down Syndrome Risk Profile with risk calculation
first trimester
Down Syndrome Risk Profile (2nd trimester) Quad
Female Hormone Profile
First Trimester Antenatal Screen
Free T3
Free T4
FSH
Growth Hormone (Fasting)
Hirsutism Profile
HRT Profile 1
HRT Profile 2
IGF-1 (Somatomedin)
IGF-BP3
Impotence Profile
Male Hormone Profile
Inhibin B
Insulin
Insulin Resistance (Fasting)
Luteinising Hormone (LH)
Macroprolactin
CODE
SAMPLE REQS
TAT
17OH
ACTH
ALDN
AFP
AMEN
ANDP
ANDR
B
J 1
B
B
B
B B
B (Frozen) 5 days
1 day
5 days
4 hrs
4 hrs
8 hrs
1 day
AMH
B
4 hrs
QHCG
BNP
CPEP
CATO
CATE
UCAT
CORT
UCOR
DHEX
DHEA
DHT
B
B
B
B (Frozen) 4
A A (Plasma Frozen) 4
PU1
B
CU
B
B
B B
4 hrs
4 hrs
3 days
1 day
5 days
5 days
4 hrs
5 days
7-10 days
4 hrs
7 days
B
4 hrs
HCGF/PAPA
DRP
DRP
IMPO
FIP
HCGF/PAPA
FT3
FT4
FSH
GH
HIRP
HRT
HRT2
SOMA
IGF3
IMPO
MIPR
INIB
INSU
FIRI
LH
PRLD
B,DRP form +
image of scan 7,8
B,DRP form 7,8
A B B G
B
B
B
B
B
B 7,35
B
B
B G
B (Frozen) 4
B (Frozen) 4
A B B G
B
B (Day 3 of cycle,frozen)
B
B G
B
B
2 days
2 days
3 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
1 day
5 days
3 days
4 hrs
5 days
4 hrs
4 hrs
4 hrs
4 days
31
Endocrinology
32
TEST
CODE
Menopause Profile
Metabolic Syndrome Profile
Metanephrines (Plasma)
Metanephrines (Urine)
Oestradiol (E2)
Oestriol (Estriol)
Oestrone
Osteocalcin
Parathyroid Hormone (Whole)
Polycystic Ovary Syndrome Profile
Pregnenolone
Progesterone
Proinsulin
Prolactin
Prolactin (Macro)
Renin
Reverse T3
Serotonin
Sex Hormone Binding Globulin
Somatomedin (IGF-1)
T3
T3 (Reverse)
Testosterone
Testosterone (Free)
Thyroglobulin Abs
Thyroglobulin Assay
Thyroid Abs (incl. TGAB + TPEX)
Thyroid Peroxidase
Thyroid Profile 1
Thyroid Profile 2
Thyroid Profile 3
Thyroxine (T4)
TSH
TSH-Receptor Antibodies
MENO
METS
PMET
UMEX
OEST
E3
E1
OST
PTHI
PITF
PCOP
QHCG
PREN
PROG
PROI
PROL
PRLD
RENI
RT3
SERT
SHBG
SOMA
T3
RT3
TEST
FTES
TGAB
TGA
THAB
TPEX
TF
TF2
TF3
T4
TSH
TSI
SAMPLE REQS
TAT
B
A B B G
A (Frozen plasma)
PU 1
B
B B
B B
B (Frozen) 4
B 4
B B
A B B B G 7
B
B
B
B (Frozen)
B
B
A (Frozen plasma) 36
B 7,37
H (Frozen whole blood) 1
B
B (Frozen) 4
B
B 7,37
B
B
B
B
B
B
B
B
B
B
B
B
4 hrs
9 days
7 days
5 days
4 hrs
4 days
4 days
4 days
1 day
1 day
5 days
4 hrs
5 days
4 hrs
5 days
4 hrs
4 days
5 days
10 days
10 days
4 hrs
1 day
4 hrs
10 days
4 hrs
3 days
1 day
1 day
1 day
1 day
4 hrs
2 days
4 hrs
4 hrs
4 hrs
4 days
Endocrinology
REPRODUCTIVE IMMUNOLOGY AT
ST HELIER, CARSHALTON
CODE
TEST
SAMPLE REQS
TAT
CD69
HSNK
69C
NK (CD69) cell Assay
NK Cytotoxicity Assay
NK (CD69) and NK Cytotoxicity
NK Cytotoxicity w.suppression, steroid,
IVIg & Intralipin
NK Cytotoxicity with suppression with
steroid, IVIg and intralipin, and NK (CD69)
cell assay
TH1/TH2 cytokine profile
Suppression with steroid, IVIg and intralipin,
NK (CD69) cell assay, TH1/TH2 cytokines H
HHH 5,34
HHH 5,34
Send Mon-Thurs only
Send Mon-Thurs only
Send Mon-Thurs only
HHH 5,34
Send Mon-Thurs only
HHH 5,34
Send Mon-Thurs only
HHH 5,34
Send Mon-Thurs only
HHH
Send Mon-Thurs only
NKCY
69CI
1TH2
NCIT
5,34
5,34
Patients need to attend Patient Reception at 76 Wimpole Street by 11.00am latest Mondays – Fridays.
Samples cannot be accepted on Saturdays/Sundays. Allow 2 days for results.
REPRODUCTIVE IMMUNOLOGY AT
ROSALIND FRANKLIN LABORATORIES, CHICAGO, USA
CODE
TEST
SAMPLE REQS
TAT
3RF
4RF
5RF
6RF
7RF
8RF
9RF
10RF
11RF
15RF
16RF
17RF
18RF
Reproductive Immunophenotype Panel
NK Assay/Cytotoxicity Panel
NK Assay Follow-Up Panel
TH1/TH2 Cytokine Ratio
Leucocyte Antibody Detection MALE Leucocyte Antibody Detection FEMALE
HLA DR Antigens
HLA DQ Alpha Antigens
HLA DQ Beta Antigens
NK Assay Endometrial Biopsy (tissue)
NK Assay Panel + Intralipids
KIR (Killer-like Immunoglobulin-like Receptors) Genotyping
Endothelial Nitric Oxide Synthase (eNOS) 8-786C mutation
Endothelial Nitric Oxide Synthase (eNOS) G894T
(Glu294Asp) mutation
H H H
H H H
H H H
H H H 5
H H H 3,4,6
B 3,4,6
A A
A A
A A
Tissue
H H H
A A A A A A 1 week
1 week
1 week
1 week
1 week
1 week
2 weeks
2 weeks
2 weeks
2 weeks
1 week
2-3 weeks
2 weeks
A A A 2 weeks
19RF
Patients who have samples taken at TDL’s Patient Reception at 76 Wimpole Street may attend any time
during hours of opening on Mondays or Tuesdays, and by NOON on Wednesdays to allow for same day
shipping to Chicago by Fed Ex. Samples for Rosalind Franklin are not accepted on Thursdays, Fridays or
Saturdays. Fed Ex charges are included in these charges.
33
Endocrinology
THYROID PROFILE 1
FT4
TSH
THYROID PROFILE 2
TAT
4
T4
Free T3
TSH
Free T4
Thyroid Antibodies
TAT
2
B
FEMALE HORMONE PROFILE
TAT
4
HOURS
FSH
LH
Testosterone
Free Androgen Index
Prolactin
SHBG
TAT
4
HOURS
Lipid Profile
Glucose
HbA1C
TSH
Prolactin
Total Testosterone
Free Testosterone
PSA
TF3
ANDROPAUSE PROFILE
DHEAs
FSH
Testosterone
Free Androgen Index
LH
SHBG
TAT
8
HOURS
MIPR
B
ERECTILE DYSFUNCTION/
IMPOTENCE PROFILE
4
HOURS
B
MALE HORMONE PROFILE
FIP B
TAT
TF2
TF LH
FSH
Prolactin
Oestradiol (17-Beta)
FT3
FT4
TSH
DAYS
HOURS
B
THYROID PROFILE 3
ANDP
B B
ANTIMULLERIAN HORMONE (AMH)
On the 3rd November 2014 the laboratory methodology was
changed from the Beckman Coulter AMH Gen II assay to the fully
automated Roche Elecsys AMH Assay.
Roche values are expected to be 25% lower. Therefore
for direct comparison between the two methods,
any results prior to the 3rd November 2014 should be
multiplied by 0.75 (x 0.75). The need for this calculation
is clearly shown with each result.
TAT
3
DAYS
IMPO
A B B G
Age related reference
intervals in women
The reference intervals below
are derived from a population
of apparently healthy women
not taking any contraceptive
medication. The reference
intervals represent the 10th –
90th percentile values for the
women in each age bracket.
CHANGE
2015
TAT
4
HOURS
Age Range
Elecsys AMH
(pmol/L)
20 – 29 years
13.1 – 53.8
30 – 34 years
6.8 – 47.8
35 – 39 years
5.5 – 37.4
40 – 44 years
0.7 – 21.2
45 – 50 years
0.3 – 14.7
More Hormone Profiles
are shown on page 32
AMH
can be taken, at any time during a patient’s monthly cycle. Ambient, unspun
B Samples
sample stability has been validated for up to 5 days. Postal samples are therefore
acceptable, and samples can also be collected and posted using TDL TINIES.
34
Endocrinology
HRT PROFILE 1
HRT PROFILE 2
FSH
Progesterone
TAT
Lipid Profile
Glucose
FT4
TSH
FSH
OEST
LH
FSH
Prolactin
TAT
TAT
HOURS
HOURS
HOURS
HRT
HRT2
AMEN
4
B
4
BG
PITUITARY FUNCTION PROFILE
TSH
FSH
LH
Prolactin
Growth Hormone
Cortisol
Please provide details of time
of day sample is taken.
Patient should be
TAT
resting for 30 mins
before sample taking.
DAY
B
Lipid Profile
Glucose
HbA1C
Insulin
CRP
hsCRP
Adiponectin
9
METS
A B B G FIRST TRIMESTER
SCREENING BLOODS ONLY
(Risk to be calculated
by requesting clinician)
FSH
LH
Testosterone
DHEAs
SHBG
Free β-hCG
PAPP-A
Free β-hCG and PAPP-A in serum and
sonographic determination of nuchal
translucency (NT) are markers of
choice to identify women at increased
risk of Down Syndrome during the first
trimester (week 11-13) of pregnancy.
TAT
TAT
HOURS
HOURS
HIRP
HCGF / PAPA
4
4
TAT
4
HOURS
MENO
DAYS
HIRSUTISM PROFILE
MENOPAUSE PROFILE
FSH
LH
TSH
FT4
TAT
PITF
B B
4
METABOLIC SYNDROME PROFILE
1
B
AMENORRHOEA PROFILE
B
B
POLYCYSTIC OVARY
SYNDROME PROFILE
Testosterone
TSH
Glucose
HbA1C
FSH
DHEAs
Insulin
LH
Lipid Profile
Prolactin
Cortisol
Antimullerian Hormone
Androstenedione
SHBG
A fasting 9.00am sample
is recommended.
TAT
5
DAYS
PCOP
A B B B G 7
35
Reproductive health
The tests in this section are drawn from all disciplines of diagnostic pathology and are listed in other
appropriate sections in the Laboratory Guide.
PUBERTY
The beginning of the reproductive
cycle of life – diagnosis tests
may include:
LH
•Oestradiol
Oestradiol
•FSH
FSH
•LH
Progesterone
•Progesterone
•Androstenedione
• DHEA sulphate
•Testosterone
•SHBG
Day1
Menstruation
•Prolactin
Day 14
Ovulation
Follicular Phase
Day 28
Menstruation
Luteal Phase
THE MENSTRUAL CYCLE/PREGNANCY
This cycle controls female fertility and is influenced by hormone levels which impact bone health and
many other aspects of female physiology. Pregnancy lasts 40 weeks and is divided into trimesters.
First Trimester (week 0–13): confirmation of pregnancy and associated tests may include:
• Pregnancy test (urine)
• Quantitated Beta HCG (serum)
• Ectopic Pregnancy assessment (Beta HCG and Progesterone)
• Recurrent Miscarriage Profile
• Antenatal Screen
• Nuchal Scan with Free Beta HCG and PAPP-A or Non-Invasive Prenatal (NIPT) for risk assessment
of Downs Risk (a DRP request form must be enclosed with samples, see back of guide, and an
image of the scan attached to the request form). Contact TDL Genetics for details of Non-Invasive
Prenatal Testing (NIPT)
• Chorionic Villus Sampling (CVS) for chromosomal analysis (PCR for Rapid Trisomy and karyotyping
for the rarer abnormalities)
• Toxoplasma/Varicella Zoster/Parvovirus/CMV
36
Reproductive health
Second Trimester (week 14–26):
testing is primarily directed at evaluating the
actual and potential development of the baby
and may include:
Third Trimester (week 27–40):
testing for foetal wellbeing and the health
of the mother may include:
• Downs Risk Profile (Triple Test +)
•Toxoplasma
• Amniocentesis for chromosomal analysis
(AmnioPCR for Rapid Trisomy and karyotyping
for the rarer abnormalities)
• Atypical antibody screening
• Glucose and Protein (urine or serum)
• Glucose and Protein (urine or serum)
• Group B Strep (35-37 weeks –
rectal and low vaginal swabs)
•Chlamydia
INFERTILITY
Infertility and its management is increasingly implicated in growing numbers of clinical disciplines.
More recently, greater emphasis is being given to male infertility. Recent data suggests that approximately
40% of all infertility is ascribed entirely, or in part, to male factors, 40% to female factors with an
additional 20% unexplained. Testing at the outset of infertility treatment can reduce some of the emotional
and financial costs, as well as allowing couples to pursue other possible options.
•Hormones
• Infection
•Lifestyle/Environmental
• Chromosomes/Genetics
• Ovarian Reserve
• Polycystic Ovary Syndrome
• Unexplained Infertility/Implantation failure
• Recurrent/Spontaneous miscarriage
• Male Factors
AGEING
Reaching menopause and andropause is a gradual process with modulating hormones as ovarian
function declines in women, and the more gradual, less defined and highly variable effect in men.
Testing may include:
• Hormones (Menopause/Andropause Profile)
• Testosterone/Free testosterone/
Bioavailable Testosterone
•SHBG
•DHEAs
General patterns of age-related decline
in estradiol levels in women (left)
and total testosterone levels in men (right)
• Thyroid function
• Osteoporosis/Bone Markers
37
Reproductive health
INFERTILITY
HORMONES
FEMALE
MALE
Testosterone/Prolactin/FSH/LH
Inhibin B (male)
Andropause Profile
Insulin Resistance
Erectile Dysfunction
Impotence Profile
FSH – day 2/3
LH
Oestradiol
Antimullerian Hormone (AMH)
Progesterone – day 21
Prolactin
Ovarian Reserve Profile
INFECTION
FEMALE
MALE
High Vaginal swab
Cervical swab
Bacterial Vaginosis screen
Toxoplasma
CMV
Syphilis
Hep B sAg/Hep B Core Abs/Hep C/HIV 1&2
Herpes Simplex I/II by PCR
STI Profiles
Infection screening by PCR
Investigations for prostatitis/urethritis
Mycoplasma Genitalium
Ureaplasma
Chlamydia in Semen
Hep B sAg/Hep B Core Abs/Hep C/HIV 1&2
Semen culture
Syphilis
STI Profiles
Infection screening by PCR
LIFESTYLE /ENVIRONMENT
FEMALE
Well Person Profile DL6
Zinc, Lead
Trace Metal Profile (blood)
Antioxidant Activity
Thyroid Profiles
Vitamin Profiles
Vitamin D (25 OH)
Folate
Selenium
Omega 3/Omega 6
38
MALE
Fit for Fertility Male Profile
Well Person Profile DL6
Trace Metal Profile (blood)
Antioxidant Activity
Thyroid Profiles
Vitamin Profiles
Vitamin D (25 OH)
Folate
Selenium
Zinc
Omega 3/Omega 6
Oxidative Stress (ROS) in Semen
Reproductive health
CHROMOSOMES/GENETICS
FEMALE
MALE
Chromosome/Karyotype (parental)
Y-Chromosome microdeletion
Fragile X Male
Cystic Fibrosis Screen
Tay Sachs
Jewish Carrier Profile
Inherited disorders (specific)
Fragile X (female)
Cystic Fibrosis Screen
Tay Sachs
Jewish Carrier Profile
Inherited disorders (specific)
OVARIAN TUMOUR
FEMALE
Antimullerian Hormone (AMH)
CA 125 / HE4
POLYCYSTIC OVARY SYNDROME
FEMALE
Polycystic Ovary Profile
UNEXPLAINED INFERTILITY/IMPLANTATION FAILURE
/RECURRENT MISCARRIAGE
FEMALE
MALE
Recurrent Miscarriage Profile
Reproductive Immunophenotyping
(CD 3/4/8, CD 5/19, CD 16/56/69)
NK Cell Profile
Antiphosholipid Antibodies
Lupus anticoagulant and Anticardiolipin Antibodies
Thrombotic Profile
Antinuclear antibodies
Anti-Thyroglobulin Antibodies
Anti Microsomal Antibodies
Infection screening (See Infection)
Y-Chromosome microdeletion
Sperm DNA Fragmentation
Sperm aneuploidy
Infection screening (See Infection)
Heavy Metals (Blood)
Male Recurrent Miscarriage Profile
Oxidative Stress in Semen (Reactive Oxygen Species)
SPERM HEALTH
MALE
See TDL Andrology on page 40.
39
TDL Andrology
The single most important factor determining a man’s fertility
potential is the production of healthy sperm. A semen analysis
has classically been used as the marker of this potential, by
providing information about the sperm count, motility and
morphology. However, there are other parameters given in a
semen analysis that are often neglected or overlooked, which
may indicate important pathologies – such as infection, prostatic
disease, immunological infertility, retrograde ejaculation,
malformation or obstruction of the genital tract, tumour, and
congenital or endocrine disorders.
Early diagnosis of the male factor is important in order to detect any underlying pathology, determine the
extent of infertility and ensure appropriate treatment. It may also avoid unnecessary investigations for the
female partner, particularly if her age is a limiting factor.
For men who have had a vasectomy, clearance should only be given when there is no evidence of
presence of sperm in two consecutive semen samples. It is therefore vital to ensure that results are
reported according to best practice guidelines. Special clearance may be given at the doctor’s discretion
when there are persistent non-motile sperm present.
Guidelines for Producing Samples
Ideally semen samples should be produced on-site at TDL’s Patient Reception at 76 Wimpole Street.
Ideally patients must abstain from ejaculation for 2-3 days prior to the test, but no less than 2 days and no
longer than 5 days before the test. This requirement is important for semen analyses and post vasectomy
analyses to ensure reliability of results. It is possible that samples that do not comply with guidelines for
abstinence and collection may not be able to be processed. All semen samples must be produced directly
into the sterile containers provided by The Doctors Laboratory.
All containers are weighed and batch tested for sperm cytotoxicity. In exceptional circumstances when
semen samples are produced off-site, they can only be accepted by the Andrology Department in sample
containers provided by TDL.
WHO 2010 guidelines state that two semen analyses should be performed before any diagnosis is
confirmed. This may require requests for two (separate) semen analyses.
Appointments
It is important to make an appointment for all semen samples (on or off site) whether for a
comprehensive semen analysis or post vasectomy analysis. It may be necessary to give patients
who attend without an appointment a specific time to re-attend. The first appointments for post
vasectomy samples should usually be 16 weeks and 24 ejaculations after surgery.
Practices or Patients should contact TDL Andrology to arrange an appointment and confirm instructions
for sample collection (There is a charge in addition to pathology charges). Appointments can be made by
calling 020 7025 7940. Times for semen sample collections are different to normal hours:
Monday to Friday: 8.00am – 5.00pm
Saturday: 9.00am – 3.00pm
Please complete a Pathology Request Form for your patient. If you would like to request other pathology,
you can use the same form or complete a second additional form. Results will usually be reported to you
within 48 hours.
If you would like to discuss these tests, or any aspect of this service, please contact TDL Andrology on
020 7025 7940 or email [email protected] for further information.
40
TDL Andrology
SEMEN
TEST
CODE
SAMPLE REQS
TAT
Semen Analysis, Comprehensive
Semen Analysis, Vasectomy Reversal
Semen Analysis, Post-Vasectomy**
SPER
SPER
PVAS
SPCU
SPCF
PMNS
ASAB
ASPA
SPPL
SEXT
MRPH
SROS
RTRO
Semen Semen 1
Semen 1
Semen
Semen
Semen
B
Semen
Semen 1
Semen 1
Semen 1
Semen 1
Contact Lab
2 days*
2 days*
2 days
2-3 days
2 days
2 days
5 days
1 day
4-6 weeks
2-3 weeks
2 days
1 day
2 days
Semen Culture
Semen Fructose
Semen Leucocytes
Sperm Antibodies (Serum)†
Sperm Antibodies /MAR Test (Semen)
Sperm Aneuploidy (FISH)
Sperm DNA Fragmentation (SCSA)
Sperm Morphology (Kruger strict criteria)
Oxidative Stress in Semen (ROS)
Retrograde Ejaculation
1
Semen parameters may be requested INDIVIDUALLY (eg count only, vitality only, etc). Please request as SPOD and indicate on the request form which parameter is required.
Semen Parameters
SPOD
Semen 1
1 day
* If required,comprehensive semen analysis can be reported within 4 hrs, with morphology to follow.
**British Andrology Society guidelines state that a minimum of two tests should be performed before clearance may be given.
† Sperm antibodies in semen are measured as part of the routine semen analysis.
BY SPECIAL ARRANGEMENT
Sperm swim test
Sperm preparation for overnight survival
Sperm motility and vitality testing for epididymal toxicity
Sperm retrieval procedures (biopsy, PESA, MESA)
Sperm cryopreservation and storage
(undertaken by Andrology Solutions – HFEA and EUTD licensed)
All men who store sperm must be screened for HIV 1&2, Hepatitis B, Hepatitis C and HTLV. Under HFEA
regulations, sperm can be stored for an initial period of 10 years with formal consent. All patients are offered
counselling prior to sperm cryopreservation.
These arrangements, and details for other specialist semen tests, are available on request. Please contact TDL
Andrology on 020 7025 7940 or email [email protected] for further information.
41
TDL Andrology
Information about Sperm DNA
Sperm DNA or aneuploidy are not part of the Comprehensive Semen Analysis and needs to be
requested as a separate test. Samples need to be frozen as soon as possible after liquefaction.
If these are prepared by another laboratory, two cryovials containing not less than 0.25mls of
liquefied, raw semen is required. Frozen samples can be sent to or collected by TDL, by arrangement,
and must be accompanied with relevant patient details, and the sperm count. A count of a minimum
1 million/ml is required for accurate DNA and aneuploidy reporting.
Results for DNA fragmentation analysis
The results are reported as follows:
DNA Fragmentation Index (%DFI; % sperm cells containing measurable DNA damage)
_< 15% DFI = Excellent to good sperm DNA integrity
> 15 to < 25% DFI = Good to fair sperm DNA integrity
> 25 to < 50% DFI = Fair to poor sperm DNA integrity
_> 50% DFI = Very poor sperm DNA integrity
The above values relate to natural and IUI conceptions. When % DFI is above 25%, current literature
suggests that the patient either try to reduce that number by medical intervention or change of
lifestyle, or skipping IUI and go on to IVF/ICSI for greatest success. (www.scsatest.com for details).
Hypothesis: A high ratio of moderate DFI to high DFI sperm may be the most negative since
moderate DFI sperm have normal nuclear morphology and will likely fertilise but may have DNA
damage beyond repair capacity of eggs.
High DNA stainability (HDS): % sperm with immature chromatin and abnormal proteins; levels in
the > 25% range are considered negative for pregnancy outcome.
If you would like to discuss these tests, or any aspect of this service, please contact TDL Andrology on
020 7307 7373 or 020 7025 7940, or email [email protected].
Oxidative Stress in Semen (ROS) and Male Infertility
Almost 50% of all cases of infertility may be associated with a male factor. Although a semen
analysis has classically been used as the gold standard for determining a man’s fertility, this test may
not detect abnormalities at the molecular level. These abnormalities may contribute to the 25% of
infertility cases that remain unexplained.
There is growing evidence to support a link between oxidative stress and male infertility. Reactive
oxygen species (ROS) are generated by human sperm as part of their normal metabolism. At low
levels, ROS enhance sperm performance and are maintained at low levels by effective anti-oxidant
pathways. However, if the production of ROS overwhelms the capacity of these anti-oxidant
pathways then oxidative stress occurs, leading to pathological effects.
Reference
Vessey, W., Perez-Miranda, A., Macfarquhar, R., Agarwal, A., Homa, S., 2014. Reactive oxygen species (ROS) in human
semen: validation and qualification of a chemiluminescence assay. Fertil Steril (in press).
42
TDL Andrology
Effects of ROS-induced Oxidative Stress
on Sperm
• Lipid peroxidation which damages the
sperm surface causing an abnormal
morphology and impaired motility.
• Damage to proteins on cell surface
responsible for cell signalling and may
affect enzyme function inside the cell.
• Increased semen viscosity.
• Peroxidation of DNA and subsequent
unravelling or fragmentation.
• Possible mutagenic effects.
• Damage to seminiferous epithelium,
damage to tubules, testicular atrophy,
reduced spermatogenesis.
• Decrease in sperm vitality.
• Impaired fertilization by affecting sperm
capacitation and the acrosome reaction.
Causes of Elevated ROS Levels
• Genito-urinary tract infection
•Prostatitis
• Vasectomy reversal
•Varicocoele
•Cryptorchidism
• Chronic disease
•Xenobiotics
• Chemical pollutants and
occupational hazards
• Heavy metal exposure
• Removal of seminal plasma during sperm
preparation for assisted conception
• Drugs – cyclophosphamide, aspirin,
paracetamol
•Smoking
• Excessive exercise
• Heat exposure
•Obesity
•Age
Semen samples need specialist handling – for this reason all requests for semen analyses should be
made by appointment. Practices or patients should contact TDL Andrology on 020 7025 7940 to make
appointments and to confirm instructions for sample collection.
MALE HORMONE PROFILE
FSH
LH
Testosterone
Free Androgen Index
Prolactin
SHBG
MALE RECURRENT
MISCARRIAGE PROFILE
Sperm DNA Fragmentation
(SCSA)
Infection Screen (PP12)
TAT
Chromosome Analysis
Y Chromosome Microdeletion
Cystic Fibrosis Carrier Screen
(139 mutations)
PolyT – 5T, 7T, 9T (Reported if
cinically relevant)
TAT
4
B
MALE GENETIC
REPRODUCTIVE PROFILE
TAT
15
HOURS
DAYS
MIPR
MRMP
Semen Key: See page 15 for sample taking and special handling instructions.
15
DAYS
GRP
A H 9
43
44
Sexual health
TEST
CODE
SAMPLE REQS
TAT
7 STI’s by PCR
PP12
FCRU/PCR/TPV
2 days
Chlamydia (PCR swab)
Chlamydia (Thin Prep)
Chlamydia (Urine)
SPCR
TPCR
CPCR
PCR
TPV
FCRU
2 days
5 days
2 days
Early Detection Screen (10 days post exposure)
Early Detection Screen with Syphilis
STDX
STXX
A 10mls or 2 x 4mls
B A 10mls or 2 x 4mls
3 days
3 days
GONN
SGON
TGON
CGON
SCG
TCG
CCG
TSCG
RSCG
GVPC
HEPA
AUAG
HCAG
HEPC
HERS
HERD
HDUO
STDX
STM
PCR
TPV
FCRU
PCR
TPV
FCRU
PCR
PCR
FCRU / PCR / TPV
B
B
B
B
PCR
FCRU / PCR / TPV
B
A 10mls or 2 x 4mls
2-3 days
2 days
5 days
2 days
2 days
5 days
2 days
2 days
2 days
5 days
4 hrs
4 hrs
4 hrs
4 hrs
5 days
5 days
4 hrs
3 days
STXX
3 days
HP20
HPVT
HPV
MGEN
SWAB
SYPS
SERJ
TVAG
TVPC
UGEN
PCR / TPV
TPV
TPV
FCRU / PCR / TPV
STM
PCR
B
Blue Micro Swab
FCRU / PCR / TPV
FCRU / PCR / TPV
5 days
5 days
2 days
5 days
2-3 days
5 days
4 hrs
2 days
5 days
5 days
FOR FAST SEXUAL HEALTH SCREENING TESTS SEE PAGE 48
Gonorrhoea (Culture)
Gonorrhoea (PCR swab)
Gonorrhoea (Thin Prep)
Gonorrhoea (Urine)
Chlamydia/Gonorrhoea (PCR Swab)
Chlamydia/Gonorrhoea (Thin Prep)
Chlamydia/Gonorrhoea (Urine)
Chlamydia/Gonorrhoea (Throat)
Chlamydia/Gonorrhoea (Rectal)
Gardnerella vaginalis by PCR
Hepatitis A Profile
Hepatitis B sAg
Hepatitis C Antigen (Early detection)
Hepatitis C Antibodies
Herpes Simplex I/II by PCR (Swab)
Herpes Simplex I/II by PCR (Urine)
HIV 1 & 2/p24Ag
HIV/HBV/HCV (Early detection by PCR)
with Syphilis
HPV (individual low & high risk DNA subtypes)
HPV (DNA and reflexed mRNA) by PCR
HPV (HR DNA types 16, 18 + others)
Mycoplasma genitalium by PCR
Swab for Culture (Any Site)
Syphilis by PCR (chancre)
Syphilis IgG/IgM
Trichomonas vaginalis (Genital) Culture
Trichomonas vaginalis by PCR
Ureaplasma urealyticum by PCR
45
STI detection
STI’s can be caused by virus, fungus, parasite or bacteria. Anyone who is sexually active may be at risk
of acquiring an STI. The risk is higher for those with increased numbers of sexual partners, or who have
had sex with someone who has/had many partners, or have had unprotected sex.
STI
46
INCUBATION PERIOD
SAMPLE SITE
Chlamydia CT
Bacterial
1 – 3 weeks, up to 6 weeks
Urine
Cervix / Vagina
Cervix / Vagina
Gonorrhoea GC
Bacterial
2 – 7 days, up to 1 month
Urine
Cervix / Vagina
Cervix / Vagina
Cervix / Vagina
CT/GC Combined
Bacterial
1 – 3 weeks, up to 6 weeks
Urine
Cervix / Vagina
Cervix / Vagina
Rectum
Throat
Mycoplasma
genitalium
Bacterial
Symptoms develop at
1 – 3 weeks
Urine
GU Site
Cervix / Vagina
Ureaplasma
urealyticum
Bacterial
Symptoms develop at
1 – 3 weeks
Urine
GU Site
Cervix / Vagina
Trichomonas
vaginalis
Parasitic
4 – 28 days, many patients are
asymptomatic carriers
Urine
GU Site
Cervix / Vagina
Gardnerella
vaginalis
Bacterial
Imbalance of normal flora
Urine
GU Site
Cervix / Vagina
Bacterial
Vaginosis (BV)
Bacterial
Imbalance of normal flora
Cervix / Vagina
Herpes Simplex
Viral I/II
Viral
2 – 14 days, testing is most appropriate
for patients with symptomatic lesion(s)
PCR swab
PCR swab
Human
Papillomavirus
Viral
HPV is the most common sexually
transmitted infection – usually
asymptomatic
Cervical cells
Cells / papilloma from
site (throat /penile anal)
Genital
warts
Viral
Weeks / months after exposure
GU Warts
Syphilis/Herpes
Bacterial /
Viral
Whenever active lesions are present
Symptomatic Lesion
STI detection
TEST
TEST CODE
SAMPLE TYPE
TAT
Chlamydia
Chlamydia
Chlamydia
CPCR
SPCR
TPCR
First catch Urine
PCR Swab
Thin Prep Vial
2 days
2 days
5 days
Gonorrhoea by PCR
Gonorrhoea by PCR
Gonorrhoea by PCR
Gonorrhoea by CULTURE
CGON
SGON
TGON
GONN
First Catch Urine
PCR Swab
Thin Prep Vial
Culture swab
2 days
2 days
5 days
2-3 days
CT/GC
CT/GC
CT/GC
CT/GC
CT/GC
CCG
SCG
TCG
RSCG
TSCG
First Catch Urine
PCR Swab
Thin Prep Vial
PCR Swab
PCR Swab
2 days
2 days
5 days
2 days
2 days
MGEN
MGEN
MGEN
First Catch Urine
PCR Swab
Thin Prep Vial
5 days
5 days
5 days
Ureaplasma by PCR
Ureaplasma by PCR
Ureaplasma by PCR
UGEN
UGEN
UGEN
First Catch Urine
PCR Swab
Thin Prep Vial
5 days
5 days
5 days
TVPC
TVPC
TVPC
First Catch Urine
PCR Swab
Thin Prep Vial
5 days
5 days
5 days
GVPC
GVPC
GVPC
First Catch Urine
PCR Swab
Thin Prep Vial
5 days
5 days
5 days
Bacterial Vaginosis (BV) Profile
by both PCR and CULTURE
STD8
Both Culture &
PCR swab
3 days
Herpes by PCR
Herpes by PCR
HERS
HERD
PCR Swab
First Catch Urine
5 days
5 days
HPV DNA/mRNA
HPV Typed DNA
HPV Typed DNA
HPVT
HP20
HP20
Thin Prep Vial
PCR Swab
Cells / Papilloma
5 days
5 days
5 days
HPV Typed DNA
HPV Typed DNA
HPV Typed DNA
HPVT
HP20
HP20
Thin Prep Vial
PCR Swab
Cells / Papilloma
5 days
5 days
5 days
Syphilis/Herpes Lesion Profile
STD9
PCR Swab
7 days
47
STI detection
BLOOD
INCUBATION PERIOD
SAMPLE SITE
Syphilis
Bacterial
9 – 21 days, but up to 90 days
Blood
Herpes Simplex
Virus I/II
Viral
IgG 4 – 6 weeks after exposure
IgM 5 – 35 days after exposure,
after which test IgG Blood
Blood
HIV
Viral
Usually 10 – 90 days, but up to
180 days
Blood
Blood
Hep B
Viral
Usually 45 – 180 days, average of
60 – 90 days
Blood
Blood
Hep C Ab
Viral
45 – 65 days
Blood
Blood
Hep C Ag
Viral
45 – 65 days
Blood
Blood
EARLY DETECTION
PROFILES BY PCR
INCUBATION PERIOD
SAMPLE SITE
7 STIs by PCR
One sample for 7 STI Tests
Urine
Cervix
Vagina
HIV / HBV / HCV
Early Detection Screen
by PCR Multiplex
HIV/HCV at 10 days
Blood
FASTest Test Now
Sexual Health Screening – ahead of expected time
•Simultaneous RT-PCR detection of both CT and Dual Target Gonorrhoea
•Sample Adequacy and Process Controls for every sample tested
•The FASTEST Results: HIV/HBV/HCV/Syphilis and CT/NG in 4 hours*
•Runs on: Cepheid GeneXpert® System
IVD
FCT FAST Chlamydia Urine
FSCT FAST Chlamydia Swab
FTCG FAST CT/NG Throat Swab
FGN FAST Gonorrhoea Urine
FSGN FAST Gonorrhoea Swab
FRCGFAST CT/NG Rectal Swab
FCG FAST CT/NG Urine
FSCG FAST CT/NG Swab
* From receipt of samples in the laboratory, First Catch Random Urine or PCR Swab.
48
STI detection
TEST
TEST CODE
SAMPLE TYPE
TAT
Syphilis IgG / IgM
SERJ
B
4 hours
Herpes IgG (past infection)
Herpes IgM (current / recent)
HERP
HERM
B
B
2 days
2 days
HIV I&II / p24 antigen
HDUO
B
4 hours
Hep B surface antigen
AUAG
B
4 hours
Hep C Antibodies
HEPC
B
4 hours
Hep C Antigen (See table on page 63)
Early detection at 10 days
HCAG
B
4 hours
TEST
TEST CODE
SAMPLE TYPE
TAT
Chlamydia
Gonorrhoea
Mycoplasma genitalium
Ureaplasma genitalium
Trichomonas vaginalis
Gardnerella vaginalis
Herpes Simplex I/II
PP12
2 days
PP12
Thin Prep Vial
or
First Catch Urine
or
PCR Swab
HIV 1&2 RNA
Hepatitis B (HBV DNA)
Hepatitis C (HCV RNA)
STDX
A 10mls or 2 x 4mls
3 days
PP12
FAST SSC
FAST USC
2 days
2 days
FAST SSC
Fast Screen SHORT
Fast Screen with URINE
Fast Screen with SWAB
HIV 1&2/p24 Ag
Syphilis IgM/IgG
FAST Urine CT/NG
HIV 1&2/p24 Ag
Hep B sAg
Hep C Abs
Hep C Ag
Syphilis IgG/IgM
FAST Urine CT/NG
HIV 1&2/p24 Ag
Hep B sAg
Hep C Abs
Hep C Ag
Syphilis IgG/IgM
FAST Swab CT/NG
TAT
4
HOURS*
FSSC
B FCRU TAT
4
HOURS*
FUSC
B FCRU Key: See page 15 for sample taking and special handling instructions.
TAT
4
HOURS*
FSWS
B FCRU 49
Sexual health
STD1
STD2
MALE PROFILE
Urethral Micro Swab
Syphilis IgG/IgM
TAT
2
HIV 1 & 2 Abs/p24 Antigen
Hep B surface Antigen
Hep C Abs
Hep C Ag (early detection)
Syphilis IgG/IgM
Chlamydia/Gonorrhoea (urine)
Urethral Swab for culture
STD1
STD2
B STM FCRU STD4
FEMALE PROFILE
TAT
FEMALE PROFILE PLUS
HIV 1 & 2 Abs/p24 Antigen
Hep B surface Antigen
Hep C Abs
Syphilis IgG/IgM
High Vaginal Swab for culture
DAYS
DAYS
STD3
STD4
B STM PCR B STM PCR STD6
BLOODS ONLY
BLOODS ONLY WITHOUT HIV
Hepatitis B Surface Antigen
Hep C Abs
Syphilis IgG/IgM
HIV 1&2/p24 Antigen
Hep C Abs
Syphilis IgG/IgM
TAT
TAT
HOURS
HOURS
STD5
STD6
4
4
50
TAT
4
2
B 4
DAYS
Syphilis IgG/IgM
High vaginal Swab (Culture swab)
STD5
TAT
DAYS
B STM FCRU STD3
MALE PROFILE PLUS
B Ensure all specimens and forms are labelled with given Full Name, Surname, DOB, Date and Time
Sexual health
STD8
SYMPTOMATIC LESION SAMPLE
USING PCR SWAB
STD9
VAGINITIS / BV PROFILE
Candida species
Syphilis by PCR
(from single swab)
TAT
TAT
DAYS
DAYS
STD8
STD9
3
PCR STM 7
PCR EARLY DETECTION SCREEN
EARLY DETECTION SCREEN WITH SYPHILIS
Positive findings will be reflexed for individual qualitative
confirmatory testing using the Roche Cobas Ampliscreen
HIV1 and HIV2 (RNA)
Hepatitis B Virus (HBV DNA)
Hepatitis C Virus (HCV RNA)
HIV1 and HIV2 (RNA)
Syphilis IgG/IgM
(HIV1/HIV2/HBV/HCV by PCR/NAT)
(HIV1/HIV2/HBV/HCV by PCR)
Samples must be received in the
laboratory within 2 days of sample taking
TAT
3
3
DAYS
DAYS
STDX
STXX
A 10mls or 2 x 4mls
7 STI PROFILE BY PCR
(7 TESTS FROM 1 SAMPLE)
STD QUAD
Syphilis IgG/IgM
HIV 1&2/p24 Antigen
Chlamydia (Urine)
Gonorrhoea (urine)
TAT
2
B FCRU TAT
Chlamydia trachomatis
N. Gonorrhoea
Ureaplasma
Herpes Simplex I/II
All tests can
be requested
individually.
TAT
2
DAYS
DAYS
STDQ
PP12
FCRU OR PCR Swab OR TPV OR Semen Key: See page 15 for sample taking and special handling instructions.
51
52
Immunology
TEST
CODE
SAMPLE REQS
TAT
Acute Viral Hepatitis Screen
Adenovirus Antibodies (CFT) IgG
Adrenal Cortex Antibodies
ANCA (Anti-Neutrophil Cytoplasmic Abs)
Anti CCP Antibodies (RF)
Anti Sla (Soluble Liver Antigen) Abs
Anti-Ri Antibodies
Antinuclear Antibodies (titre & pattern)
Antistaphylolysin Titre (SGOT)
Antistreptolysin Titre/ASOT
Autoantibody Profile I
Autoantibody Profile II
Borrelia Antibodies (Lyme Disease) IgG, IgM
Borrelia Antibodies (Lyme Disease) IgM
Borrelia Confirmation (Immunoblot)
Brucella Confirmation
C1 Esterase Inhibitor
C3 Complement
C3/C4 Complement
C4 Complement
Calprotectin
Calprotectin/Elastase Profile
Cardiolipin Antibodies (IgG+IgM)
CCP Antibodies (RF)
Centromere Autoantibodies
CH50 (Classical pathway)
Chlamydia Species Specific Ab Screen
Chronic Fatigue Syndrome Profile
Coeliac/Gluten Sensitivity Profile
Coeliac/Gluten Profile 2
Cotinine (Serum)
Cotinine (Urine)
Cryoglobulins
DNA (Single Stranded) Antibodies
DNA (Double Stranded) Antibodies
Echinococcus (Hydatid) Antibodies
Elastase (Faecal)
Elastase / Calprotectin Profile
Endomysial Antibodies (IgA)
Extractable Nuclear Antibodies
(nRNP, Sm, Ro ,La, Jo1, Scl70)
Faecal Elastase
FTA (IgG)
AHSC
ADAB
ACTX
ANCA
CCP
LSA
RIAB
ANAB
ASTT
ASLT
AUTO
ENDO
BORR
BORM
BORC
BRUC
C1EI
C3
COMP
C4
CALP
CEP
ACAB
CCP
CAB
CH50
CHAB
VIP1
GSA
GSA2
GSA3
COT
COTT
CRYO
DNAS
DNAA
EFAT
ELAS
CEP
AEAB
B
B
B
B
B
B
B
B
B
B
B
B
B 9,14
B
B 9,14
B 9
B B
B
B
RF
RF
B
B
B
B (Frozen) 4
B
A or Chex + B 10
B
A B
A B
B
RU
J 6
B
B
B 9,14
RF
RF
B
4 hrs
2 days
2 days
2 days
2 days
10 days
3 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
10 days
2-3 weeks
5 days
4 hrs
4 hrs
4 hrs
5 days
5 days
2 days
2 days
2 days
4 days
2 days
5 days
2 days
10 days
10 days
2 days
2 days
10 days
5 days
2 days
2 days
5 days
5 days
2 days
ENA
B
2 days
ELAS
FTA
RF
B
5 days
2 days
53
Immunology
54
TEST
CODE
Ganglioside GM1, GD1B, GQ1B Abs
Gastric Parietal Autoantibodies
Giardia Antigen (Fresh Stool)
Gliadin Antibodies (IgA + IgG)
Glomerular Basement Membrane Abs
Gluten Sensitivity Evaluation
Gluten/Coeliac Profile 2
H. pylori Antibodies (IgG)
H. pylori Antigen (QUICK Breath Test)
H. pylori Antigen (Stool)
Histamine Releasing Urticaria Test
IgE (Total)
Influenza Screen
Insulin Antibodies
Interleukin 1 Beta
Interleukin 2
Interleukin 4
Interleukin 6
Interleukin 8
Interleukin 10
Intrinsic Factor Antibodies
Islet Cell Antibodies
Legionella Antibodies
Liver Kidney Microsomal Antibodies
Lupus Anticoagulant and Anticardiolipin Abs
Lyme Disease (Borrelia Abs) IgG, IgM
Lyme Disease (Borrelia Abs) IgM
Meningococcal Abs
Mitochondrial Antibodies
Myeloperoxidase Antibodies
Myositis Panel
Neuronal Antibody (Hu, Ri, Yo, Cv2, Ma2)
Nucleic Acid Antigen Antibodies
Oligoclonal Bands
Ovarian Autoantibodies
Pemphigus/Pemphigoid Autoantibodies
Phospholipid Antibodies
Pneumococcal Antibody Screen
Proteinase 3 Ab
Reticulin Antibodies (IgA)
GANG
GASP
GIAG
AGAB
AGBM
GSA
GSA2
GSA3
HBPA
HBQT
HBAG
CURT
IGE
IMM
INFL
INAB
ILB
IL2
IL4
IL6
IL8
IL10
IFAB
ICAB
LEGO
LEGA
LKM
LUPA
BORR
BORM
MENI
AMIT
MPO
MYOS
NEUR
DNA
CSFO
OVAB
SKAB
PLIP
PNEU
PR3
ARAB
SAMPLE REQS
TAT
B
B
RF 9,14
B
B
B
A B
A B
B
J (Blowbag kit) 1
RF
B
B
B
B
B
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B
B
B
RU
B
B C 4,18
B 9,14
5 days
2 days
2 days
2 days
2 days
2 days
10 days
10 days
2 days
2 days
3 days
10-14 days
1 day
4 hrs
2 days
5 days
1-2 weeks
1-2 weeks
1-2 weeks
1-2 weeks
1-2 weeks
1-2 weeks
2 days
2 days
2 days
1 day
2 days
2 days
2 days
2 days
2-4 weeks
2 days
2 days
5 days
5 days
2 days
5 days
2 days
2 days
2 days
7 days
2 days
2 days
B
B
B
B
B
B
B
CSF+B
B
B
B
B
B
B
Immunology
TEST
CODE
Rheumatoid Factor (Latex Test)
Rheumatology Profile 1 (Screen)
Rheumatology Profile 2 (Connective tissue)
Rheumatology Profile 3 (Rheumatoid/Basic)
Rheumatology Profile 4 (Systemic Lupus)
Rheumatology Profile 5 (Mono Arthritis)
Rheumatology Profile 6 (Rheumatoid Plus)
Rheumatology Profile 7 (Srogren’s syndrome)
Rickettsial Species Antibodies
Salivary Duct Antibodies
Sjrogren’s Syndrome
Skin (Pemphigus/Pemphigoid) Autoantibodies
Smooth Muscle Antibodies
Sperm Antibodies (Serum)
Steroid Cell Antibody
Striated/Skeletal Muscle Antibody
Syphilis IgG/IgM
TB Quantiferon®-TB Gold
Testicular Autoantibodies
Thyroid Abs (incl. Thyroglobulin + Thyroid Peroxidase Abs)
Thyroid Peroxidase Antibodies/Anti TPO
Tissue Transglutaminase IgA (Coeliac)
Tissue Transglutaminase IgG
Torch Screen
Total Immunoglobulin E
Urticaria Test (Histamine Releasing)
VDRL (RPR)
RF
RH
RH2
RH3
RH4
RH5
RH6
RH7
RICK
SAB
RH7
SKAB
ASMO
ASAB
SCA
STRA
SERJ
TBQ
TAB
THAB
TPEX
TAA
TAAG
TORC
IGE
TSI
CURT
VDRL
SAMPLE REQS
TAT
B
A B
A A B B
A B
A B B
A A B B
B
B
B
B
B
B
B
B
B
B
B
J/special tubes 1
B
B
B
B
B
B
B
B
B
B
1 day
2 days
3 days
2 days
2 days
3 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
5 days
2 days
2 days
4 hrs
3 days
2 days
1 day
1 day
2 days
5 days
2 days
1 day
4 days
10-14 days
2 days
55
Immunology
HLA DQ2/DQ8
TEST
CODE
Coeliac Disease Profile 2
Coeliac Disease – HLA DQ2/DQ8 Genotype
GSA
GSA2
GSA3
Q2Q8
GLUTEN SENSITIVITY EVALUATION
(COELIAC DISEASE ANTIBODY)
Endomysial IgA
Reticulin IgA
Gliadin IgA + lgG Total IgA
Tissue Transglutaminase (IgA)
SAMPLE REQS
TAT
B
A B
A B
A9
2 days
10 days
10 days
10 days
COELIAC DISEASE PROFILE 2
TAT
2
Endomysial IgA
Reticulin IgA
Gliadin IgA + lgG
Total IgA
HLA DQ2/DQ8
DAYS
DAYS
GSA
B
TAT
10
GSA2
A B
COELIAC DISEASE PROFILE 3
HLA DQ2/DQ8
Total IgA
TAT
10
DAYS
GSA3 A B
Coeliac Disease (CD) is an immune-mediated disease of the intestines that is triggered by the ingestion
of gluten in genetically susceptible individuals. Gluten is the major protein component of wheat, rye,
and barley. Genetic predisposition does play a key role in CD, and it is well known that CD is strongly
associated with specific HLA class II genes known as HLA-DQ2 and HLA-DQ8. Approximately 95% of
CD patients express HLA-DQ2, and the remaining patients are usually HLA-DQ8 positive. The negative
predictive value for both tests is higher than 99%. However, the HLA-DQ2 allele is common and is carried
by approximately 30% of Caucasian individuals. Thus, HLA-DQ2 or HLA-DQ8 is necessary for disease
development but is not sufficient for disease development; its estimated risk effect is only 36-53%.
Note: History taking is important if a patient has been on a gluten-free diet for 6-12 months, approximately
80% will lose their antibody response. After 5 years this increases to >90%.
56
Immunology
CHLAMYDIA SPECIES SPECIFIC
(MIF) ANTIBODY SCREEN
AUTOANTIBODY PROFILE I
AUTOANTIBODY PROFILE II
Thyroid Peroxidase Antibodies
Antinuclear Antibodies
Gastric Parietal Cell Antibodies
Reticulin Antibodies
LKM
Thyroid Peroxidase Antibodies
Adrenal Antibodies
Gastric Parietal Cell Antibodies
Gonadal (Ovarian/
Testicular) abs
TAT
TAT
TAT
DAYS
DAYS
DAYS
AUTO
ENDO
CHAB
B
B
CHRONIC FATIGUE
SYNDROME PROFILE
FAECAL CALPROTECTIN
ELASTASE PROFILE
Faecal Calprotectin
Faecal Elastase
TAT
5
Human Herpes Virus 6
(lgG/IgM)
Epstein-Barr Virus
Antibody Profile
Lymphocyte Subsets
(CD4/CD8)*
CRP
Vitamin D (25 OH)
DAYS
TAT
5
DAYS
CEP RF
2
2
2
B
(serovar A-K & L1-L3)
Chlamydia pneumoniae
Chiamydia psittaci
VIP1
A OR CHEX + B 10
57
Immunology
RHEUMATOLOGY
PROFILE 5
Mono Arthritis
RHEUMATOLOGY
PROFILE 3
Rheumatoid Disease
RHEUMATOLOGY
PROFILE 1
FBC
ESR
Uric Acid
RF
Antinuclear Autoantibodies
C Reactive Protein
HLA B27
FBC
ESR
Uric Acid
RF
C Reactive Protein
FBC
ESR
Uric Acid
RF
C Reactive Protein
TAT
TAT
TAT
DAYS
DAYS
DAYS
A B
RHEUMATOLOGY
PROFILE 2
General screen for
Connective Tissue Disorders
A A B B
RHEUMATOLOGY
PROFILE 4
Rheumatoid Factor
RF
C Reactive Protein
TAT
2
DAYS
RH6 B
RHEUMATOLOGY
PROFILE 7
Anti RO (SS-A)
Anti La (SS-B)
Salivary duct antibodies (SAB)
C Reactive Protein
TAT
TAT
TAT
DAYS
DAYS
DAYS
2
3
2
RH4 RH2
A A B B
RHEUMATOLOGY
PROFILE 6
Systematic Lupus
Erythematosus
FBC
ESR
Anti-dsDNA
Antibodies to Extractable
Nuclear Antigens (ENA)
Anti nRNP
Anti Sm
Anti Ro (SS-A)
Anti La (SS-B)
Anti Jo-1
Anti Scl 70
Anti CENP
RF
Anti CCP Antibodies
Anti Cardiolipin Autoantibodies
Complement 3,4
C Reactive Protein
FBC
ESR
Uric Acid
Anti-dsDNA
Antibodies to Extractable
Nuclear Antigens (ENA)
Anti nRNP
Anti Sm
Anti Ro (SS-A)
Anti La (SS-B)
Anti Jo-1
Anti Scl 70
Anti CENP
RF
Anti CCP Antibodies
HLA B27
C Reactive Protein
RH5
RH3
RH
A B
3
2
2
A B B
RH7 B
Patients with Irritable Bowel Syndrome (IBS) may benefit by testing for Calprotectin, see page 53 for details.
58
Tropical immunology
TEST
CODE
Amoebic (E. histolytica) Antibodies
Amoebic (E. histolytica) Antigen
Bilharzia (Schistosome) Antibody Screen
Bilharzia (Schistosome) Antigen
Bilharzia (Urine)
Borrelia Antibodies (Lyme Disease) IgG, IgM
Borrelia Antibodies (Lyme Disease) IgM
Cryptosporidium Antigen Detection
Dengue Virus Serology
DVT/Pre-travel Screen (see profile)
Enteric Organism Rapid Detection
Filaria (Lymphatic and Non-Lymphatic) Antibodies
Filaria Antigen
Insect/Worm/Ova/Cysts
Leishmania Antibodies
Malarial Antibodies (Pl. falciparum)
Post-Travel Screen 1
Rickettsial Species Antibody Profile
Schistosome Antigen
Schistosome (Bilharzia) Antibodies
Shigella Abs
Toxoplasma Antibodies (IgG+IgM)
Tropical Screen
AFAT
AMAG
BILH
SHAG
USCH
BORR
BORM
CRPA
DENG
DVT1
EFAT
EORD
FIFA
FIAG
GIAG
FLEA
LEIS
MALA
PTS
PTS2
DVT1
RICK
SHAG
BILH
SHIG
TFAM
TROP
SAMPLE REQS
TAT
B
RF
B 14
B
RU 14
B 9,14
B
RF
B 9,14
A A B 9
B 9,14
RF
B 9,14
A A
RF 9,14
Send Specimen 9,14
B
B 9,14
A A B G 14
A A B B B G 14
A A B 9
B 14
B
B 14
B
B 9
B B 9,14
2 days
2 days
2 days
3 weeks
8 hrs
2 days
2 days
1 day
5 days
5 days
2 days
2 days
10 days
4 days
2 days
5 days
2 days
2 days
10 days
10 days
5 days
2 days
3 weeks
2 days
5 days
4 hrs
10 days
A range of specialist tests is available. Please contact the Immunology
Department for advice, requests and interpretation of results.
DETAILS OF PATIENT’S TRAVEL HISTORY IS ALWAYS ESSENTIAL
59
Tropical immunology
TROPICAL SCREEN
(from 6 weeks post-travel)
Amoebic Antibodies
Schistosomal Antibodies (Bilharzia)
Echinococcus Antibodies
(Hydatid)
Malarial Antibodies (IFA)
Toxoplasma Antibodies IgG
Toxoplasma Antibodies IgM
POST-TRAVEL SCREEN 1
(Prior to 6 weeks)
POST-TRAVEL SCREEN 2
(Prior to 6 weeks)
Haematology Profile
Filaria Antibodies
Schistosome Antigen
Malarial Parasites
Hep A IgM Abs
Hep B s Ag
Hep C Abs
Hep C Ag
HIV Duo
Haematology Profile
Filaria Antibodies
Schistosome Antigen
Malarial Parasites
TAT
DAYS
DAYS
TROP
PTS
A A B G14
ENTERIC ORGANISM
RAPID DETECTION
10
10
DAYS
B B 9,14
TAT
TAT
10
PTS2
A A B B B G14
DVT/PRE-TRAVEL SCREEN
Detection of Bacterial, Viral and
Parasitic Infection by Multiplex
Real-Time PCR
Bacteria and Bacterial Toxins
Salmonella, Shigella,
Campylobacter, Costridiium
difficile Toxin A/B, Enterotoxigenic
E. Coli (ETEC) LT/ST, E. coli 0157,
Shiga-like Toxin Producing E. coli
(STEC) stx 1/stx 2, Vibrio cholera,
Yersinia entericolitica
FBC
Factor V Leiden
Anticardiolipin
Antibodies
TAT
5
DAYS
Viruses
Adenovirus 40/41, Rotavirus A
Norvirus G1/G11
DVT1
A A B 9
Parasites
Gardia, Entamoeba histolytica
Cryptosporidium
This does NOT include stool for m/c/s –
this needs to be requested as a separate
test. Please provide two samples if this
is required.
TAT
2
DAYS
EORD
RF
60
Virology
IMMUNE STATUS
TEST
CODE
Haemophilus Influenzae B Antibodies
Hepatitis A Immunity (IgG)
Hepatitis B Immunity (see page 63)
Measles Antibodies (IgG) Immunity
Measles Antibodies (IgM)
Measles, Mumps, Rubella (MMR)
Mumps Antibodies (IgG)
Mumps Antibodies (IgM)
Pertussis (Whooping Cough) Antibodies
Polio Virus 1, 2, 3 Antibodies
Rabies Antibody
Rubella Antibody (IgG)
Rubella Antibody (IgM)
Rubella PCR
Tetanus Screen
Varicella zoster Antibodies (IgG)
Varicella zoster Antibodies (IgM)
HINF
HAIM
HBIM
MEAS
MEAM
MMR
MUMP
MUMM
PERS
PNEU
POLO
RABI
RUBE
RUBM
RUBP
TETA
VZOS
VZOM
SAMPLE REQS
TAT
B
B
B
B
B 9
B
B
B
B B
B 9
B
B
B
A/Amniotic Fluid
B
B
B
7 days
4 hrs
4 hrs
1 day
2 days
1 day
1 day
1 day
5 days
7 days
5 days
10 days
4 hrs
4 hrs
5 days
5 days
1 day
2 days
Hepatitis B Immunity/Vaccination
Anti HBs
less than 10 mIU/ml
Non-immune to Hepatitis B
10 – 50 mIU/ml
borderline – Booster indicated
50 – 100 mIU/ml
low level immunity – Booster suggested
100 and over
Immune to Hepatitis B
61
Virology
HEPATITIS TESTING
TEST
CODE
Hepatitis (Acute) Screen
Hepatitis A (IgM)
Hepatitis A Profile
Hepatitis A, B & C Profile
Hepatitis B Core Antibody – IgM
Hepatitis B Core Antibody – Total
Hepatitis B DNA (Viral load)
Hepatitis B ‘e’ Antigen and Antibody
Hepatitis B Immunity
Hepatitis B (PCR) Genotype
Hepatitis B Profile
Hepatitis B Resistant Mutation
Hepatitis C Quantification (Viral Load)
Hepatitis C Abs Confirmation (RIBA)
Hepatitis C Genotype
Hepatitis Delta Antibody
Hepatitis Delta Antigen
Hepatitis Delta RNA
Hepatitis E IgG/IgM
Hepatitis G (PCR)
AHSC
HAVM
HAIM
HEPA
ABC
HBCM
HBC
DNAB
HEPE
HBIM
BGEN
HEPB
HBRM
AUAG
QPCR
RIBA
HCAG
HEPC
CGEN
HEPD
HDAG
DRNA
HBE
HEPG
STDX
HEPATITIS
B PROFILE
B
B
B
B
B
B
B
A
B
B
A
B
A or B
B
A
B
B
B
A
B
B
A (Frozen plasma)
B
A (Frozen plasma)
A 10mls or 2 x 4mls
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
5 days
4 hrs
4 hrs
7 days
4 hrs
7 days
4 hrs
5 days
5 days
4 hrs
4 hrs
5 days
5 days
5 days
5 days
5 days
2 weeks
3 days
HEPATITIS
A, B & C PROFILE
Hepatitis A Profile
Hepatitis B Profile
Hepatitis C Abs
Hepatitis C Ag
LFT’s
Hepatitis A IgM Abs
Hepatitis C Abs
Hepatitis C Ag
TAT
TAT
TAT
HOURS
HOURS
HOURS
HEPB
AHSC
ABC
4
62
TAT
ACUTE VIRAL
HEPATITIS SCREEN
Hep B Surface Antigen
Hep B Surface Antibodies
Hep B Core IgG/IgM
B
SAMPLE REQS
4
4
B
B
Virology
HBV Assays
HBV Genotyping (BGEN)
HBc IgM (HBCM)
Detects IgM antibodies specific to the hepatitis B core
antigen. These antibodies are the first to appear in HBV
infection and can persist for 3-9 months after recovery.
ANTI-HBcore (HBC)
Detection of antibodies to hepatitis B nucleocapsid or
core antigen is the marker for the presence of past or
recent infection by HBV. Testing of anti-HBc antibodies
can be particularly useful in detecting a chronic infection.
Screening for anti-HBc antibodies is useful for preventing
transmission of HBV.
Identifies the hepatitis B genotype (A to H) in a patient’s
serum/plasma. This is critical for determining treatment
and monitoring response.
HBV Drug Resistence Detection (HBRM)
Detects hepatitis B virus wild-type and drug-induced
mutations associated with famciclovir and lamivudine
drug resistance, including YMDD mutants.
HCV Assays
HCV Antibody (HEPC)
Detects the presence of hepatitis B surface antigen,
which indicates infection, within human serum. It is the
first marker to appear and may be observed 2 or 3 weeks
before clinical symptoms. HBsAg persisting over 6 months
denotes chronic hepatitis.
The test indicates exposure to virus but does not
necessarily signify current infection. The HCV antibody test
may therefore be used to screen patients for possible HCV
infection to detect the presence of antibodies to the virus,
indicating exposure to HCV. This test cannot tell if the viral
infection is active, only that you were exposed to the virus
in the past.
HBs Ab (HBIM)
HCV Antigen (HCAG)
HBs Ag (AUAG)
Detects antibodies to hepatitis B surface antigen in human
serum. This determinant is present in up to 80% of the
cases of acute Hepatitis B, being detectable between 1-3
months after appearance of HBs antigen, and helps to
establish the immune or infective status of the patient.
HB e Antigen (HEPE)
Detects hepatitis B e antigen (HBe Ag) or antibody to
hepatitis B e antigen (Anti-HBe) in serum. The presence
of HBe Ag indicates an infective state of the serum and
shows that the virus is replicating. Appearance of antibody
to HBe Ag indicates a decreased viral replication and
generally represents a good clinical prognosis. It can also
demonstrate the effectiveness of treatment.
HBV Viral Load (DNAB)
This assay measures the concentration of hepatitis B viral
DNA in patient serum. The test enables the viral load at the
beginning of treatment to be established and, thereafter,
monitored to indicate treatment success.
HVC Antigen is detectable well before the occurrence
of antibodies against HCV. When virus is present, but
antibodies are not detectable, a negative antibody test
does not rule out HCV infection. Active HCV infection, either
acute or chronic is characterised by the presence of HCV
Antigen. This is analogous to HepBsAg (AUAG) in active
HBV Infection.
HCV Viral Load (QPCR)
Measures the concentration of hepatitis C viral RNA in
patient serum. This state-of-the-art assay enables the viral
load at the beginning of treatment to be established and,
thereafter, monitored to indicate treatment success.
HCV Genotype for Treatment (CGEN)
Determines the HCV genotype in a patient’s serum.
The result is presented as being of either Genotype [1, 5,
6], [4] or [2, 3]. This grouping reflects required treatment
duration of the different genotypes.
HCV RNA
Anti HCV Abs
HCV Ag
WINDOW PERIOD
0
20
40
60
80
HCV Ag is detectable
in the majority of
PCR +ve, and HCV
Ab +ve patients, and
is considered useful
to confirm HCV in
untreated patients
at any time.
HCV Ag will be
undertaken for
confirmatory testing
when HCV Abs
are detected.
100 days
63
Virology
HEPATITIS B
• Transmission:
Sexual, parenteral, perinatal, direct contact
between individuals.
• Development of chronic form:
Yes (5% of adult cases).
• Prevention:
Vaccination ++++; specific IgG.
• Clinical Signs:
Asymptomatic in 90% of cases.
• Main Marker:
HBS Ag, anti HBc IgM, total anti HBc Ab,
Anti-HBs Ab, HBe Ag, Anti-HBe Ab, HBV DNA.
• Cure: 95% of cases (adults).
How to request for Hepatitis B Surface Antigen / A
• Complications:
Cirrhosis and hepatocellular carcinoma.
Not detected
Weakly Reactive or
Total anti-HBc Ab
Positive
Incubation
4-7 weeks
Proceed to Full Hep B Profile
(undertaken
byphase
TDL as routine reflex
Acute
testing to identify
4-12 weeksactive information)
Cure
years
Anti-HCV Ab
Positive
Not detectedHCV Ag
HepB e Antigen
HepB core Specific IgM
HepB e Antigen
HepB core Specific IgM
HCV RNA
contact
clinical signs
HCV RNA
HBs Ag
HCV Ag
HepB
Anti-HCV AbDNA Quantitative (reports viral load)
Increase in transaminase levels
20 – 4656 IU/ml
4656 – 4.4 million IU/ml
> 4.4 million IU/ml
low viraemia
moderate viraemia
high viraemia
Incubation
Acute phase
Convalescence
Cure
4-12 weeks
2-12 weeks
2-16 months
years
Total anti-HBc Ab
Anti-HBs Ab
HBs Ag
Anti-HBe Ab
Anti-HBc IgM
HBe Ag
clinical signs
contact
immunity
infectivity
HBV DNA
HBe Ag
HBs Ag
Anti-HBc IgM
Total Anti-HBc Ab
Anti-HBe Ab
Anti-HBs Ab
64
Virology
HEPATITIS C
• Transmission:
Parenteral, nosocomial, sexual.
• Complications:
Cirrhosis and hepatocellular
carcinoma.
• Clinical Signs:
Asymptomatic in 90% of cases.
• Prevention:
Hygiene, no vaccination.
• Main Marker:
Anti HCV Ab, HCV Ag, HCV RNA.
• Development of chronic form:
Yes (80% of adult cases).
• Cure:
95% of cases (adults).
How to request for Hepatitis C Antibodies
Weakly Positive
Reactive
Not detected
mial.
Positive
0% of cases.
The prognostic value
of HCV genotyping
lts).
tocellular
ronic form:
cases).
Chronic hepatitis; cirrhosis
may, ultimately develop in
up to 20% of HCV cases.
Genotype 1b is more
frequent (~70%)
Genotype 1a, 2a and 2b
are less frequent (~10%)
HCV RNA Quantitative (reports viral load)
< 4,000 IU/ml
4,000 – 40,000 IU/ml
> 40,000 IU/ml
considered low levels
considered moderate levels
considered high levels
ation.
Patient / treatment
management
Confirmation by HCV Ag
(Quantitative)
Positive
Not detected
(Proceed to Hep C RNA
Viral Load)
Total anti-HBc Ab
(No further investigation)
Incubation
Acute phase
Cure
4-7 weeks
4-12 weeks
years
Anti-HCV Ab
HCV Ag
HCV RNA
contact
clinical signs
HCV RNA
HBs Ag
HCV Ag
Anti-HCV Ab
Incubation
Acute phase
Convalescence
Cure
65
Virology
HIV TESTING
TEST
CODE
SAMPLE REQS
TAT
HIV Screening: HIV1&2 Abs/p24 Ag
HIV Confirmation of Positive Screens
(Using 3 methodologies)
HIV 1 Quantitation (viral load by PCR)
HTLV 1&2 Abs. (Human T Lymphotropic Virus Type I-II)
HIV Drug Resistance Genotyping
HDUO
B
4 hrs
HIVC
B
1 day
IDSQ
HIV2
STDX
HTLV
HIVD
A A
A10mls or 2 x 4mls
B
A
5 days
5 days
3 days
8 hrs
7 days
HIV 1&2 Abs, using saliva is available for insurance/underwriting organisations only.
HIV DUO SCREEN
EARLY DETECTION SCREEN
(Simultaneous testing for
HIV1/HIV2/HBV/HCV by PCR/NAT)
Appropriate for screening from
4 weeks post-contact
HIV 1 & 2 Antibody
p24 Antigen
HIV1 and HIV2 (RNA)
TAT
4
HOURS
HDUO
B
66
TAT
3
DAYS
STDX
A 10mls or 2 x 4mls
Virology
HIV (Human Immunodeficiency Virus)
• Transmission:
Sexual, infected blood, sharing needles/stick injury,
pregnancy and birth.
• Clinical Signs:
Flu-like symptoms possible within a month or two
after exposure to the virus – fever, headache, fatigue,
and enlarged lymph nodes (time of high infectivity).
Long asymptomatic period followed by enlarged
glands before onset of AIDS. AIDS applies to the most
advanced stages of HIV infection.
• Cure:
Currently, there is no cure for HIV or AIDS. However,
certain therapies can help. Early initiation of treatment
is the best course.
• Complications:
HIV is the virus that causes AIDS (acquired
immunodeficiency syndrome). By destroying cells of
your body’s immune system, HIV progressively destroys
the body’s ability to fight infections and certain cancers.
Most people infected with HIV will develop AIDS but this
may take several years. It is estimated that aproximately
50% of people with HIV will develop AIDS within 10 years
of becoming infected.
• Prevention:
Education, safe sex, no vaccine.
• Main Diagnostic Markers:
HIV 1&2 Abs/p24 antigen, HIV RNA.
to request for HIV 1 & 2 Antibodies (Serum)/p.24 Antigen
mmunodeficiency Virus)
Not detected
d blood, sharing
ury, pregnancy and birth.
ms possible within a
fter exposure to the –
e, fatigue, and enlarged
ime of high infectivity).
matic period followed by
s before onset of AIDS.
the most advanced
nfection.
If acute HIV infection is suspected
on clinical grounds suggest repeat
HIV Abs/p24 Ag test (HDUO)
at 10-14 days
Positive/Reactive
Suggest
confirmation using
3 methodologies
is no cure for HIV or
, certain therapies can
ation of treatment is the
that causes AIDS
nodeficiency syndrome).
lls of your body's immune
ogressively destroys the
o fight infections and
. Most people infected
velop AIDS but this may
ars. It is estimated that
0% of people with HIV
DS within 10 years of
ted.
sex, no vaccine.
c Markers:
24 antigen, Proviral HIV
sis, HIV RNA.
HIVC
(HIV Confirmation)
OR
Not detected
Positive
HIV RNA
(Quantitative)
Not detected
Positive
Refer for Patient Management
67
Virology
68
TEST
CODE
Aspergillus Precipitins
Cytomegalovirus (IgG/IgM) Antibodies
Cytomegalovirus Avidity
Cytomegalovirus DNA (PCR)
Cytomegalovirus (PCR)
Cytomegalovirus IgM
Enterovirus Screen
Epstein-Barr Virus Antibodies IgG/IgM
Herpes I/II Antibody Profile (IgG)
Herpes Simplex I/II IgM
Human Herpes Virus – 6 (IgG/IgM) Ab
Human Herpes Virus – 6 by PCR
Human Herpes Virus – 8 (IgG)
Mycoplasma pneumoniae IgM and IgG
Neurological Viral Screen
Parvovirus Antibodies (IgM)
Parvovirus IgG Antibodies
Parvovirus IgG/IgM Abs
Pneumonia (Atypical) Screen
Q Fever (C Burnetti) Antibodies
Respiratory Synctial Virus
Respiratory Viral Screen
Torch Screen
Viral Antibody Screen
ADAB
ASPP
CMV
CMAV
CMVP
CMVU
CMVM
ENTO
EBVA
HERP
HERS
HERD
HERM
HSV6
HHV6
HHV8
MEAS
MEAM
MUMM
MYCO
NVIR
PARV
PARG
PARP
APS
QFEV
RSV
RESP
RUBE
RUBM
TORC
TFAM
VZOS
VZOM
VIRA
SAMPLE REQS
TAT
B
B
B
B
A
RU
B
B
B
B
PCR
FCRU / PCR/ TPV B
B
A
B
B
B 9
B
B
B B
B
B
B
B
B 9
B
B
B
B
B
B 9
B
B
B B
2 days
5 days
4 hrs
10 days
5 days
5 days
4 hrs
2 days
2 days
2 days
5 days
5 days
2 days
2 days
5 days
10 days
1 day
2 days
1 day
2 days
2 days
2 days
2 days
2 days
2 days
3 days
2 days
2 days
4 hrs
4 hrs
2 days
4 hrs
1 day
2 days
2 days
Virology
VIRAL ANTIBODY SCREEN
Influenza A CFT
CMV
Influenza B CFT
HSV 1
Measles IgG
HSV 2
Measles IgM
Mumps IgG
Mumps IgM
Mycoplasma pneumonia
Adenovirus CFT
TAT
Chlamydia CFT
2
Q fever CFT
DAYS
NEUROLOGICAL VIRAL SCREEN
Toxoplasma Antibodies
(IgG, IgM)
Rubella Antibody (IgG, IgM)
CMV Antibody (lgG, IgM)
Herpes Antibody
(HSV1/HSV2 IgG)
Influenza A CFT
Influenza B CFT
Measles IgG
Measles IgM
Mumps IgG
Mumps IgM
CMV IgG
HSV 1/2 IgG
HSV 1/2 IgM
VZV IgG
TAT
TAT
DAYS
DAYS
NVIR
TORC
2
2
VIRA
B B
TORCH SCREEN
B B 2
Coxsackie virus A mix CFT
Coxsackie virus B mix CFT
ECHO virus N Mix CFT
ECHO virus P
Mix CFT
Influenza A CFT
Influenza B CFT
Adenovirus CFT
Parainfluenza
mix CFT
RSV CFT
TAT
2
DAYS
DAYS
ENTO
APS
B
RESPIRATORY VIRAL SCREEN
ENTOVIRUS SCREEN
ATYPICAL PNEUMONIA SCREEN
Mycoplasma pneumonia Abs
Chlamydia pneumoniae (MIF)
Legionella
pneumophila (IF)
TAT
B B
TAT
2
DAYS
RESP
B
VIRAL SCREENS BY PCR
SITE OF PCR SWAB
CODE
SAMPLE REQS
TAT
Herpes Simplex I/II from symptomatic lesion
Skin/Mucosal Swab
HERS
PCR
5 days
VPSK
PCR
5 days
VPE
PCR
4 days
VPR
PCR or as
specified
5 days
VPCR
CSF
5 days
Herpes Simplex virus; Varicella Zoster virus. (If chicken pox
or shingles suspected, please indicate very clearly on form).
Eye Swabs
Herpes Simplex virus; Varicella Zoster virus; Adenovirus.
Respiratory Samples
e.g. throat swabs, nasopharyngeal aspirates, sputums
Adenovirus; Parainfluenza 1, 2, 3; Influenza A, B; Respiratory Syncytial virus;
Rhinovirus; Human Metapneumovirus.
CSF
Herpes Simplex virus; Varicella Zoster virus; Enterovirus;
Any other required, please specify.
Other swabs
Note: If no site or test code is specified PCR swabs will be processed for Herpes Simplex I/II.
Please state sample type on all samples to ensure correct assay procedure.
69
Special assays by PCR / Nucleic
acid amplification
Pathogenic micro-organisms can be detected by molecular detection. For further information about any
test please contact the Immunology department at TDL. Tests for viral pathogens, atypical organisms,
bacteria, fungi and protozoa.
TEST
CODE
Enterovirus by PCR
Epstein-Barr Virus (EBV-DNA)
H1N1 (Swine Flu)
HIV1/HIV2/HBV/HCV Early Detection Screen
HPV (individual low and high risk DNA subtypes)
HPV (HR DNA type 16, 18 + others)
Human Herpes Virus – 6 by PCR
MRSA (Rapid PCR) one swab per site Mycobacterium tuberculosis – DNA
Mycoplasma genitalium DNA by PCR
Neisseria Gonorrhoea – DNA
Pertussis by PCR
Rubella Virus – RNA by PCR
Sexual Health Screen
Ureaplasma by PCR
CMVP
ENPC
EBVQ
H1N1
DNAB
QPCR
STDX
IDSQ
HPVT
HP20
HPV
HHV6
MRSA
TBPC
MGEN
TGON/SGON
PERP
RUBP
PP12
UGEN
TAT
A
A/RF/PCR
A
2x PCR
A
A A 10mls or 2 x 4mls
A TPV
PCR/TPV
TPV
A
Blue Micro Swab
A
FCRU / PCR / TPV
TPV/PCR
Throat swab PCR
A/Amniotic Fluid
FCRU/PCR/TPV/Semen
FCRU / PCR / TPV
5 days
5 days
7 days
1 day
5 days
5 days
3 days
5 days
5 days
5 days
2 days
5 days
4 hrs
5 days
5 days
5 days
5 days
5 days
2 days
5 days
EARLY DETECTION SCREEN
7 STI PROFILE BY PCR
(7 TESTS FROM 1 SAMPLE)
N. gonorrhoea
Ureaplasma
Herpes Simplex I/II
SAMPLE REQS
(Simultaneous testing for
HIV1/HIV2/HBV/HCV by PCR)
All tests can
be requested
individually.
HIV1 and HIV2 (RNA)
TAT
2
DAYS
70
3
DAYS
STDX
PP12
FCRU OR PCR Swab OR TPV OR Semen TAT
A 10mls or 2 x 4mls
Tumour markers/sites
TEST
CODE
Alpha Feto Protein
Beta HCG (Oncology)
Breast/Ovarian Cancer – BRCA1 + BRCA2 full screening +
CHANGE
deletions/duplications
Breast/Ovarian Cancer NGS Panel – full sequencing
NEW
across 39 genes + deletions/duplications
CA 15-3
CA 19-9
CA 50
CA 125
Carcino Embryonic Antigen
Cyfra 21-1
Early CDT-Lung
HE4 + ROMA
Neurone Specific Enolase
NMP22 (Bladder tumour)
Osteocalcin
PCA3 (Molecular test for the detection of prostate cancer from urine)
Prostate Profile (Total & Free PSA)
Prostate Specific Antigen (Total)*
S100 Malignant Melanoma
Squamous Cell Carcinoma
Testicular Tumour Profile
* Results that fall between 2.00 and 10.00 ug/L will automatically
reflex to a Free PSA with a calculated ratio. The ratio of Free to
Total PSA may help discriminate between prostate cancer and
benign prostatic hyperplasia.
TUMOUR MARKERS/SITES
BHCG: Testes
Cyfra 21-1: Oesophagus, Lung, Bladder
BRCA1/2: Breast
HE4: Ovary
CA 125: Ovary
NMP22: Bladder
CA 15-3: Breast
NSE: Lung, Brain, Thyroid
CA 19-9: Stomach, Colorectal,
Gastrointestinal, Pancreas
PCA3: Prostate
CA 50: Bladder, Colon
S100: Melanoma
CDTL: Lung
SCC: Oesophagus, Bronchus,
Lung, Cervix
AFP: Liver, Testes
CEA: Stomach, Liver, Breast,
Ovary, Gastrointestinal, Lung
AFP
HCGQ
SAMPLE REQS
TAT
B
B
4 hrs
4 hrs
GENE
A A 9,11
3 weeks
GENE
A A 9,11
6 weeks
C153
C199
CA50
C125
CEA
CY21
CDTL
HE4
NSE
NMP
OST
PCA3
PR2
PSPA
S100
SCC
TTP
B
B
B
B
B
B
B
B
B
J 1
B (Frozen) 4
J 1,6
B
B
B
B
B
4 hrs
4 hrs
5 days
4 hrs
4 hrs
4 days
7 days
1 day
5 days
4 days
4 days
7 days
4 hrs
4 hrs
4 days
4 days
4 hrs
HE4 Earlier Detection of Ovarian Tumour
HE4 / CA 125 / ROMA
Calculated Algorithm for pre
and post menopausal risk
of malignant disease
(see page 72)
TAT
1
DAY
HE4
B
PROSTATE PROFILE Total and Free PSA
PSA: Prostate
Total PSA
Free PSA
Calculated Ratio
TAT
4
HOURS
PR2
B
71
HE4
CA 125, HE4 and ROMA (Risk of Ovarian Malignancy Algorithm)
Ovarian Cancer is the fourth or fifth most common cause of cancer-related deaths among women
worldwide and is responsible for 5% of all cancer deaths in women. Ovarian cancer is often detected
at an advanced stage, which generally results in a poor prognosis and poor survival rate. Early
detection is the key to improved survival among women with ovarian cancer.
CA 125 is, to date, the best known test for ovarian cancer diagnosis, and is the serum marker most
widely used to monitor therapeutic response and to detect disease or disease recurrence in patients
treated for epithelial ovarian cancer. Its recognised limitations have prompted the development of
biomarkers with better sensitivity for early stage diagnosis, with the ability to differentiate women
with ovarian cancer from those with benign ovarian conditions. CA 125 has a high false positive rate
among women with benign gynaecological conditions such as endometriosis. It is well documented
that approximately 20% of ovarian cancers lack expression of CA 125, and levels are not increased
in nearly 40-50% of early stage ovarian cancers.
HE4 is a new marker for ovarian carcinoma, which is over-expressed in patients with ovarian cancers.
When combined with CA 125, HE4 significantly raises the level of sensitivity for the detection of
ovarian cancer. HE4 is consistently expressed in patients with ovarian cancer and demonstrates
an increased sensitivity and specificity over that of CA 125 alone.
A Risk of Ovarian Malignancy Algorithm (ROMA) classifies patients as being at low or high risk for
malignant disease using both the CA 125 and HE4 results and a woman’s menopausal status. This risk is
given as an adjunct to the two test results for CA 125 and HE4. ROMA calculates a risk of finding ovarian
cancer during surgery. ROMA classifies patients as being at low or high risk for malignant disease.
HE4 is CE marked as an aid in estimating the risk of epithelial ovarian cancer in premenopausal and postmenopausal women
EXAMPLE OF LOW RISK CALCULATION
HE4
CA 125
36
10
pmol/L
U/mL
(< 140)
(0 – 35.0)
Premenopausal ROMA3.5%
Low Risk = High Risk = Less than 7.4%
Greater than or equal to 7.4%
Postmenopausal ROMA6.4%
EXAMPLE OF HIGH RISK CALCULATION
72
HE4
CA 125
39
146
pmol/L
U/mL
(< 140)
(0 – 35.0)
Premenopausal ROMA
4.9%
Postmenopausal ROMA
34.7%
Site
Tumour SampleTurnaround
markertype time
Oesophagus CA 19-9
CEA
SCC
serum
serum
serum
4 hours
4 hours
4 days
Site
Tumour
SampleTurnaround
marker typetime
Thyroid CEA
Thyroglobulin
Calcitonin
serum 4 hours
serum 1 day
1ml
1 day
Frozen serum
Site
Tumour
marker
SampleTurnaround
typetime
Breast
Breast Cancer EDTA
NGS Panel
CA 15-3
serum
CEA
serum
Site
Tumour
marker
SampleTurnaround
typetime
Liver
AFP
CEA
Ferritin
serum
serum
serum
Tumour
marker
SampleTurnaround
typetime
Site
markertype time
Bronchial/
Lung
NSE*
SCC*
CDTL
CEA
Cyfra 21-1
Site
markertype time
Bile duct
CA 19-9
CEA
Site
markertype time
Site
Pancreas
CA 19-9
CEA
Gastro- CEA
intestine CA 19-9
serum
serum
Site
markertype time
Site
Tumour
marker
SampleTurnaround
typetime
Ovarian Cancer EDTA
NGS Panel
CA125
serum
CA 15-3
serum
HE4
serum
AFP
serum
serum
serum
serum
serum
serum
serum
serum
serum
serum
5 days
4 days
7 days
4 hours
4 days
4 hours
4 hours
4 hours
4 hours
6 weeks
4 hours
4 hours
4 hours
4 hours
4 hours
4 hours
4 hours
Site
markertype time
Ovary
Bladder/
Chorion
CEA
serum 4 hours
CA 50
serum 5 days
NMP22urine 4 days
Site
Tumour
marker
SampleTurnaround
typetime
Site
markertype time
Colon
CEA
CA 19-9
CA 50
serum
serum
serum
Cervix/
Uterus
SCC
CEA
Site
Tumour
marker
SampleTurnaround
typetime
Carcinoid
5-HIAA 24 hour 5 days
urine/
acidified
serum
serum
4 days
4 hours
Site
markertype time
Prostate
Prostate serum 4 hours
Profile (Total + Free PSA)
PCA3 7 days
Site
markertype time
Melanoma
S-100
serum
Testes AFP
serum
Beta HCG
serum
(quantitative)
Site
Tumour
marker
6 weeks
4 hours
4 hours
1 day
4 hours
4 hours
4 hours
5 days
4 hours
4 hours
SampleTurnaround
typetime
Osteocalcin serum
(frozen)
4 days
4 days
* NSE: Neurone Specific Enolase
SCC: Squamous Cell Carcinoma
PCA3: A MOLECULAR TEST SPECIFIC FOR PROSTATE CANCER
The PCA3 assay detects the presence of PCA3 mRNA from a first catch urine sample following a digital rectal examination
(DRE). A DRE is required to release prostatic cells into the urine. Samples must be collected using specific Gen-Probe PCA3
sample collection tubes. Once collected in the urine collection tubes samples are stable for 5 days.
Please contact the laboratory on 020 7307 7373 for further details, or email [email protected].
73
74
TDL Genetics
TDL Genetics is a consultant-led service which is
able to provide extensive expertise in the testing,
diagnosis and genetic counselling of inherited
disorders. Genetic tests are performed on DNA
for molecular genetic analysis and on whole
chromosomes for cytogenetic analysis. Some tests are part of profiles that can be linked with assays from other
TDL disciplines, such as biochemistry and haematology, to give more comprehensive results for the patient.
Genetic tests are available for:
• Prenatal diagnosis and rapid trisomy
screening by Amnio-PCR
• Carrier screening
• Newborn chromosome analysis
• Confirmation of symptomatic individuals
and pre-symptomatic testing
• Genetic variation that influences risk of disease
• Identity studies (paternity, zygosity, tissue typing)
• Fertility studies
• Products of conception
Genetic testing is sometimes complex and tests will vary in their ability
to detect mutations or to detect all patients who have, or will develop, the
disease. Some tests are diagnostic for a condition, others are indicative
or are associated with an altered risk for a condition. Results can affect
the lives of individuals and have implications for their family, for insurance
and employment. Where testing will predict the inheritance of a disease in
a healthy person, counselling and consent are mandatory. For these tests,
please complete the Genetic Request form at the back of the guide (including
informed consent). Our service provides result interpretation and risk
assessment to patients and their family members. Genetic counselling
can be arranged by TDL’s Consultant Clinical Geneticist.
DNA peaks from
normal fetus
DNA peaks from
To meet the increasing range and complexity of genetic testing we have
Down Syndrome fetus
developed an excellent collaboration with other specialist laboratories.
Tests marked GENE are sent to these laboratories within our network and have a fixed price.
Specimen Receipt at The Doctors Laboratory is 24 hours a day. Specifically, TDL Genetics results service is
available Monday to Friday 8.30am – 5.30pm with the laboratory also open for processing of samples on
Saturdays from 9.00am – 1.00pm.
Test codes, sample requirement codes, turnaround times may be found on the following pages. All samples
must be collected in the specified containers, as shown in the key at the back of this guide. Samples should
be fresh and in good condition (e.g. not clotted if EDTA whole blood is required) otherwise testing may be
adversely affected and another sample may be required. Small DNA samples are stored routinely for one year,
larger DNA samples can be stored by special arrangement.
Instructions for transportation, sample labelling, and the completion of request forms can be found on the inside
cover of the TDL Genetics Request and Consent Forms pad.
The locations of the Laboratory and Patient Reception are indicated on the map on the reverse of each
request form. If you do not find the test you require in this directory or need more information and advice
please telephone the laboratory on 020 7307 7409 and ask to speak to the Consultant Clinical Geneticist
or the Director of TDL Genetics.
Always provide Clinical Details and Family History with requests for Genetic Tests.
75
TDL Genetics
Genetic Testing
THE IMPORTANCE OF CLINICAL DETAILS
Clinical details are very important when providing genetic analysis. The more clinical information that is available
(e.g. details of ultrasound information, phenotypic features or family history) the better the service we can provide.
Failure to provide this information for cytogenetic studies may result in an inaccurate analysis.
CYTOGENETICS
Cytogenetic analysis is performed according to the Professional Guidelines for the Association of Clinical
Cytogeneticists and the recommendations provided are dependent on the clinical indications given for
each case.
Clinical details inform the investigation at all stages:
• Prior to analysis, clinical details may indicate, for example, that specialist procedures such as
chromosome breakage or leukaemic studies are required, which must be referred to a specialist centre.
• During analysis they may indicate that extra cells should be screened to investigate the possibility of
mosaicism, for example in a diagnosis of suspected Turner syndrome, or that particular chromosomes must
be targeted for high-resolution study, for example chromosome 4 in suspected Wolf-Hirschhorn syndrome.
• When the analysis has been completed they may help to provide an accurate interpretation of the findings
and in some instances prompt further investigations, for example FISH or molecular genetic studies.
When clinical details are not available a routine analysis will be performed and a conditional report issued.
MOLECULAR GENETICS
Clinical details can be extremely important for clinical interpretation of a molecular genetic test.
For example, the clinical comments accompanying a cystic fibrosis screening report will vary depending on
whether the patient is a potential gamete donor or a person exhibiting a cystic fibrosis phenotype. Similarly,
the interpretative comment accompanying Factor II and V studies may vary depending on whether the
investigation is prompted by a history of recurrent miscarriage or the need to determine a thrombotic risk.
It may also be crucial, where a mutation has already been shown to be segregating in a family, to be provided
with information concerning the mutation and a family pedigree to ensure the correct analysis is performed
and reliable risk figures calculated.
Notes for Cytogenetics
As cytogenetic studies require living cells, please ensure that samples reach the laboratory quickly. If a delay
before despatch is unavoidable, samples may be stored in a refrigerator (4°C) but they must not be frozen.
Information concerning packaging, transportation, and labelling of samples is provided on the inside cover of
our TDL Genetics Request Form Pad.
On completion of analyses, fixed cell suspensions are stored for a minimum of three months and are available
for additional follow-up studies (for example, FISH), if necessary.
Requesting additional tests
Any further tests not requested at the time of sample receipt must be requested within:
2 weeks for DNA testing
2 weeks for cell culture testing
3 months for FISH testing
Samples can be stored for longer periods if specifically requested at the time of sample receipt.
76
TDL Genetics
POSTNATAL DIAGNOSIS (BLOOD CULTURE)
Reasons for analysis: Chromosome studies are requested where problems that may have a cytogenetic basis are
suspected, e.g. babies with birth defects; children with developmental delay and physical handicaps, or adults with
fertility problems. Additionally, prospective gamete donors are screened to detect carriers of balanced chromosome
rearrangements.
Sample requirements: Lithium heparin whole blood specimens are required – gently mixed to prevent clotting and
must not be frozen, or exposed to temperatures greater than 38°C. Sample volumes may be reduced for children
(2-4ml) and neonates (1-2ml).
Turnaround time: The usual turnaround time is 2-3 weeks however the laboratory will endeavour to respond to
urgent requests. Where a major trisomy is suspected, a rapid PCR screen may be performed to provide an urgent
provisional result.
Notes
a) Rarely, blood samples fail to culture (<1%);
b) The culture may yield chromosomes of insufficient quality. This will be indicated on the report
and a repeat study suggested;
c) The laboratory should be informed if the patient has recently received a blood transfusion.
LEUKAEMIC STUDIES (BONE MARROW)
Sample requirements: 5-10ml bone marrow in preservative free heparin and RPMI medium. This can be supplied by
the laboratory.
Clinical information: Please complete the Leukaemic Studies Request form at the back of the guide, including WBC,
reason for referral, stages of disease/treatment and analysis required e.g. karyotype and/or FISH or PCR.
PRENATAL DIAGNOSIS
Reasons for analysis: Chromosome studies are requested where pregnancies are identified as being at risk of a
cytogenetic abnormality e.g. advanced maternal age; positive maternal serum screening; fetal abnormalities found on
ultrasound; or where a parent is a known carrier of a chromosome anomaly, or where a high risk trisonomy has been
found by NIPT.
Sample requirements:
a) amniotic fluid – 10ml+ in a plain sterile, leak-proof container. Suitable containers can be provided by the laboratory.
The specimen must not be frozen.
b) chorionic villus – 5mg+ in sterile transport medium. Suitable containers containing medium can be provided by
the laboratory. The specimen must not be frozen.
c) fetal blood – 1-2ml LITHIUM HEPARIN whole blood, gently mixed to prevent clotting. The specimen must not be frozen.
Turnaround time: This is dependent on the rate of cell growth, however, the usual turnaround time is approximately
2 weeks. Fetal blood results will usually be reported within 7 days.
Notes
a) Maternal contamination, and mosaicism may complicate the analysis and may lead to the suggestion
that a second invasive test is performed.
b) Rarely, cultures fail to grow (overall <1%)
c) Very small chromosome abnormalities may not be detected (this is why the phrase ‘No trisomies
or major chromosome abnormalites detected…’ is used in our reports).
d) for TTTs or heavily blood stained amniocentesis samples, please provide a maternal EDTA blood sample
for comparison studies.
77
TDL Genetics
SOLID TISSUE
Reasons for analysis: Fibroblast cultures may be used in addition to blood cultures, for example where tissue specific
mosaicism is suspected, or where blood samples cannot be obtained. POC samples may be requested for early
spontaneous miscarriages, stillbirths, or to confirm a prenatal diagnosis.
Sample requirements: All specimens should be placed in a sterile container, preferably containing transport medium.
This can be supplied by the laboratory. Sterile normal saline can be used if transport medium is not available.
Samples must not be placed in formaldehyde or other preservative and must not be frozen.
Turnaround time: This is dependant on the rate of cell growth, however, the usual turnaround time is approximately
4 weeks.
Notes
a) Material from miscarriages has a relatively high culture failure rate (around 20%)
b) If no villus or fetal parts are identified in supposedly POC material and a normal female chromosome
result is found, this may indicate that maternal tissue has been cultured (this will be noted on our report)
c) Sensitive disposal of miscarriage material can be arranged if requested at the time of sample receipt.
If no special request is made, the material will be disposed of by incineration.
FLUORESCENCE IN SITU HYBRIDISATION (FISH)
Where FISH studies for specific microdeletion syndromes are required this must be indicated on the request form.
Note: FISH studies for a prenatal aneuploidy screen have now been superceded in our laboratory by multiplex-PCR
technology. Subtelomeric screens are now performed by Array CGH as part of developmental delay investigations.
Common microdeletion syndrome testing is now performed by BOBs analysis.
KEY PERSONNEL
78
Consultant Clinical Geneticist
Prof. Michael Patton
020 7307 7409
[email protected]
Head of Cytogenetics
Terry Ballard
020 7307 7319
[email protected]
Senior Cytogeneticist Kath Masters
020 7307 7409
[email protected]
Director of Genetic Services
Dr Lisa Levett
020 7307 7409
[email protected]
Head of Molecular Genetics Dr Stuart Liddle
020 7307 7409
[email protected]
TDL Genetics
TEST
CODE
SAMPLE REQS
TAT
1p36 Deletion Syndrome – karyotype + FISH
KARY,
FISH
CVS/AF/H 9
12-17 days
GENE
A 9,11
8 weeks
DGB,
KARY
CVS/AF/A H 9
5-15 days
DGB
CVS/AF/A 9
5 days
GENE
A 9
3 weeks
GENE
A 9
4 weeks
GENE
A 9,11
4 weeks
GENE
SAFP
A AF 9
3 weeks
5-10 days
GENE
A 9
4 weeks
GENE
A A 9
6 weeks
GENE
A 4 weeks
GENE
A A 6 weeks
APC
AF 9
1-2 days
APCC
AF 9
2-15 days
ACUL
AF 9
10-15 days
ABOB
AF 9
3-6 days
ABK
AF 9
5-15 days
GENE
A 9,11
8 weeks
PWAM
A 9
5 days
GENE
A A 9
6 weeks
GENE
A 9
8 weeks
APEG
A 5 days
CGH
CVS/AF/A H 9
10 days
GENE
A 9,11
10 days
GENE
A 9,11
4 weeks
21-Hydroxylase Deficiency (Congenital Adrenal Hyperplasia)
– 7 mutations + deletions/duplications
22q11 & 10p14 deletion (Di George Syndrome)
– BOBs (5 days) + karyotype (15 days)
22q11 & 10p14 deletion (Di George Syndrome)
– BOBs only
5' Fluorouracil Toxicity (DPD deficiency)
– common mutation (IVS14+1G>A)
Achondroplasia (Postnatal) – 2 common mutations
in FGFR3 (c.1138G>A + c.1138G>C).
Alpers Syndrome – 3 common POLG mutations
(p.A467T + p.W748S + p.G848S)
Alpha 1 Antitrypsin Genotype – PI*M, PI*S, PI*Z
Alpha Fetoprotein on Amniotic fluid
Alpha Thalassaemia – multiplex PCR for common
large deletions
Alport Syndrome NGS Panel – full sequencing
CHANGE
COL4A3 + COL4A4 + COL4A5
Alstrom Syndrome – ALMS1 sequencing
Amelogenesis/Osteogenesis Imperfecta NGS Panel
NEW
– full sequencing across 20 genes
AmnioPCR only – rapid common aneuploidy
diagnosis by QF-PCR
Amniocentesis – rapid PCR diagnosis for common
aneuploidies (2 days) + culture (10-15 days)
Amniocentesis culture (karyotype) only
AmnioBOBs only – rapid aneuploidy diagnosis for all
chromosomes + common microdeletion syndromes
Amniocentesis – rapid BOBs aneuploidy diagnosis for
all chromosomes (5 days) + culture (10-15 days)
– see profiles
Androgen Insensitivity – AR sequencing
+ deletions/duplications
Angelman Syndrome (Primary Screen) – methylation PCR
Angelman/Rett Syndromes NGS Panel –
NEW
full sequencing across 18 genes
Apert Syndrome – 2 common mutations in FGFR2 (c.755G>G
+ c.758C>G)
Apolipoprotein E genotype – E2, E3, E4
Array CGH (Comparative Genomic Hybridisation)
Ashkenazi Jewish Carrier Screen
CHANGE
– see Pan-ethnic / Jewish Carrier Profile
Ashkenazi Breast Cancer Screen
– 3 common mutations
9
9
9,11
9
79
TDL Genetics
TEST
NEW
Ataxia/Episodic Ataxia NGS Panel
– full sequencing across 33 genes + whole mt.DNA
Azoospermia – karyotype + cystic fibrosis screen
+ polyT(5T) + Y deletions
BCR/ABL (Chronic Myeloid Leukemia)
– fusion gene PCR + Philadelphia chromosome
(9:22 translocation) analysis
BCR/ABL Quantitative – fusion gene sizes p190 + p210 –
MUST arrive in the laboratory within 36 hours
Becker Muscular Dystrophy – deletions/duplications
Beckwith-Wiedemann Syndrome – methylation studies
on 11p15 imprinting domains KvDMR + H19
Behcet’s Disease – HLA Tissue Typing B*51
Beta Thalassaemia – beta-globin sequencing
CODE
SAMPLE REQS
TAT
GENE
A A 9
8 weeks
GRP
A H 9
15 days
CBMA
Contact lab
5 days
GENE
Contact lab
10 days
DND
9
A 10 days
GENE
9
A 4 weeks
B51
A
A 9
6 weeks
GENE
10 days
9
BOBs rapid chromosome analysis – see profiles
CHANGE
NEW
Breast/Ovarian Cancer – BRCA1 + BRCA2 full screening
GENE
Contact consultant clinical geneticist
A A 9,11
3 weeks
Breast/Ovarian Cancer NGS Panel – full sequencing
GENE
A A 9,11
6 weeks
Breast Cancer Ashkenazi Screen – 3 common mutations
GENE
CADASIL – NOTCH 3 mutation screening
GENE
NEW Calreticulin – CALR exon 9 mutation screen
NEW
NEW
NEW
NEW
NEW
Cardio-Facio-Cutaneous/Noonan/LEOPARD/
Costello Syndromes NGS Panel – full sequencing
across 12 genes
Cardiomyopathy NGS Panel
Carrier Screen (Pan-ethnic or Jewish) – see profiles
Cerebellar Hypoplasia NGS Panel – full sequencing
across 7 genes
Cerebral Cavernous Malformations Panel
– full KRIT + CCM2 + PDCD10 sequencing +
Charcot Marie Tooth Type 1A – PMP22 duplications
Charcot-Marie-Tooth Syndrome NGS Panel
CHARGE Syndrome – CHD7 sequencing
NEW Cholestasis NGS Panel – full sequencing across 7 genes
Chromosome Analysis (Amniocentesis)
– rapid PCR diagnosis for common aneuploidies
(2 days) + culture (10-15 days)
Chromosome Analysis (Amniocentesis)
– rapid BOBs aneuploidy diagnosis for all
chromosomes (5 days) + culture (10-15 days)
– see profiles
Chromosome Analysis (Amniocentesis) – culture only
80
4 weeks
GENE
A 9,11
A 9,11
A 9
GENE
A A 9
8 weeks
GENE
A A 9,11
6 weeks
GENE
A 9,11
10 days
GENE
A A 9
6 weeks
GENE
A A 9
8 weeks
GENE
A 9
4 weeks
4 weeks
4 weeks
GENE
9
A A
6 weeks
GENE
A
A A 9
4 weeks
GENE
APCC
AF 9
2-15 days
ABK
AF 9
5-15 days
ACUL
AF 9
10-15 days
9,11
Turnaround times are quoted as working days.
6 weeks
TDL Genetics
TEST
CODE
SAMPLE REQS
TAT
Chromosome Analysis (Blood)
Chromosome Analysis (Bone Marrow)
– please send with complete Leukaemic Studies Request form
at back of guide
Chromosome Analysis (Chorionic Villus)
– rapid PCR diagnosis for common aneuploidies
(2 days) + culture (10-15 days)
– rapid BOBs aneuploidy diagnosis for all chromosomes
(5 days) + culture (10-15 days) – see profiles
– culture only
KARY
H 5-15 days
CBMA
Contact lab
5-20 days
CVPC
CVS 1,9
2-15 days
CBK
CVS 9
5-15 days
CVSC
CVS 1,9
10-15 days
Chromosome Analysis (Products of Conception)
PROC
Placental
Sample 1,9
20-25 days
PBK
Placental
Sample 1,9
5-25 days
CHSL
PROC
Slide 9
Fetal tissue 1,9
Contact lab
4-5 weeks
GENE
H 1,9
4 weeks
YDEL
Q2Q8
A 9
A 9
10 days
GENE
A A 9,11
6 weeks
CGH
CVS/AF/A H 9
10 days
GRP
A H 9,11
15 days
GENE
A 9,11
8 weeks
GENE
A 9
3 weeks
GENE
A A 9
6 weeks
GENE
A A 9
6 weeks
GENE
A 9
8 weeks
GENE
A A 9
8 weeks
GENE
A A 9
4 weeks
PBOB,
KARY
CVS/AF/A H 9
5-15 days
Chromosome Analysis (Product of Conception)
– BOBs rapid aneuploidy diagnosis for all chromosomes
(5 days) + culture (25 days)
Chromosome Analysis (Slide for opinion)
Chromosome Analysis (Solid Tissue)
Chromosome Breakage Studies (Postnatal)
– induced chromosome breakage within culture
Chromosome Y Deletion – AZFa, AZFb, AZFc + SRY
NEW
NEW
NEW
NEW
CHANGE
Coeliac Disease – HLA DQ2/DQ8 genotyping
Colon Cancer NGS Panel – full sequencing across
21 genes + deletions/duplications
Comparative Genomic Hybridisation (Array CGH)
Congenital Absence of Vas Deferens
– karyotype + cystic fibrosis screen + polyT(5T)
+ Y deletions
Congenital Adrenal Hyperplasia (21-Hydroxylase Deficiency)
– 7 mutations + deletions/duplications
Congenital Central Hypoventilation Syndrome
– PHOX2B repeat analysis
Congenital Disorders of Glycosylation (CDG)
NGS Panel – full sequencing across 38 genes
Connective Tissue Disease NGS Panel
Connexin-26 Associated Deafness
(+ Connexin-30 common deletion)
Costello/Noonan/LEOPARD/Cardio-FacioCutaneous Syndromes NGS Panel – full sequencing across
12 genes
Craniosynostosis – including Crouzon, Jackson-Weiss, Pfeiffer
& Saethre-Chotzen Syndromes.
Genes analysed tailored to clinical diagnosis
Cri du Chat Syndrome
9
5 days
81
TDL Genetics
TEST
Cri du Chat Syndrome – BOBs only
CVSBOBs only – rapid aneuploidy diagnosis for all chromosomes
+ common microdeletion syndromes
CVSBOBs – rapid BOBs aneuploidy diagnosis for all
chromosomes (3-5 days) + culture (10-15 days)
– see profiles
CVS PCR for common anueploidies (2 days)
+ culture (10-15 days)
NEW CYP450 2D6 Genotyping
NEW
NEW
NEW
82
SAMPLE REQS
TAT
PBOB
CVS/AF/A 5 days
CBOB
CVS 9
5 days
CBK
CVS 9
5-15 days
CVPC
CVS 9
2-15 days
TGEN
PLYT
A 9
A 9
A 9
A 9
GENE
A 8 weeks
GENE
A A 9,11
8 weeks
GENE
A A 9,11
6 weeks
GENE
A 9
3 weeks
CVS/AF/A H 9
5-15 days
CYP450 Genotyping for drug metabolism
GENE
Cystic Fibrosis – 139 common mutations
CFS
Cystic Fibrosis Poly T (5T, 7T, 9T)
Deafness – Connexin-26 sequencing
+ Connexin-30 common deletion
Dementia/Movement Disorders NGS Panel
NEW
Diabetes/Obesity NGS Panel –
NEW
full sequencing across 56 genes
Dihydropyrimidine Dehydrogenase deficiency
(5-FU Toxicity) – common mutation (IVS14+1G>A)
DiGeorge Syndrome (22q11 & 10p14 deletion)
DiGeorge Syndrome (22q11 & 10p14) – BOBs only
NEW
CODE
DGB,
KARY
DGB
9
10 days
4 weeks
5 days
5 days
9
CVS/AF/A 9
5 days
10 days
DVT1
A 9,11
A 9,11
A 9
A 9
A A B 9
DNA Extraction & Storage – 3 years (longer upon request)
XDNA
DNA Identity Profile – 15 STR markers
DNAF
Duchenne Muscular Dystrophy – deletions/duplications
DMD
Duchenne Muscular Dystrophy – full DMD1 sequencing
GENE
DVT/Pre-travel Screen – see profiles
Ehlers-Danlos Syndrome NGS Panel
Epidermolysis Bullosa NGS Panel
– full sequencing of KRT5 + KRT14 genes
Epilepsy NGS Panel – full sequencing across 342 genes
Eye Disorders NGS Panel – full sequencing across 138 genes
10 days
10 days
6 weeks
5 days
GENE
A A 9
6 weeks
GENE
A A 9
8 weeks
GENE
A A 9
6 weeks
GENE
GENE
A A 9
A 9
6 weeks
Fabry Disease, X-linked – GLA sequencing
Facioscapulohumeral Muscular Dystropy (FSHD)
– D4Z4 repeat deletion
GENE
A A A 9
8 weeks
Factor II Prothrombin – G20201A mutation
FX2
FX5
A 9
A 9
5 days
Factor V Leiden – G1691A mutation
Factor VIII (F8) Severe Haemophilia A
– common 1/22 exon inversion
GENE
A 9
3 weeks
Familial Adenomatous Polyposis (FAP)
– APC sequencing + deletions/duplications
GENE
Familial Cutaneous Malignant Melanoma
– CDKN2A + CDK4 exon 2 sequencing
GENE
6 weeks
5 days
A 9,11
8 weeks
A 9,11
8 weeks
TDL Genetics
TEST
Familial Hypocalciuric Hypercalcaemia (FHH)
– CASR sequencing
Familial Hypercholesterolaemia – comprehensive
LDLR + APOB + PCSK9 + LDLRAP1 sequencing
Familial Mediterranean Fever – MEFV hotspot sequencing
Familial Medullary Thyroid Carcinoma
– RET gene hotspot sequencing
NEW Fever Syndromes NGS Panel – full sequencing across 21 genes
Fragile X Syndrome screen – FMR1 repeat analysis
PCR (3 weeks) + Southern Blot (8 weeks) if required
Friedreich Ataxia – frataxin gene repeat analysis
NEW
NEW
NEW
NEW
NEW
CHANGE
CHANGE
CODE
SAMPLE REQS
TAT
GENE
A 9
8 weeks
GENE
A A 9
4 weeks
GENE
A 6 weeks
9
GENE
A GENE
A A GENE
A A A 3-8 weeks
GENE
6 weeks
8 weeks
9,11
6 weeks
9
9
Genetic Reproductive Profile (Male) – see profiles
GRP
Gilbert Syndrome – common UGT1A1 repeat variation
Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency
– common mutations
Haemochromatosis – HFE common mutations C282Y + H63D
Haemophilia A (Severe) – Factor VIII (F8) common
1/22 exon inversion
Haemophilia/Coagulation NGS Panel –
F8 + F9 + GP1BA + vWF full sequencing
Harmony™ Prenatal Test (Non-Invasive Prenatal Testing) –
common aneuploidy screening from maternal blood
Hearing Loss NGS Panel – full sequencing across 103 genes
Hereditary Cancer NGS Panel – full sequencing
Hereditary Hemorrhagic Telangiectasia
– ACVRL1 + ENG full sequencing + deletions/duplications
Hereditary Neuropathy with Liability to Pressure Palsy –
PMP22 deletion analysis
Hereditary Neuropathy NGS Panel
Hereditary Non-Polyposis Colon Cancer (Lynch Syndrome)
NGS Panel – full sequencing of MLH1
+ MSH2 + MSH6 + deletions/duplications
Hereditary Pancreatitis – PRSS1 hotspot
sequencing + deletions/duplications + SPINK1 N34S
common mutation
Hereditary Spastic Paraplegia NGS Panel
– full sequencing across 24 genes + deletions/duplications
HFE gene (Haemochromatosis)
– common mutations C282Y + H63D
HLA Tissue Typing A
GENE
A A H 9
A 9
GENE
A 9
6 weeks
HMD
A 3 days
GENE
A 3 weeks
GENE
A A 9
6 weeks
NIPT
J/Special tubes 1
GENE
A A 9
up to
10 days
6 weeks
GENE
A A 9,11
6 weeks
GENE
A A 9
8 weeks
GENE
A 9
4 weeks
GENE
A A 9
6 weeks
GENE
A A 9,11
8 weeks
GENE
A 9
8 weeks
GENE
A A 9
6 weeks
HMD
A 9
3 days
HLA
HLBA
HLA Tissue Typing A+B+C (Class I)
HABC
HLA Tissue Typing A/B/C/DRB1/3/4/5/DQB1 (Class I & II)
HLFC
A A 9
A 9
A 9
10 days
HLA Tissue Typing A+B
9
9
9
9
15 days
6 weeks
10 days
10 days
10 days
83
TDL Genetics
TEST
CODE
SAMPLE REQS
TAT
HLA Tissue Typing A/B/DRB1/3/4/5
HLAF
HLF
HLA Tissue Typing B
HLB
HLA Tissue Typing B*27 only
HLAB
HLA Tissue Typing B*51 (Behcet’s Disease)
B51
HLA Tissue Typing B*57:01 high resolution
HL57
HLA Tissue Typing C
HLC
HLA Tissue Typing Coeliac Disease – DQ2/DQ8
Q2Q8
HLA Tissue Typing DRB1/3/4/5
DRB1
HLA Tissue Typing DRB1/3/4/5/DQB1 (Class II)
HLDQ
HLA Tissue Typing Narcolepsy – DRB1*15/DQB1*06
NARC
A A 9
A 9
A 9
A 9
A 9
A 9
A 9
A 9
A 9
A 9
10 days
HLA Tissue Typing A/B/DRB1/3/4/5/DQB1
Huntington Disease – HD gene repeat analysis PCR
(3 weeks) + Southern Blot (8 weeks) if required
Hyperparathyroidism – CASR sequencing
Hypochondroplasia (Postnatal) – 2 common mutations
in FGFR3 (c.1620C>A + c.1620C>G)
Identity Profile (DNA) – 15 STR markers
Incontinentia Pigmenti, X-linked
– IKBKG/NEMO common mutation
Intellectual Disability NGS Panel – full sequencing
NEW
Iron Overload Profile – see profiles
JAK 2 – V617F common mutation
NEW JAK 2 – exon 12 sequencing (rare mutations)
CHANGE Jewish / Pan-ethnic carrier screening – see profiles
Joubert Syndrome NGS Panel
NEW
Karyotype – see Chromosome Analysis
Kennedy Disease (Spinal Bulbar Muscular Atrophy)
– AR repeat expansion
Kenny-Caffey (Sanjad-Sakati) Syndrome
– common 12bp TBCE gene deletion
Krabbe Disease – GALC sequencing + 502T/del
common deletion
Langer-Giedion Syndrome – BOBs (5 days) +
karyotype (15 days)
Langer-Giedion Syndrome – BOBs only
Lebers Hereditary Optic Neuropathy
– m.3460G>A + m.11778G>A + m.14484T>C
common mutations
LEOPARD/Noonan/Cardio-Facio-Cutaneous/
across 12 genes
Leukaemic Studies (Bone Marrow) – please send
with complete Leukaemic Studies Request form
at back of guide
84
GENE
9
10 days
10 days
3 days
10 days
10 days
10 days
10 days
10 days
10 days
10 days
A 9,11
3-8 weeks
GENE
A 9
8 weeks
GENE
9
A 4 weeks
DNAF
A 10 days
GENE
A 4 weeks
GENE
A A 9,11
IOP
9,11
9
6 weeks
GENE
A A B A 9
A 9
A 9,11
GENE
A A 9
6 weeks
GENE
A 9
6 weeks
TBC
A 9
10 days
GENE
A 9
8 weeks
PBOB,
KARY
CVS/AF/A H 9
5-15 days
PBOB
CVS/AF/A 5 days
GENE
A 9
8 weeks
GENE
A A 9
6 weeks
CBMA
Contact lab
4 weeks
JAK2
GENE
9
4 weeks
10 days
9
3 days
10 days
TDL Genetics
NEW
CHANGE
NEW
NEW
NEW
TEST
CODE
SAMPLE REQS
Li-Fraumeni Syndrome (p53-related cancer
predisposition) – TP53 sequencing
GENE
A 9,11
6 weeks
Loeys-Dietz (Marfan-Like) Syndrome
–TGFBR1 + TGFBR2 sequencing
Lowe (Oculocerebrorenal) Syndrome
– OCRL sequencing + large deletions
Lung Disorders NGS Panel – full sequencing
across 51 genes
Lynch Syndrome (HNPCC) NGS Panel – full sequencing
of MLH1 + MSH2 + MSH6 + deletions/duplications
Lysosomal Disorders NGS Panel – full sequencing
across 105 genes
Male Genetic Reproductive Profile – see profiles
Marfan Syndrome – FBN1 sequencing +
Marfan/Loeys-Dietz/TAAD Syndromes – full sequencing
Maturity-Onset Diabetes of the Young (MODY)/
Neonatal NGS Panel – full sequencing across 29 genes
Medium-Chain Acyl-CoA Dehydrogenase Deficiency
– ACADM sequencing
Microdeletion (common) Syndromes – BOBs only
TAT
GENE
A 9
8 weeks
GENE
A 9
8 weeks
GENE
A A 9
6 weeks
GENE
A A 9,11
8 weeks
GENE
A A 9
6 weeks
GRP
A H
15 days
GENE
A 8 weeks
GENE
A A 9
6 weeks
GENE
A A 9
6 weeks
GENE
A 9
6 weeks
PBOB
CVS/AF/A 9
5 days
CVS/AF/A H 9
5-15 days
CVS/AF/A 9
5 days
GENE
A 9
6 weeks
GENE
A 9
4 weeks
MTHF
9
9
Miller-Dieker Syndrome
Miller-Dieker Syndrome – BOBs only
Mitochondrial Myopathy – full mitochondrial DNA sequencing
Myeloproliferative Leukaemia (MPL) gene
NEW
– W515X mutation screen
MTHFR – common C677T mutation
PBOB,
KARY
PBOB
MTHFR – common C677T + A1298C mutations
Multiple Epiphyseal Dysplasia (Pseudoachondroplasia)
– COMP sequencing
Multiple Endocrine Neoplasia Type 1 –
MEN1 sequencing
Multiple Endocrine Neoplasia Type 2 –
RET gene hotspot sequencing
Muscular Dystrophy/Myopathy NGS Panel
NEW
– full sequencing across 163 genes + whole mt.DNA
Myotonic Dystrophy Type 1 – DMPK repeat PCR
GENE
A
A 9
3 weeks
GENE
A 9
8 weeks
GENE
A 9,11
8 weeks
GENE
A 9,11
8 weeks
GENE
A A 9,11
8 weeks
GENE
GENE
Narcolepsy – HLA DRB1*15/DQB1*06
Neurofibromatosis Type 1 – NF1 + SPRED1 sequencing +
CHANGE
deletions/duplications – MUST arrive in the laboratory
within 36 hours
NARC
A 9
A 9
A 9
4 weeks
Myotonic Dystrophy Type 2 (PROMM) – ZNF9 repeat PCR
GENE
A A 9,11
8 weeks
9
5 days
4 weeks
10 days
85
TDL Genetics
TEST
Neurofibromatosis Type 2 (Bilateral Acoustic)
– NF2 sequencing + deletions/duplications
Neuronal Migration Disorders NGS Panel
NEW
Non-Invasive Prenatal Testing
– common aneuploidy screening from maternal blood
Noonan Syndrome Prenatal Screening
– PTPN11 exons 3 & 8 only
Noonan/LEOPARD/Cardio-Facio-Cutaneous/
across 12 genes
Oculopharyngeal Muscular Dystrophy
– PABPN1 repeat analysis
Osteogenesis/Amelogenesis Imperfecta NGS Panel
NEW
p53-related cancer predisposition
(Li-Fraumeni Syndrome) – TP53 sequencing
CHANGE Pan-Ethnic Carrier Screen – see profiles
Pancreatitis (Hereditary) – PRSS1 hotspot sequencing +
deletions/duplications + SPINK1 N34S common mutation
Paternity Testing (postnatal and prenatal) –
sample required from each person being tested (3 people)
Pelizaeus-Merzbacher Syndrome –
PLP1 sequencing + deletions/duplications
Periodic Fever Syndromes NGS Panel
NEW
Peutz-Jegher Syndrome – STK11 sequencing
Phelan-McDermid Syndrome – karyotype + FISH
NEW
Pheochromocytoma/Paraganglioma NGS Panel
POLG-Related Disorders – full POLG sequencing
Prader-Willi Syndrome (Primary Screen)
– methylation PCR
Product of Conception BOBs only
– rapid aneuploidy diagnosis for all chromosomes
Product of Conception – rapid BOBs aneuploidy diagnosis
for all chromosomes (5 days) + culture (25 days)
– see profiles
Pseudoachondroplasia (Multiple Epiphyseal Dysplasia) –
COMP hotspot sequencing
PTEN-related disorders (including Bannayan-RileyRuvalcaba, Cowden & Proteus Syndromes) –
sequencing + deletions/duplications
QF-PCR rapid common aneuploidy screen
Recurrent Miscarriage Profile (female) – see profiles
86
CODE
SAMPLE REQS
TAT
GENE
A 9,11
8 weeks
GENE
A A 9
8 weeks
NIPT
J/Special tubes 1
up to
10 days
GENE
CVS / AF
10 days
GENE
A A 9
6 weeks
GENE
A 9
4 weeks
GENE
A A 9,11
6 weeks
GENE
A 9,11
6 weeks
GENE
A 9,11
10 days
GENE
A 9
8 weeks
A/AF/CVS 9,11,12
5 days
GENE
A 9,11
8 weeks
GENE
A A 9
6 weeks
GENE
A 9,11
8 weeks
KARY,
FISH
CVS/AF/H 9
12-17 days
GENE
A A 9,11
8 weeks
GENE
A 9
6 weeks
PWAM
A 9
5 days
KBOB
Placental Sample or
Solid Tissue 1,9
5 days
PBK
Placental
Sample 1,9
5-25 days
GENE
A 9
8 weeks
GENE
A 9,11
8 weeks
APC
AF/ A 9
1-2 days
Contact
lab
RMP
A A B C C C H 9,18
10-15 days
TDL Genetics
NEW
TEST
CODE
Renal Cysts And Diabetes (RCAD)
– HNF-1β sequencing + deletions/duplications
GENE
A 9,11
8 weeks
Retinitis Pigmentosa NGS Panel
GENE
A A 9
6 weeks
Retinoblastoma – RB1 sequencing + deletions/duplications
GENE
Rett Syndrome – MECP2 sequencing + deletions/duplications
Rett/Angelman Syndromes NGS Panel
NEW
Rubenstein-Taybi Syndrome
– cREBBP + EP300 + SRCAP sequencing
Sanjad-Sakati (Kenny-Caffey) Syndrome
– common 12bp TBCE gene deletion
Short-Chain Acyl-CoA Dehydrogenase Deficiency
– ACADS sequencing
Short Stature – SHOX mutation screening
Silver-Russell Syndrome – methylation studies on 11p15
imprinting domains KvDMR + H19
Skeletal Dysplasia NGS Panel
NEW
Smith-Lemli-Opitz Syndrome – DHCR7 sequencing
Smith-Magenis Syndrome
Smith-Magenis Syndrome – BoBs only
Sotos Syndrome (Cerebral Gigantism)
– NSD1 sequencing + deletions/duplications
Spastic Paraplegia NGS Panel – full sequencing
NEW
Spinal Bulbar Muscular Atrophy (Kennedy Disease)
– AR repeat analysis
Spinal Muscular Atrophy – SMN1 deletions/duplications
Spinocerebellar Ataxia – multiplex SCA1+2+3+6+7+17
repeat expansions
SRY (Sex-determining Region Y)
Tay Sachs Screen – 5 common mutations.
See also Pan-Ethnic/Jewish Carrier Profile
Thrombotic Risk – see profiles
Torsion Dystonia (DYT1) – TOR1A common mutation
c.904-906delGAG
Tuberous Sclerosis – TSC1 + TSC2 sequencing
Uni Parental Disomy (UPD) – parents and child
Very Long-Chain Acyl-CoA Dehydrogenase Deficiency –
ACADVL sequencing
SAMPLE REQS
TAT
A 9,11
8 weeks
GENE
A 9
8 weeks
GENE
A A 9
6 weeks
GENE
A A 9
6 weeks
TBC
A 9
10 days
GENE
A 9
6 weeks
GENE
A 9
8 weeks
GENE
A 9
4 weeks
GENE
A A 9
6 weeks
GENE
PBOB,
KARY
PBOB
A 9
8 weeks
CVS/AF/A H 9
5-15 days
CVS/AF/A 9
5 days
GENE
A 9
4 weeks
GENE
A A 9
6 weeks
GENE
A 9
6 weeks
SMA
9
A 3 weeks
GENE
A 4 weeks
SRY
A 2 days
GENE
A 3 weeks
9
9
9
PROP
A A B
C C C18
5 days
GENE
A 9
6 weeks
GENE
Specify
type
A 9,11
6 weeks
A 9,12
5 days
GENE
A 9
6 weeks
87
TDL Genetics
TEST
CODE
SAMPLE REQS
Von Hippel-Lindau Syndrome
– VHL sequencing + deletions/duplications
GENE
A 9
8 weeks
Williams Syndrome – BOBs (5 days) + karyotype (15 days)
Williams Syndrome – BOBs only
88
PBOB,
KARY
PBOB
CVS/AF/A H 9
TAT
5-15 days
CVS/AF/A 9
5 days
A 9
4 weeks
CVS/AF/A H 9
5-15 days
CVS/AF/A 9
5 days
GENE
A 9
8 weeks
YDEL
A 9
5 days
Wilson Disease – ATP7B sequencing
Wolf-Hirschhorn Syndrome – BOBs (5 days) + karyotype
(15 days)
Wolf-Hirschhorn Syndrome – BOBs only
X-linked Hydrocephalus/MASA Syndrome
– L1-CAM sequencing
Y chromosome microdeletions
– AZFa + AZFb + AZFc + SRY
GENE
PBOB,
KARY
PBOB
Zygosity testing – comparative DNA profile
DNAC
A (From each twin and
both parents) 9
5 days
TDL Genetics
ARRAY CGH TESTING
Chromosome abnormalities can be associated with developmental delay, autism spectrum disorder, learning
difficulties, dysmorphic features and other congenital abnormalities.
Array CGH can detect smaller genetic changes than is possible by conventional karyotyping, and can provide
accurate information on the size and possible consequences of the gains (duplications) or losses (deletions)
identified. Multiple studies have shown that Array CGH, when applied to appropriate patients, will detect
up to three times more pathogenic chromosome imbalances than karyotyping due to its greater precision
and sensitivity.
Array CGH testing is now considered to be the front line test for patients presenting with developmental delay
(motor or growth), autism spectrum disorder, moderate to severe learning difficulties, dysmorphic features,
with or without congenital abnormalities. Consortiums in the USA and many EU countries have adopted Array
CGH as the front line test in this patient cohort.
Array CGH is now more frequently used for prenatal studies as an adjunct or replacement for conventional
cytogenetic studies, particularly where structural fetal abnormalities are seen at ultrasound scan but also at
a patient’s or doctor’s request. The technique may also be utilised as a follow up test to characterise anomalies
detected by a previous study (e.g. an apparently balanced de novo rearrangement or marker chromosome).
When to use Array CGH
In postnatal cases, patients should present with one or more of the following:
• Mental retardation
• Autism/autism spectrum disorder
• Developmental delay
• Dysmorphic features
• Congenital malformations
In prenatal cases, patients may present with:
• Abnormalities on ultrasound scan which may be associated with a chromosome imbalance.
• Approximately 10-20% of results identify extra or missing DNA which may or may not be relevant to the
clinical phenotype, and will require further family studies to assist with interpretation.
What can Array CGH detect?
Deletions and duplications with greater sensitivity than conventional karyotyping.
What does Array CGH not detect?
• Balanced chromosome rearrangements such as translocations or inversions.
• Low frequency mosaicism (<30% abnormal cells), some types of polyploidy like triploidy, Uniparental
disomy (UPD) and Fragile X syndrome, imprinting defects, genetic diseases caused by point mutations
or multifactorial inheritance.
Further information is provided by the UNIQUE website at www.rarechromo.org/html/home.asp
TEST
CODE
SAMPLE REQS
TAT
Postnatal array CGH
CGH
A H
10 days
9
Blood from both parents may also be provided in case of follow up studies at no extra charge.
Prenatal array CGH
CGH
Amniotic fluid or CVS 9
10 days
EDTA and heparin blood from both parents should be provided at the time of prenatal sampling in case of follow up
studies at no extra charge.
89
TDL Genetics
PAN-ETHNIC CARRIER SCREENING FOR COMMON DISEASES
The Recombine CarrierMapTM is the most comprehensive genetic carrier screen for people of all ethnic
backgrounds. It examines 2000+ mutations across 250+ diseases, including Cystic Fibrosis, Sickle Cell Disease,
Thalassemia, Spinal Muscular Atrophy and Fragile X Syndrome.
CarrierMapTM can also be filtered to report only on diseases common to the Jewish population – such as
Bloom Syndrome, Canavan Disease, Gaucher Syndrome, Niemann-Pick and Tay Sachs Disease.
Indications for use
• Pre-pregnancy screening for couples that wish to check if they are silent carriers for a disease that would
have serious implications for the future health of any children.
• For patients who are concerned about a family history of a particular disease, where the common mutation
detection rate is very high, such as Sickle Cell or Tay Sachs Disease
The report comes with an extensive synopsis of any diseases for which a mutation was found, including
prognosis, treatment and mode of inheritance. It includes an estimated risk assessment (based on reported
ethnicity & family history) and recommendations for further testing.
A full list of diseases covered by this test is available from the laboratory.
CarrierMap
Jane Smith
John Smith
Practice Code: 675
Miller MD
374 Broadway
New York, NY 10000
Physician: Dr. Frank Miller
Report Date: 1/16/2014
Patient: Jane Smith
Procedure ID: 204
Specimen: Saliva, #401
Partner: John Smith
DOB: 01/29/1974
Gender: Male
Ethnicity: European
Procedure ID: 203
Specimen: Saliva, #400
Barcode: 987654321
Results summary as
Specimen Collected: 1/11/2014
recommended by ACMG
Specimen Received: 1/13/2014
Practice
Guidelines
Specimen Analyzed:
1/16/2014
DOB: 02/19/1973
Gender: Female
Ethnicity: European
Barcode: 123456789
Specimen Collected: 1/11/2014
Specimen Received: 1/13/2014
Specimen Analyzed: 1/16/2014
Couple reports to assist
with results interpretation
SUMMARY OF RESULTS
Jane Smith
CarrierMap TM
Biotinidase Deficiency
Ordering Practice
HIGH REPRODUCTIVE RISK
Disease
Jane Smith
John Smith
Cystic Fibrosis
High Impact
Treatment Benefits
Carrier (1 abnormal copy)
Gene: CFTR
c.1521_1523delCTT (p.508delF)
Carrier (1 abnormal copy)
Gene: CFTR
c.G1558T (p.V520F)
Biotinidase deficiency is a treatable condition caused by the
deficiency of the vitamin biotin. In this disease, the BTD gene
responsible for extracting and recycling vitamin H (biotin) is
defective. Individuals with this condition exhibit signs and
symptoms within the first few months of life. Children with the
more severe form of thecondition often experience seizures,
weak muscle tone (hypotonia), breathing problems, and
delayed development. If left untreated, the disorder can lead
to hearing loss, loss of vision, problems with movement and
balance (ataxia), skin rashes, hair loss (alopecia), and a
fungal infection called candidiasis.
Status
John Smith: Carrier (1 abnormal copy)
p.Q456H (c.A1368C)
Jane Smith: No mutations detected.
Next Steps
~0.09% reproductive risk remaining.
Inheritance: Autosomal Recessive
To learn more visit: http://recombine.com/diseases/biotinidase-deficiency
25% reproductive risk. Genetic counseling is recommended.
Information on disease
impact & management
X-Linked diseases are
clearly marked
Next steps & implications
are clearly defined
Prognosis
Treatment
Prognosis is generally favorable. Immediate treatment
and lifelong management with biotin supplements can
prevent many of the complications. Once vision
problems, hearing loss, and developmental delay
occur, they are usually irreversible with biotin therapy.
Immediate treatment and lifelong management with
biotin supplements typically reverses and prevents
most symptoms of this condition. Other treatment for
this condition include routine assessment of vision and
hearing to ensure that a treated individual is not
symptomatic.
~ <1% Reproduction Risk Remaining.
Use this data to calculate residual reproductive risk
for your patients based on their ethnicities
~
Risk Assessment
Clinical Information
Physical Impairment
Cognitive Impairment
All other mutations analyzed by Recombine were not detected, reducing but not eliminating your chance to be a carrier for the associated genetic diseases.
A list of all the diseases and mutations you were screened for is included later in this report. Recombine does not screen for every possible genetic disease.
For disease information, please visit www.recombine.com/our-test. To speak with a Genetic Counselor, call 855.OUR.GENES .
Diseases Tested: F 213, M 191
High Impact
Treatment Lessens Symptoms
Mutations Tested: F 1668, M 1462
Genes Tested: F 201, M 180
Chip: V4
Shortened Lifespan
Effective Treatment
Panel: F CarrierMap, M CarrierMap
Lab Technician: Bob Jones
Example Calculation:
Reviewed by: Susan Jones, PhD, HCLD
Panel
clearlyRecombine
indicated
for this genetic assay using the Illumina Infinium Custom HD Genotyping Assay. The test is intended for clinical preconception and/or prenatal screening
*Methods
and Limitations:
developed
purposes
and ispartner
not validated for detection of homozygous mutations. False positive or negative results may occur for reasons that include: genetic variants, assay limitations, sample mix-up, sample
each
contamination, and molecular and technical errors. Recombine tests for Spinal Muscular Atrophy via an Identity-by-State shared haplotype comparison algorithm. Detection is limited to haplotypes within
our library of known carriers of the most common mutation (deletion of Exon 7).
Copyright 2014 Recombine, LLC
•
•
•
1/277
Residual risk
for negative
partner by
ethnicity
×
Ethnicity
Detection
rate
Pre-test
carrier risk
General
55.6%
1/123
1/2
Chance non-carrier
partner could pass
unknown mutation
×
1/2
Chance carrier
partner could pass
known mutation
855.OUR.GENES | www.recombine.com | [email protected]
=
Post-test
carrier risk
1/277
1/1108
Residual
Reproductive
Risk Version: 4.0
Limitations
This test only examines very specific common diseases and mutations (a full list is available from the laboratory,
along with estimated ethnic detection rates). A normal result does not rule out the possibility that the patient
carries a rare mutation not detectible by this particular assay.
For this reason, this test is also not appropriate to use as a direct prenatal screen (both parents must be
confirmed carriers for a particular disease before we can offer prenatal diagnosis).
90
TEST
CODE
Pan-Ethnic Carrier Screen
Jewish Panel Carrier Screen
SAMPLE REQS
TAT
GENE
9,11
A 10 days
GENE
A 9,11
10 days
TDL Genetics
NON-INVASIVE PRENATAL TESTING (NIPT)
Non-invasive prenatal testing (NIPT analyses cell-free
DNA circulating in the pregnant mother’s blood. It is a
new option in prenatal screening for Down syndrome
(trisomy 21) and other common chromosomal
conditions (trisomies 18 and 13), X and Y chromosome
conditions. This test can be requested for any
singleton pregnancy, including in vitro fertilization
(IVF) pregnancies with egg donors. It can now also be
requested for ALL twin pregnancies (without X or Y)
conceived naturally or by IVF using the patient’s own
egg or a donor egg.
About the Ariosa HarmonyTM Prenatal Test
DNA from the fetus circulates in the mother’s blood.
Cell-free DNA (cfDNA) results from the natural
breakdown of fetal cells (presumed to be mostly
placental) and clears from the maternal system
within hours of giving birth.
During a pregnancy, cfDNA can be tested to give the
most accurate screening approach in estimating the
risk of a fetus having a common chromosome condition
sometimes called a trisomy. This occurs when there
are three copies of a particular chromosome instead
of the expected two. The test looks to detect the
following trisomies:
• Trisomy 21 is the most common trisomy at the
time of birth. Also called Down syndrome, it is
associated with moderate to severe intellectual
disabilities and may also lead to digestive disease,
congenital heart defects and other malformations.
• Trisomy 18 (Edwards syndrome) and Trisomy 13
(Patau syndrome) are associated with a high rate
of miscarriage. These babies are born with severe
brain abnormalities and often have congenital heart
defects as well as other birth defects. Most affected
individuals die before or soon after birth, and very
few survive beyond the first year of life.
• Sex chromosome conditions. The sex
chromosomes (X and Y) determine whether we are
male or female. X and Y chromosome conditions
occur when there is a missing, extra, or incomplete
copy of one of the sex chromosomes. The Harmony
with X, Y test can assess risk for XXX, XYY,
XXYY, XXY (Klinefelter syndrome), and a missing
X chromosome in a girl (Turner syndrome). There
is significant variability in the severity of these
conditions, but most individuals have mild, if any,
physical or behavioural features. If the mother is
interested in having this optional testing, she should
talk with her healthcare provider to determine if it
is right for her. This option is not available for twin
pregnancies.
Risk
The testing is non-invasive: it involves taking a blood
sample from the mother. The pregnancy is not put at
risk of miscarriage, or from other adverse outcomes
that are associated with invasive testing procedures
such as amniocentesis.
Accuracy
Clinical studies have shown that the Ariosa HarmonyTM
Prenatal Test has exceptional accuracy for assessing
fetal trisomy risk.
A ‘high risk’ result is indicative of a high risk for a
trisomy. The test identifies in singleton pregnancies
more than 99% of fetuses with trisomy 21, 98% of
fetuses with trisomy 18, and 80% of fetuses with
trisomy 13, and 96% of fetuses with Turner Syndrome.
X and Y analysis provides >99% accuracy for fetal
sex. Accuracy for detecting other sex chromosome
anomalies varies by condition.
After the test, the number of women required to have
a CVS or an amniocentesis is less than 1%.
It is important to note that if the test results show there
is a high risk that the fetus has trisomy 21, 18, 13 or
sex chromosome conditions, it does not mean that the
fetus definitely has one of these conditions, although it
is highly likely. For this reason, in the event of a ‘high
risk’ (or positive) result, follow-up testing by an invasive
procedure is recommended.
In the same way if the test results show that there is a
‘low risk’ that the fetus has trisomy 21, 18, 13 or sex
chromosome conditions, it is unlikely that the fetus has
one of these conditions. However, there is a very small
risk that not all trisomy fetuses will be detected.
All results should be interpreted by a clinician in the
context of clinical and familial data. Patients should
continue with their usual scan appointments following
testing.
91
TDL Genetics
Who can have the test?
Who carries out the analysis of the test?
The Ariosa Harmony Prenatal Test can be ordered by
healthcare professionals for women with pregnancies
of at least 10 weeks’ gestational age. The HarmonyTM
Prenatal Test can now be ordered for all IVF singleton
pregnancies, including those with egg donors.
Samples from pregnant women with twins naturally
conceived, or those conceived using the patient’s own
egg, are also accepted. This test does not assess risk
for mosaicism, partial trisomies or translocations.
Her sample and completed request form need to be
sent to TDL Genetics, after which they will be referred
to Ariosa Diagnostics Inc, USA. Ariosa performs the
HarmonyTM Prenatal Test on the DNA extracted from
her blood sample.
Repeat samples
Transfer of the mother’s information outside
the European Union
TM
Will the mother need to have any other tests?
The Ariosa HarmonyTM Prenatal Test does not provide
information on other rare chromosomal abnormalities.
The results will be ready in approximately two weeks, If the ultrasound scan shows a high nuchal
translucency or other major physical defects such
at which time most women can have their 12-week
as brain abnormalities, heart abnormalities, the risk
scan for a detailed examination of the fetal anatomy,
including measurement of nuchal translucency, nasal for some rare chromosomal defects may be high.
bone and other important factors. In this visit, patients In such cases, the mother may choose to have a CVS
or an amniocentesis.
can discuss the DNA and ultrasound results with
their obstetricians.
The non-invasive prenatal test does not provide
information on other physical defects such as spina
On the basis of the NIPT result and the ultrasound
bifida, or information on fetal growth. It is therefore
findings, a patient can decide whether or not she
advisable that the mother has all the usual ultrasound
wants to have an invasive procedure (for example,
scans during her pregnancy.
CVS or amniocentesis).
There needs to be enough fetal DNA in the maternal
blood to be able to provide a result. If there is
insufficient fetal DNA in the sample (occurring in 3%
of cases), another blood sample from the mother may
be required. This will be processed in the laboratory
at no extra charge.
What is the process?
For the purposes of carrying out the Ariosa HarmonyTM
Prenatal Test, the mother’s personal information
will be transferred outside of the European Union,
to the USA. Please be aware that the laws applicable
to her personal data in the USA are different from
those operating in the UK, where TDL Genetics is
established.
Once the mother has taken an independent personal
decision that she wants to have the non-invasive
prenatal test performed, she will be asked to sign a
consent form and her blood sample can be taken from
a vein in her arm.
92
TEST
CODE
SAMPLE REQS
TAT
Non-Invasive Prenatal Testing –
common aneuploidy screening
from maternal blood
NIPT
Two 10ml tubes of maternal blood –
special tubes provided by the laboratory
up to
10 days
TDL Genetics
MALE GENETIC
REPRODUCTIVE PROFILE
PAN-ETHNIC CARRIER SCREEN
Chromosome Analysis
Y-Chromosome Microdeletions
Cystic Fibrosis Carrier Screen
(139 common mutations)
PolyT (5T,7T,9T) if clinically
indicated
2000+ Common Mutations
across 250+ Diseases*
includes 20+ X-linked Diseases
and 60+ Jewish Panel Diseases
TAT
TAT
15
10
DAYS
DAYS
GENE
GRP
THROMBOTIC RISK PROFILE
FBC
Coagulation Profile
Antithrombin III
MTHFR gene
Fibrinogen
Lupus Anticoagulant
Protein C
Free Protein S Ag
Anticardiolipin Abs
10-15
JEWISH CARRIER SCREEN
DAYS
60+ Jewish Panel Diseases*
RMP
uses the same technology as the
Pan-Ethnic Carrier Screen, but
filters results to only report on
mutations commonly seen in
the Jewish Population
TAT
10
DAYS
TAT
5
PROP
A A B C C C H 9,18
PRENATAL DIAGNOSIS
(BOBS + CULTURE)
Rapid Aneuploidy Diagnosis for
All Chromosomes + Common
Microdeletion Syndromes
by BOBs Analysis
TAT
3-5
GENE
DAYS
DAYS
Chromosome Analysis
(Karyotype)
A 9,11
* Disease list available from
the Laboratory
A A B C C C 18
PRE-TRAVEL (DVT) SCREEN
FBC
Anticardiolipin Antibodies
Factor II Prothrombin Mutation
(G20210A)
Factor V Leiden Mutation
(G1691A)
TAT
15
DAYS
ABK or CBK
AF / CVS 9
IRON OVERLOAD PROFILE
PRODUCTS OF CONCEPTION
(BOBS + CULTURE)
Iron
Total Iron Binding Capacity
Ferritin
Haemochromatosis
C282Y, H63D
Rapid Aneuploidy Diagnosis for
all Chromosomes
TAT
by BOBs Analysis
3-5
DAYS
TAT
TAT
DAYS
DAYS
5
3
Chromosome Analysis
(Karyotype)
IOP
DVT1
A A B 9
FBC
Coagulation Profile
Antithrombin III
MTHFR gene
Fibrinogen
Lupus Anticoagulant
Protein C
Protein S
Anticardiolipin Abs
Chromosome Analysis
Please request Partner’s Chromosome
Analysis using a separate
request form.
TAT
A 9,11
A H 9
RECURRENT MISCARRIAGE
PROFILE (FEMALE)
A A B 9
TAT
25
DAYS
PBK
Placental sample1,9
93
94
In-vivo tests
These tests, ideally, must be carried out by appointment. Please telephone 020 7307 7383 for details, information for patient preparation, and appointment times. Sample taking fees for Extended tests are charged at per visit.
TEST
CODE
ECG
Glucose Tolerance (2 hrs)
Glucose Tolerance + Insulin
Glucose Tolerance Test
Glucose Tolerance Test (Short)
Glucose Tolerance Test (Extended)
Lactose Tolerance Test
Renin
Synacthen Stimulation Test
ECG
GTTS
GTTI
GTT
GTT3
GTTE
HBQT
LTT
RENI
SYNA
SAMPLE REQS
TAT
X
G G 2x RU
X
G G G G G 5x RU(X)
G G G 3x RU(X)
G G G G G G 6x RU(X)
J (Blowbag kit) 1
J 1
X
2 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
2 days
8 hrs
5 days
4 hrs
ANTIBIOTIC ASSAYS
TEST
CODE
Amikacin Level (State dose)
Gentamicin Assay
Metronidazole Level
Teicoplanin Assay
Tobramycin Assay (Provide Clinical Details)
Vancomycin Hydrochloride
AMIK
GENT
METR
TEIC
TOBR
VANC
SAMPLE REQS
TAT
B B 4
B 4
B
B
B
4 hrs
4 hrs
7 days
5 days
3 days
4 hrs
4
Therapeutic drug assays
There are three different collection times for Therapeutic Drug Monitoring:
TROUGH LEVEL
Blood should be collected just before the next dose. Trough Levels check that the appropriate drug concentration is being maintained.
PEAK LEVELS
Sample collection time is dependent on specific drug type and method of administration. Peak levels check that the drug level is not in the toxic range.
SUSPECTED TOXICITY
Blood can be collected any time.
All collections should have the following noted on the request form:
• Dosage schedule including the amount and frequency and time of the last dose
• Time of specimen collection
• Clinical status of patient (e.g. routine, suspected toxicity)
• Name(s) of other drugs being taken by the patient
95
Therapeutic drug assays
THERAPEUTIC DRUG ASSAYS
96
TEST
CODE
Amitriptyline
Anafranil (Clomipramine)
Carbamazepine (Tegretol)
Clobazam
Clomipramine (Anafranil)
Clonazepam
Diazepam (Valium)
Digoxin
Epanutin (Phenytoin)
Erythropoietin
Ethosuximide
FK506 (Tacrolimus/Prograf)
Flecainide (Tambocor)
Fluoxetine (Prozac)
Gabapentin
Imipramine
Lamotrigine
Levetiracetam (Keppra)
Lorazepam
Methotrexate
Mysoline (Primidone)
Olanzapine
Paracetamol
Phenobarbitone
Phenytoin (Epanutin)
Primidone (Mysoline)
Propanalol
Risperidone
Sinequan (Doxepin)
Sirolimus
Streptomycin Levels
Sulpiride
Tacrolimus/Prograf (FK506)
Tegretol (Carbamazepine)
Temazepam
Theophylline
Topiramate (Topamax)
Trimipramine
Valium (Diazepam)
Valproic Acid (Epilim)
Vigabatrin (Sabril)
AMTR
CHLO
CARB
CLOB
CHLO
CLON
DIAZ
DIGO
PHEN
ERY
ETHO
FK5
FLEC
PROZ
GABA
IMIP
LAMO
LEVE
LITH
LORA
METX
PRIM
OLAN
PARA
PHB
PHEN
PRIM
PRO
RISP
DOXE
SIRO
STRM
SULP
FK5
CARB
TEMA
THEO
TOPI
TRIM
DIAZ
VALP
VIGA
SAMPLE REQS
A A
B
A
A
A
A
B
B
B
A
A 4
A
A 4
B 4
A 4
B 4
B 4
B
A 4
B
B 4
A 4
B
B
B
B 4
B 4
A 4
A
A
F
B 4
A 4
B
B 4
B
B 4
A
A
B
A
4
TAT
5 days
7 days
4 hrs
5 days
7 days
7 days
7 days
4 hrs
4 hrs
4 days
7 days
1-2 days
5 days
5 days
5 days
4 days
5 days
3 days
4 hrs
10 days
2 days
3 days
5 days
4 hrs
4 hrs
4 hrs
3 days
7 days
7 days
10 days
3 days
5 days
4 days
1-2 days
4 hrs
4 days
4 hrs
4 days
5 days
7 days
4 hrs
10 days
Vitamins, Nutrition and Lifestyle
Life Length/Testing for Telomeres
Measuring critically short telomeres and comparing biological age vs chronological age can encourage patients
to take healthier decisions that can improve their day to day lives as well as their life-span allowing them to
modify habits that accelerate aging and take nutritional/neutraceutical supplements when appropriate under
clinical supervision.
TELOMERE ANALYSIS TECHNOLOGY (LIFE LENGTH)
www.lifelength.com
3 x Lith Heparin
Completion of Online anonymous questionnaire required
Sample Preparation for The Spanish National Cancer Research Centre, Madrid
TAT
4
Contact the laboratory for details
WEEKS
TSPA
H H H
VITAMIN B PROFILE
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B6
Vitamin B9 (red cell)
MINERAL SCREEN
VITAMIN PROFILE 1
TAT
5
DAYS
Vitamin A
Beta Carotene
Vitamin B1
Vitamin B2
Vitamin B6
Vitamin C
Vitamin E
TAT
5
DAYS
VITS
VBP
A B B A A B VITAMIN PROFILE 2
TAT
FBC/ESR
5
DAYS
Omega 3/Omega 6
Total Antioxidant Status
Ferritin
C-Reactive Protein
HDL/LDL
Mineral Screen
Vitamin B9 (Red Cell Folate)
Vitamin A
Beta Carotene
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B6
Vitamin B9 (Red Cell Folate)
Vitamin C
TAT
Vitamin D (25-OH)
5
Vitamin E
A A A B B B B
G K 4
5
DAYS
MINE
MINERAL SCREEN
– WHOLE BLOOD
SPORTS/PERFORMANCE PROFILE
Red Cell Potassium
Red Cell Magnesium
Red Cell Calcium
Red Cell Manganese
Red Cell Zinc
Red Cell Copper
Red Cell Selenium
Red Cell Chromium
TAT
5
DAYS
SPOR
TAT
B K 7,13
13
Calcium
Magnesium
Zinc
Iron
Copper
Chromium
Manganese
DAYS
VIT2
A A A B B 7,13
RMIN
H H Patients taking supplements may be advised to stop medication prior to testing.
97
Vitamins, Nutrition and Lifestyle
TEST
CODE
SAMPLE REQS
TAT
Antioxidant Status (total/activity)
Ceruloplasmin
Copper (Serum)
Essential Fatty Acid Profile (Red Cell)
Folate (Red Cell)
FRAD
CERU
COPP
EFAR
RBCF
B
B
B
A A 4
A
7 days
1 day
5 days
5-7 days
2 days
Hair Mineral Analysis
HMA
2g (2 tbsp) of hair close to scalp 10 days
Magnesium (Blood)
Mineral Screen
Mineral Screen – Whole blood
Mineral Screen and Rbc Industrial
Heavy Metal Screen (Trace Metals)
Omega 3/Omega 6 (see page 99)
Selenium (Blood)
Selenium (Serum)
Sports/Performance Profile
Zinc (Blood)
Zinc (Serum/Plasma)
RCMG
MINE
RMIN
A or H
B K
H H 4 days
5 days
5 days
TRAC
B H K
7-10 days
OMG3
SELR
SELE
SPOR
RBCZ
ZINC
A 4
A or H
B
A A A B B B B G K 4
A or H
K
5-7 days
4 days
4 days
5 days
5 days
1 day
Zinc (Urine)
URZN
CU
5 days
This provides valuable diagnostic information, which can be assimilated with other diagnostic markers in the
assessment of nutritional status, and compares favourably to semi-quantitative functional assays. For fertility
and lifestyle refer to page 36.
98
TEST
CODE
1,25 Vitamin D
Vitamin A (Retinol)
Vitamin B Profile
Vitamin B1 (Thiamine)
Vitamin B2 (Riboflavin)
Vitamin B3 (Nicotinamide)
Vitamin B6 (Pyridoxine)
Vitamin B9 (Folic acid) – Red cell
Vitamin B9 (Folic acid) – Serum
Vitamin C (Active)
Vitamin D (1, 25 Dihydroxy)
Vitamin D (25-OH)
Vitamin E (Alpha Tocopherol)
Vitamin Profile 1
Vitamin Profile 2
D3
VITA
VBP
VIT1
VIB2
VIB3
VITB
RBCF
FOLA
B12
B12F
VITC
D3
VITD
VITE
VITS
VIT2
SAMPLE REQS
B (Frozen)
B
A A B 13
A 13
A 13
B A 13
A
B
B
A B
B (Frozen) 7
B (Frozen) B
B A B B 7,13
A A A B B 7,13
TAT
5-8 days
5 days
5 days
5 days
5 days
5 days
5 days
2 days
1 day
1 day
2 days
5 days
5-8 days
4 hrs
5 days
5 days
5 days
Omega3/6
Essential Red Cell Fatty Acids Omega-3/Omega-6
Omega-3 is the name given to a family of polyunsaturated fatty acids, which the body needs but cannot
manufacture itself. Omega-3 fats are used as the building blocks for fat derived hormones such as
prostaglandins and leukotrienes. The hormones with an Omega-3 base tend to reduce inflammation,
while those that have an Omega-6 base increase inflammation. In the cell membrane the competition
between these two essential fats has a direct bearing on the type of local hormone produced and the
level of inflammation in the cell.
The Omega-6 to Omega-3 ratio in the cell membranes is key to the development of inflammatory
disorders such as rheumatoid arthritis and heart disease. Diets low in oily fish and high in grains will
promote inflammation and affect good health. The ratio of Omega-6 to Omega-3 in the West is around
15 to 1, fifteen times more Omega-6 on the cell membrane promoting inflammation. Having twice as
much Omega-6 is considered by most experts to be the optimal amount but a ratio of 2:1 is not easy to
produce by diet alone. Many people are aware of the health benefits of Omega-3 but the supplementation
to achieve optimal health is erratic. Being able to test for Essential Red Cell Fatty Acids (Omega-6/
Omega-3 ratio) identifies a person’s current status and is sufficiently specific to allow an accurate
supplementation recommendation to be made.
Results show the Omega Ratio with a clear recommendation for the required level of Omega Supplementation (if any) to achieve optimal levels.
TEST
CODE
Omega 3/Omega 6
OMG3
SAMPLE REQS
TAT
A 4
4 days
Results show the ratio of Omega 3 to Omega 6, against an optimal ratio and provide a supplementation recommendation
to achieve this optimal ratio.
99
Allergy
Allergy, Asthma and Autoimmune diseases are increasing around the world, especially in industrialized
countries and affect all ages. Since every country has their own dietary habits there are noteworthy
differences in the allergens causing food allergy.
UK PROFILE
MEDITERRANEAN PROFILE
Total IgE with individual IgE
allergens for:
allergens for:
allergens for:
Food Mix inc.
Cod, Cows Milk, Egg White,
Soya Bean, Peanut, Wheat
A. alternata
Cat Epithelium and Dander
Cows Milk
Egg White
House Dust Mite
(Dermatophagoides
pteronyssinus and
Dermatophagoides farinae)
Olive
Peanut
Rye-grass
Timothy Grass
Food Mix inc.
Cod, Cows Milk, Egg White,
Soya Bean, Peanut, Wheat
Grass Mix inc.
Cocksfoot, Meadow, Meadow
Fescue, Rye, Timothy
Cat Dander
Cladosporum Herbarum
Dog Dander
House Dust Mite
Latex
Fish: Cod
B
100
MIDDLE EAST PROFILE
Fish: Cod
Dust Mix inc.
House Dust Mite,
Dermatophagoides
pteronyssinus,
Dermatophagoides farinae,
Blatella germanica
TAT
TAT
TAT
DAYS
DAYS
DAYS
ALUK
ALMD
ALME
2
2
B
2
B
Allergy
TEST
CODE
SAMPLE REQS
TAT
Allergy – Individual Allergens See list on page 105
Total IgE
ALLE
IGE
B
B
2 days
1 day
Allergy Profile (UK)
Allergy Profile (Mediterranean)
Allergy Profile (Middle East)
ALUK
ALMD
ALME
B
B
B
2 days
2 days
2 days
Allergy Profile 1 (Food & Inhalants)
Allergy Profile 2 (Inhalants)
Allergy Profile 3 (Food)
Allergy Profile 4 (Nuts & Seeds)
Allergy Profile 5 (Children’s Panel)
Allergy Profile 6 (Shellfish)
Allergy Profile 7 (Finfish)
Allergy Profile 8 (Cereal – singles)
Allergy Profile 9 (Antibiotics)
Allergy Profile 10 (Insects)
Allergy Profile 11 (Combined Shellfish/Finfish)
Allergy Profile 12 (Milk & Milk Proteins)
Allergy Profile 13 (Stone fruit/Rosaceae family)
1A
2A
3A
4A
5A
6A
7A
8A
9A
10A
11A
12A
13A
BB
B
B
B
B
B
B
B
B
B
B
B
B
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
Eczema Provoking Profile
Rhinitis Provoking Profile
ALEC
ALRN
B
B
2 days
2 days
Allergen Component Profiles See page 104
ISAC Panel
CURT
ISAC
B
B
10-14 days
3 days
ECZEMA
PROVOKING PROFILE
(9 Allergens)
Total IgE with
individual
IgE allergens for:
Cat Dander
Egg White
Egg Yolk
Fish Mix
Hazelnut
House Dust
B
RHINITIS PROVOKING PROFILE
(10 Allergens)
Total IgE with
Mite
Milk
Peanut
Soya Bean
Wheat
individual
IgE allergens for:
TAT
Birch
Cat Dander
Dog Dander
Egg White
Egg Yolk
House Dust
Mite
Milk
Nettle
Peanut
Timothy Grass
IMMUNOCAP ISAC PANEL
Simultaneous measurement in a
single test of specific antibodies to
more than one hundred allergen
components from more than 50
preselected allergen sources.
TAT
TAT
DAYS
DAYS
DAYS
ALEC
ALRN
ISAC
2
2
B
3
B
101
Allergy
IgE ALLERGY PROFILE 1
(Food and inhalants)
(Food)
Total IgE with individual IgE Tree Mix, inc.
allergens for:
Box Elder
Common Silverbirch
Grass Mix, inc.
Hazel
Cocksfoot
Oak
Meadow Fescue
London Plane
Meadow
Maple
Rye
Sycamore
Timothy
Total IgE with individual
IgE allergens for:
Codfish
Cows Milk
Egg White
Egg Yolk
Single Allergens (19)
Beef
Bermuda Grass
Cat Dander
Clam
Dust Mix, inc.
Common Silver Birch
Blatella germanica
Cows Milk
Dermatophagoides
Crab
pteronyssinus
Dog Dander
Dermatophagoides Egg White
farinae
Egg Yolk
Hollister-Stier Labs
Fish (Cod)
Mould Mix, inc.
Hazel Nut
A. alternata
Horse Dander
Aspergillus fumigatus
Latex
Candida albicans
Nettle
Cladosporum herbarum
Peanut
Helminthosporium Shrimp/Prawn
halodes
Soya Bean
TAT
Penicillium notatum
Wheat
Weed Mix, inc.
Common Ragweed
Giant Ragweed
Western Ragweed
2
Kiwi
Peanut
Sesame
Soya
Wheat
TAT
2
DAYS
3A
B
(Nuts and Seeds)
Total IgE with individual IgE Pecan
allergens for:
Pine Nut
Pistachio
Almond
Poppy Seed
Brazil Nut
Pumpkin Seed
Cashew
Sesame Seed
Hazel Nut
Sunflower Seed
Macadamia Nut
Walnut
Peanut
TAT
2
DAYS
4A
B
DAYS
(Children’s Panel)
1A
B B
Total IgE with individual IgE Mite, Pteronyssinus
allergens for:
Peanut
Soya Bean
Cat Dander
Timothy Grass
Cows Milk
Wheat Flour
Egg White
(Inhalants)
Total IgE with individual
IgE allergens for:
Alternaria
Aspergillus
Birch Pollen
Cat Dander
Cladosporum
Common Ragweed
Derma farinae
Dog Dander
House Dust Mite
Horse Dander
Timothy Grass
Egg Yolk
2
DAYS
5A
TAT
B
2
DAYS
2A
B
102
TAT
Allergy
(Insects)
(Shellfish)
Total IgE with individual IgE Lobster
allergens for:
Octopus
Prawns/Shrimp
Clam
Scallop
Crab
Squid
Crawfish/Crayfish
TAT
2
DAYS
Total IgE with individual IgE Paper Wasp
Yellow Hornet
allergens for:
White Faced Hornet
Common Wasp,
Yellow Jacket
Bee
6A
B
B
Total IgE with individual IgE Sardine/Pilchard
Salmon
allergens for:
Sole
Codfish
Swordfish
Mackerel
Tuna
Plaice
(Combined Shellfish/Finfish)
TAT
2
Total IgE with individual IgE Salmon
Scallop
allergens for:
Squid
Cod
Tuna
Prawn/Shrimp
DAYS
7A
B
allergens for:
Barley
Oat
Rye
Wheat
TAT
2
DAYS
11A
B
(Milk & Milk Proteins)
(Cereal – singles)
TAT
2
DAYS
Total IgE with individual IgE Cow’s Milk
Goat’s Milk
allergens for:
Mare’s Milk
Alpha-lactalbumin –
Sheep’s Milk
milk proteins
Whey (cow and ewe)
Beta-lactoglobulin –
milk proteins
Casein – milk proteins
8A
B
TAT
2
DAYS
12A
B
(Stone Fruit, Rosaceae family)
(Antibiotics)
Total IgE with individual IgE Pen G
Pen V
allergens for:
TAT
2
DAYS
Total IgE with individual IgE Cherry
Peach
allergens for:
Pear
Almond
Plum
Apple
TAT
Raspberry
Apricot
Strawberry
DAYS
2
9A
B
2
DAYS
10A
(Finfish)
Ampicillin
Amoxicillin
Cefaclor
TAT
13A
B
103
Allergy
SPECIALIST ALLERGY TESTING
ImmunoCAP Allergen Components, highly refined specific allergy testing, employs carefully selected
components and recombinant engineered allergens. Using ImmunoCAP Allergen Components can help refine
the understanding of sensitization, by assessing a person’s sensitization pattern at the molecular level.
When used in conjunction with traditional extract-based IgE testing, ImmunoCAP Allergen Components
provide information at the individual component level.
For more information, please contact the Immunology Department on 020 7025 7917.
104
TEST
CODE*
SAMPLE REQS
TAT
Alternaria Components
Apple Components
Aspergillus Components
Birch Components
Brazil Components
Cashew Components
Cat Components
Celery Components
Cow’s Milk Components
Dog Components
Egg Components
Fish Components
Hazelnut Components
House Dust Mite Components
Kiwi Components
Latex Components
Olive Components
Peach Components
Peanut Components
Shrimp Components
Soybean Components
Timothy Grass Components
Venom Components
Wall Pellitory Components
Walnut Components
Wheat Components
ZZ1
ZZ36
ZZ2
ZZ3
ZZ4
ZZ35
ZZ5
ZZ6
ZZ7
ZZ8
ZZ9
ZZ10
ZZ11
ZZ12
ZZ32
ZZ13
ZZ14
ZZ15
ZZ16
ZZ17
ZZ18
ZZ19
ZZ33
ZZ20
ZZ34
ZZ21
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
PR-10 Proteins
Lipid Transfer Proteins
Profilins
Polcalcins
Seed Storage Proteins
Glycan Determinants
Lipocalins
Parvalbumins
Serum Albumins
Tropomyosins
ZZ22
ZZ23
ZZ24
ZZ25
ZZ26
ZZ27
ZZ28
ZZ29
ZZ30
ZZ31
B
B
B
B
B
B
B
B
B
B
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
3 days
* Please quote the ZZ Code when requesting Allergen Component Profiles.
Allergy
Allergens, when requested individually are priced as single tests, sample 1 x B
(up to 5 allergens).
Protein allergens are manufactured by Thermofisher (Phadia) and are IgE specific.
GRASS POLLENS
Bahia grass g17
Barley g201
Bermuda grass g2
Brome grass g11
Canary grass g71
Cocksfoot g3
Common reed g7
Cultivated oat g14
Cultivated rye g12
Cultivated wheat g15
False oat-grass g204
Johnson grass g10
Maize, Corn g202
Meadow fescue g4
Meadow foxtail g16
Meadow grass,
Kentucky blue g8
Redtop, Bentgrass g9
Rye-grass g5
Salt grass g203
Sweet vernal grass g1
Timothy grass g6
Velvet grass g13
Wild rye grass g70
WEED POLLENS
Alfalfa w45
Camomile w206
Careless weed w82
Cocklebur w13
Common pigweed w14
Common ragweed w1
Dandelion w8
Dog fennel w46
False ragweed w4
Firebush (Kochia) w17
Giant ragweed w3
Goldenrod w12
Goosefoot,
Lamb’s quarters w10
Japanese Hop w22
Lupin w207
Marguerite, Ox-eye daisy w7
Mugwort w6
Nettle w20
Plantain (English), Ribwort w9
Rape w203
Rough marshelder w16
Saltwort (prickly),
Russian thistle w11
Scale, Lenscale w15
Sheep sorrel w18
Sugar-beet w210
Sunflower w204
Wall pellitory w19
Wall pellitory w21
Western ragweed w2
Wormwood w5
Yellow dock w23
TREE POLLENS
Acacia t19
American beech t5
Australian pine t73
Bald cypress t37
Bayberry t56
Box-elder t1
Cedar t212
Cedar elm t45
Chestnut t206
Common silver birch t3
Cottonwood t14
Cypress t222
Date t214
Douglas fir t207
Elder t205
Elm t8
Eucalyptus, Gum-tree t18
European ash t25
Grey alder t2
Hackberry t44
Hazel t4
Horn beam t209
Horse chestnut t203
Italian/Mediterranean/
Funeral cypress t23
Japanese cedar t17
Linden t208
Maple leaf sycamore,
London plane t11
Melaleuca, Cajeput-tree t21
Mesquite t20
Mountain juniper t6
Mulberry t70
Oak t7
Oil Palm t223
Olive t9
Paloverde t219
Pecan, Hickory t22
Peppertree t217
Pine t213
Privet t210
Queen palm t72
Red cedar t57
Red mulberry t71
Russian olive t54
Scotch broom t55
Spruce t201
Sweet gum t211
Walnut t10
White ash t15
White hickory t41
White pine t16
Willow t12
Virginia live oak t218
MICROORGANISMS
Acremonium kiliense m202
Alternaria alternata m6
Aspergillus flavus m228
Aspergillus fumigatus m3
Aspergillus niger m207
Aspergillus terreus m36
Aureobasidium pullulans m12
Botrytis cinerea m7
Candida albicans m5
Chaetomium globosum m208
Cladosporium herbarum m2
Curvularia lunata m16
Epicoccum purpurascens m14
Fusarium proliferatum
(F. moniliforme) m9
105
Allergy
Setomelanomma rostrata
(Helminthosporium halodes) m8
Malassezia spp. m227
Mucor racemosus m4
Penicillium chrysogenum
(P. notatum) m1
Penicillium glabrum m209
Phoma betae m13
Pityrosporum orbiculare
(syn. Malassezia) m70
Rhizopus nigricans m11
Staphylococcal enterotoxin A m80
Staphylococcal enterotoxin B m81
Staphylococcal enterotoxin C
m223
Staphylococcal enterotoxin TSST
m226
Stemphylium herbarum
(S. botryosum) m10
Tilletia tritici m201
Trichoderma viride m15
Trichophyton mentagrophytes var.
goetzii m210
Trichophyton mentagrophytes var.
interdigitale m211
Trichophyton rubrum m205
Trichosporon pullulans m203
Ulocladium chartarum m204
EPIDERMALS AND
ANIMAL PROTEINS
Budgerigar droppings e77
Budgerigar feathers e78
Camel dander u328
Canary bird droppings e200
Canary bird feathers e201
Cat dander e1
Chicken droppings e218
Chicken feathers e85
Chicken, serum proteins e219
Chinchilla epithelium e208
Cow dander e4
Deer epithelium e216
Dog dander e5
Duck feathers e86
Ferret epithelium e217
Finch feathers e214
Fox epithelium e210
Gerbil epithelium e209
Goat epithelium e80
106
Goose feathers e70
Guinea pig epithelium e6
Hamster epithelium e84
Horse dander e3
Horse, serum proteins e205
Mink epithelium e203
Mouse epithelium e71
Mouse epithelium,
serum proteins and urine
proteins e88
Mouse serum proteins e76
Mouse urine proteins e72
Parakeet droppings e197
Parakeet feathers e196
Parakeet serum e198
Parrot feathers e213
Pigeon droppings e7
Pigeon feathers e215
Rabbit epithelium e82
Rabbit, serum proteins e206
Rabbit, urine proteins e211
Rat epithelium e73
Rat epithelium, serum proteins
and urine proteins e87
Rat serum proteins e75
Rat urine proteins e74
Reindeer epithelium e202
Sheep epithelium e81
Swine epithelium e83
Turkey feathers e89
MITES
Acarus siro (Storage mite) d70
Blomia tropicalis
(House dust mite) d201
Dermatophagoides farinae
Dermatophagoides microceras
Dermatophagoides pteronyssinus
Euroglyphus maynei
Glycyphagus domesticus
(Storage mite) d73
Lepidoglyphus destructor
(Storage mite) d71
Tyrophagus putrescentiae
(Storage mite) d72
ALLERGEN COMPONENTS
nDer p 1 House dust mite d202
rDer p 2 House dust mite d203
rDer p 10 Tropomyosin,
House dust mite d205
HOUSE DUST
Greer Labs., Inc. h1
Hollister-Stier Labs. h2
INSECTS
Berlin beetle i76
Blood worm i73
Cockroach, American i206
Cockroach, German i6
Cockroach, Oriental i207
Fire ant i70
Grain weevil i202
Green nimitti i72
Horse fly i204
Mediterranean flour moth i203
Mosquito i71
Moth i8
VENOMS
Bumblebee i205
Common wasp (Yellow jacket i3
European Paper Wasp i77
European hornet i75
Honey bee i1
Paper wasp i4
White-faced hornet i2
Yellow hornet i5
DRUGS
Amoxicilloyl c6
Ampicilloyl c5
Cefaclor c7
Chlorhexidine c8
Chymopapain c209
Gelatin bovine c74
Insulin bovine c71
Insulin human c73
Insulin porcine c70
Penicilloyl G c1
Penicilloyl V c2
Pholcodine c261
Morphine c260
Suxamethonium
(succinylcholine) c202
Allergy
OCCUPATIONAL
Abachi wood dust k212
Bougainvillea k214
Castor bean k71
Chloramin T k85
Cotton seed k83
Ethylene oxide k78
Ficus k81
Formaldehyde/Formalin k80
Green coffee bean k70
Hexahydrophtalic anhydrid k209
Isocyanate HDI (Hexamethylene
diisocyanate) k77
Isocyanate MDI (Diphenylmethane
diisocyanate) k76
Isocyanate TDI (Toluene
diisocyanate) k75
Ispaghula k72
Latex k82
Methyltetrahydrophtalic
anhydrid k211
Phthalic anhydride k79
Savinase k206
Silk k74
Silk waste k73
Sunflower seed k84
Trimellitic anhydride, TMA k86
PARASITES
Anisakis p4
Ascaris p1
Echinococcus p2
MISCELLANEOUS
Artemia salina, fish feed o202
Cotton, crude fibers o1
Daphnia, fish feed o207
Mealworm o211
MUXF3 CCD, Bromelain o214
Seminal fluid o70
Streptavidin o212
Tetramin, fish feed o203
Tobacco leaf o201
FOODS – FRUITS & VEGETABLES
Apple f49
Apricot f237
Asparagus f261
Aubergine, eggplant f262
Avocado f96
Bamboo shoot f51
Banana f92
Beetroot f319
Blackberry f211
Blueberry f288
Broccoli f260
Brussel sprouts f217
Cabbage f216
Carambola f295
Carrot f31
Cauliflower f291
Celery f85
Cherry f242
Cucumber f244
Date f289
Fennel, fresh f276
Fig f328
Garlic f47
Grape f259
Grapefruit f209
Guava f292
Jack fruit f318
Jujube f336
Kiwi f84
Lemon f208
Lettuce f215
Lime f306
Litchi f348
Mandarin (tangerine, clementine,
satsumas) f302
Mango f91
Melon f87
Olive (black, fresh) f342
Onion f48
Orange f33
Papaya f293
Passion fruit f294
Peach f95
Pear f94
Persimon (kaki fruit, sharon) f301
Pineapple f210
Plum f255
Potato f35
Pumpkin f225
Raspberry f343
Red currant f322
Rose hip f330
Spinach f214
Strawberry f44
Sweet potato f54
Tomato f25
Watermelon f329
FOODS – SEED,
LEGUMES & NUTS
Almond f20
Barley f6
Blue vetch f310
Brazil nut f18
Buckwheat f11
Cashew nut f202
Chick pea f309
Coconut f36
Common millet f55
Fenugreek f305
Foxtail millet f56
Gluten f79
Green bean f315
Hazel nut f17
Japanese millet f57
Lentil f235
Lima bean f182
Linseed f333
Lupin seed f335
Macadamia nut f345
Maize, Corn f8
Oat f7
Pea f12
Peanut f13
Pecan nut f201
Pine nut, pignoles f253
Pistachio f203
Poppy seed f224
Pumpkin seed f226
Quinoa f347
Rape seed f316
Red kidney bean f287
Rice f9
Rye f5
Sesame seed f10
Soybean f14
Spelt wheat f124
Sugar-beet seed f227
Sweet chestnut f299
Walnut f256
Wheat f4
White bean f15
107
Allergy
FOODS – SPICES
Allspice f339
Anise f271
Basil f269
Bay leaf f278
Black pepper f280
Caraway f265
Cardamon f267
Chilipepper f279
Clove f268
Coriander f317
Curry (Santa Maria) f281
Dill f277
Fennel seed f219
Ginger f270
Green pepper (unripe seed) f263
Lovage f275
Mace f266
Marjoram f274
Mint f332
Mustard f89
Oregano f283
Paprika, Sweet pepper f218
Parsley f86
Saffron f331
Sage f344
Tarragon f272
Thyme f273
Vanilla f234
FOODS – FISH, SHELLFISH &
MOLLUSCS
Abalone f346
Anchovy f313
Blue mussel f37
Cat fish f369
Chub mackerel f50
Clam f207
Crab f23
Crayfish f320
Eel f264
Fish (cod) f3
Grouper f410
Gulf flounder f147
Haddock f42
Hake f307
Halibut f303
Herring f205
Jack mackerel, Scad f60
Langust (spiny lobster) f304
108
Lobster f80
Mackerel f206
Megrim f311
Octopus f59
Orange roughy f412
Oyster f290
Pacific squid f58
Plaice f254
Pollock f413
Red snapper f381
Salmon f41
Sardine (Pilchard) f308
Sardine, Japanese Pilchard f61
Scallop f338
Shrimp f24
Snail f314
Sole f337
Squid f258
Swordfish f312
Tilapia f414
Trout f204
Tuna f40
Walleye pike f415
Whitefish (Inconnu) f384
FOODS – ADDITIVES
Carob (E410) f296
Guar, guar gum (E412) f246
Gum arabic (E414) f297
Tragacanth (E413) f298
Cochineal extract
(Carmine red) (E120) f340
FOODS – MISCELLANEOUS
Cacao f93
Coffee f221
Honey f247
Hop (fruit cone) f324
Malt f90
Mushroom (champignon) f212
Tea f222
Yeast f45
FOODS – EGG & FOWL
Chicken f83
Egg f245
Egg white f1
Egg yolk f75
Turkey meat f284
FOODS – MEAT
Beef f27
Elk/moose meat f285
Horse meat f321
Mutton f88
Pork f26
Rabbit f213
FOODS – MILK
Cheese, cheddar type f81
Cheese, mold type f82
Cow’s whey f236
Goat milk f300
Mare’s milk f286
Milk f2
Milk, boiled f231
Sheep milk f325
Sheep whey f326
Cytology / Histopathology
RECORD…
…the patient’s full name and date of birth on the vial.
…the patient information and medical history on the cytology
requisition form.
OBTAIN…
…an adequate sample from the cervix using a Cervex Brush
(broom-like device). Insert the central bristles of the brush
into the endocervical canal deep enough to allow the shorter
bristles to fully contact the ectocervix. Push gently and rotate
the brush in a clockwise direction five times.
RINSE…
…the Cervex Brush immediately into the PreservCyt Solution
vial by pushing it into the bottom of the vial 10 times, forcing
the bristles apart. As a final step, swirl the brush vigorously to
further release material. Visually inspect the Cervex Brush to
ensure that no material remains attached. Discard the brush.
Do not leave the head of the Cervex Brush in the vial.
TIGHTEN…
…the cap so that the black torque line on the cap passes
the black torque line on the vial. Do not over-tighten.
PLACE…
…the vial and requisition in a specimen bag for
transportation to TDL.
109
The Cytology Laboratory provides a rapid service for liquid based gynaecological samples. Urine
cytology is performed in house while other non-gynaecological cytology samples are referred
to a CPA accredited laboratory for reporting.
Human papilloma virus (HPV), Chlamydia and Gonorrhoea testing is carried out routinely from
ThinPrep vials and can be requested at the time of smear taking or up to 21 days post sampling.
Laboratory hours
The laboratory department is open between 9.00am and 6.00pm. Out of hours results available on
020 7307 7373.
Urgent samples
It is helpful if requests for urgent samples can be discussed with the Cytology Manager. Please
telephone 020 7307 7323.
Use of service/Information required
Request forms must include 3 identifiers (this can be patient’s full name = 2, date of birth, hospital
number or reference number) and need to accompany each sample. This form needs to include
appropriate clinical information including treatment and histological diagnosis, and the LMP for
gynaecological samples. Tick boxes are provided to assist you.
The specimen container also needs to be clearly labelled with patient details. Forms and samples
which are mismatched will result in the sample being returned to the sender for correction and will
delay to the report turn around time.
Clinical advice
The Consultant Cytopathologists and the Advanced Practitioner work together to provide clinical and
technical advice, including recommendations for follow-up, HPV testing and management of complex
cases. To contact the department directly, please telephone 020 7307 7323.
110
Gynaecological Samples
The Cytology department processes gynaecological samples directly referred from all sectors of
practice – Health Screening, Occupational Health, GP’s, Consultants, Colposcopy Units, Clinics,
Hospitals and other Laboratories.
Conventional PAP slides are no longer accepted, Liquid Based Cytology (LBC) is processed using the
Hologic ThinPrep system. The Doctors Laboratory uses the Hologic Imaging system as an enhanced
Quality Control.
Information for Sample Takers is available by contacting the department. Importantly the head of the
cervical broom must NOT be left in the vial. The use of lubricant interferes with LBC sampling and may
result in an inadequate sample. Use of lubricant is not recommended as it can affect the processing quality
of the sample. Supplies of Thinprep vials are available from TDL.
TEST
CODE
PAP – Thin Prep (Cervical Cytology)
PAPT
SAMPLE REQS
TAT
TPV
2-3 days
Additional tests from Hologic Thin Prep Vial (HPV – see page 114)
Tests are priced individually. Please request tests individually. ThinPrep Vials are kept for 21 days after
receipt of sample. Requests for additional tests from the vial already received in the laboratory can be
made by contacting the Department Manager.
Infection by PCR (singles)
N. Gonorrhoea
Ureaplasma urealyticum
Herpes Simplex I/II
TPCR
TGON
TCG
MGEN
UGEN
TVPC
GVPC
HERD
TPV
TPV
TPV
TPV
TPV
TPV
TPV
TPV
5 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
7 STI PROFILE BY PCR FROM THIN PREP VIAL
N. gonorrhoea
Ureaplasma
Herpes Simplex I/II
All tests can be
requested indivdually
TAT
2
DAYS
PP12
TPV
111
ThinPrep® PAP Test Cervex Brush Protocol
PREPARE ALL EQUIPMENT BEFORE STARTING THE PROCEDURE
• Note expiry date on sample collection vial. Do not use expired vials.
• Ensure the entire plastic seal is removed from the lid of the vial and discarded.
• Complete patient details on both the request form and the vial.
Specimens may be returned or discarded if details are missing from the vial.
• Remove the lid from the vial before taking the sample.
• Use of lubricant is not recommended.
DO
DON’T
•If excessive mucus is present, this should
be gently removed before sampling.
•DO NOT detach the head of the Cervex
Brush into the vial.
•Use either the Cervex Brush (broom-like
device) on its own or a Plastic spatula
and endocervical brush combination.
•DO NOT routinely clean the cervix or
take a cervical swab before taking a
cervical sample.
•The Cervex Brush should be rotated
5 times in a clockwise direction. The
Plastic spatula should be rotated through
360 degrees and the endocervical brush
rotated through one quarter to one
half turn.
•An endocervical brush should never be
used in isolation.
•Immediately rinse the collected material
into the vial.
•DO NOT leave the collection device sitting
in the vial whilst dealing with the patient.
•DO NOT over-tighten the lid on the vial.
•Replace the lid and tighten so that the
black torque line on the cap passes
the black torque line on the vial to
avoid leakage.
•DO NOT place multiple labels on the
outside of the vial.
•Keep the unlabelled portion of the sample
vial free of labels so that the contents can
be seen.
•DO NOT use expired vials.
•If barcoded labels are used these must
be applied horizontally around the vial.
•Samples should be sent to the laboratory
without delay.
112
•DO NOT under any circumstances use
a wooden spatula.
•DO NOT apply barcoded labels vertically
on the vial.
•DO NOT delay the sending of vials to
the laboratory. The sample needs to be
processed within 3 weeks of collection.
•DO NOT use excessive lubricant –
please avoid if possible.
Introducing Triage and Test of Cure
Cervical cancer prevention is in transition, with a move from cytology only based screening programmes
to HPV based screening. HPV testing will be important to decide which women need to be referred for
further evaluation or treatment. Treatment will be aimed at women who are at risk of developing cervical
cancer and extended screening intervals should become more confidently accepted after a negative
HPV test.
The aetiological role of HPV infection among women with cervical cancer is now clearly established,
and the use of testing for high risk HPV in the management of low grade cytological abnormalities of
the cervix well documented.
There are over 100 subtypes of HPV, most of which do not cause significant disease but some (notably
types 16 and 18 which account for 70% of all cervical cancer cases worldwide) have been identified
and confirmed as causal agents for cervical cancer. These are known as High Risk HPV (HR-HPV) types.
Although most women will have at least one HPV infection at some time in their lives, the majority of
HPV infections are transient and are cleared by the immune system. A small but still significant number
of HPV infections do not clear spontaneously, and it is these women who are at an increased risk of
developing cervical intraepithelial neoplasia (CIN) and cervical cancer. Because it is recognised that
almost 100% of cervical cancers contain HPV DNA women with no evidence of HR-HPV infection are
extremely unlikely to develop cervical cancer in the short to medium term.
HPV Triage and Test of Cure has been introduced across the NHS Cervical Screening Programme
in keeping with national protocols. All women in the screening age range of 24.5 – 64 are eligible
for HPV Triage and Test of Cure.
HPV Triage introduces reflex testing for HR-HPV for women whose cervical cytology shows either
borderline changes or low grade dyskaryosis. A recommendation to refer for colposcopy will be made
if HR-HPV is detected. If results show that HPV is not detected, the recommendation will be to return
to routine screening.
Test of Cure uses HR-HPV testing to assess the risk of residual or recurrent disease in women who have
been treated for any grade of CIN. Women who have normal cytology and are negative for HR-HPV at
the time of their follow up screening appointment are at very low risk of residual disease, and can be
returned to 3 yearly recall, unless advised different by their gynaecologist. If HR-HPV is detected she
needs to be referred again for colposcopy and followed up in accordance with national guidelines.
This strategy will also be applied to women receiving treatment for CGIN or for invasive disease.
TDL provides a HR-HPV Assay that is an NHS approved qualitative DNA assay, able to collectively test
for 14 high risk HPV subtypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68) and partially
genotype 16 and 18. This assay provides the minimum necessary information for patient stratification.
Any request for Cervical Cytology that is not accompanied by a specific request for HPV testing, but is
reported with either borderline or low grade changes, will automatically reflex to 16/18 HPV high risk
DNA test. The cost of this reflexed test is included in the price of the cervical cytology (PAPT). There
is no additional charge. For women whose cytology findings are high grade, the recommendation for
referral for colposcopy will continue to be given, even if HPV DNA is not detected.
113
The primary benefit of using HPV testing lies in its high sensitivity and high negative predictive value,
but HPV DNA testing, on its own, cannot identify progression from transient to a transforming infection
or oncogenic activity. This is when an HPV infection has transformed from merely being present and
insignificant, to become an integrated infection. The expression of viral oncoproteins E6 and E7, which
affect cell cycle control, initiate the cervical cancer process. The detection of E6/E7 mRNA confirms the
persistent expression of viral oncoproteins in human cells.
TEST
CODE
SAMPLE REQS
TAT
HPV DNA types 16, 18 + collective reporting
HPV
TPV
2 days
of 12 other High Risk DNA subtypes
*If HPV has not been included with a request for Thin Prep PAP (PAPT) and the cervical cytology shows
borderline or mild changes, this High Risk HPV (HR-HPV) DNA test will be undertaken at no additional charge.
HR-HPV subtypes are reported collectively (negative/positive) with Types 16 and 18 reported if present.
HPV DNA types 16, 18 + all other
HPV
TPV
2 days
High Risk DNA subtypes
High Risk HPV (HR-HPV) subtypes, reported collectively (negative/positive) with Types 16 and 18 reported
if present.
HPV Typed DNA
HP20
HPV DNA subtypes will be reported (5 low risk and 14 high risk).
TPV/PCR
5 days
HPV Typed DNA/mRNA
HPVT
TPV
5 days
If one or more of types 16, 18, 31, 33 or 45 are positive, reflex testing for expression of E6/E7 oncoproteins
will be undertaken.
HPV mRNA only
HPVR
TPV
3 days
Usually requested by laboratories who have undertaken DNA testing, this option confirms expression
of E6/E7 oncoproteins.
The benefit of a negative HPV result is its negative predictive value – meaning a negative result indicates
that a patient is at very low risk of developing cervical disease. The Negative Predictive Value (NPV) for
both DNA and mRNA is the same. DNA based tests detect presence of virus only, whilst the mRNA-based
test detects the persistence of viral oncogenic expression. mRNA testing can be undertaken from Hologic
Thin Prep samples only.
HPV/PAPT Combined Report
Where HPV result is reported with Cervical Cytology, a recommendation for patient management will be
given, based on the combined findings. Patients who are monitored by a Colposcopist/Gynaecologist will
receive a recommendation indicating that patient management is at clinician’s discretion.
114
Non-Gynaecological Cytology
Urines
Ideally 30mls of a freshly fully voided (empty bladder) mid-morning urine sample should be submitted in
a suitable container ideally containing a preservative (available from TDL supplies). Use of a preservative
will ensure the cellular material is preserved up to 48 hours. A mid stream sample is NOT recommended
for cytological assessment as it could lead to a low cellular yield. If a delay (> 24 hours) in reaching the
laboratory is anticipated) samples should be refrigerated at 4° C.
Sputum
Sputum should be collected on at least three occasions if underlying lung carcinoma is suspected.
A single sputum is sufficient for microbiological assessment. Sputum should be sent to the laboratory
immediately following production, or stored in a universal container containing cytolyt cell fixative if there
is a likely delay. Please note that this is only acceptable if sputum only for Cytology. Microbiology cannot
be performed on fixed material. Early morning sputum is ideal, but contamination with food, toothpaste
and tobacco should be avoided.
Fluids
All available material should be submitted in a sterile container without fixative as quickly as possible.
If any delay is anticipated, the material should be submitted in cytolyt fixative.
Cerebrospinal fluid (CSF)
Ideally CSF should be submitted fresh or as an air dried cytospin slide, unstained and in a plastic
transport slide box. A minimum of 3mls should be submitted either in fresh form or spun on multiple
slides for cytopathologists’ review and opinion. Please contact TDL Cytology for advice if required on
020 7307 7323 / 7373.
URINE/SPUTUM/FLUID
TEST
CODE
SAMPLE REQS
TAT
CATF
4
Fluid Cytology
Urine Cytology (Urine cytology containers
available from TDL Supplies)
Fluid
3 days
URCY
Urine 2 days
21
HISTOPATHOLOGY
TEST
CODE
Category 1
Category 2
Category 3
Category 4
Category 5
CAT1
CAT2
CAT3
CAT4
CAT5
SAMPLE REQS
TAT
Single small
Small medium
Medium
Large
Large complex
from 3-5 days
from 3-5 days
from 3-5 days
from 3-5 days
from 3-5 days
115
116
Screening for Drugs of Abuse / Alcohol
DRUGS OF ABUSE SCREENING
DRUGS OF ABUSE PROFILE – RANDOM
URINE SAMPLE/NO CHAIN OF CUSTODY
DRUGS OF ABUSE PROFILE –
WITH CHAIN OF CUSTODY
MDMA
Alcohol
Amphetamines
Methadone
Barbiturates
Metamphetamines
Benzodiazepine
Methaqualone
Cannabinoids
Morphine – opiate
Cocaine
Phencyclidine
Codeine – opiate Propoxyphene
Dihydrocodeine – opiate
Ephedrine
TAT
TAT
Ketamine
GCMS
2 5 WITH
LSD
CONFIRMATION
DAYS
Ephedrine
Amphetamines
MDMA
Barbiturates
Methadone
Benzodiazepine
Metamphetamines
Cannabinoids
Morphine – opiate
Cocaine
Codeine – opiate
Dihydrocodeine – opiate
TAT
TAT
2
DAYS
RU/CoC collection containers
DOA
plus Alcohol
DOA3
RU
* See page 118
TAT
TAT
DAYS
DAYS
2
5
WITH GCMS
CONFIRMATION
DOAN
RU
DRUGS OF ABUSE FROM BLOOD –
WITHOUT CHAIN OF CUSTODY
DRUGS OF ABUSE PROFILE –
As above but with
NO Chain of Custody
2
Amphetamines
Barbiturates
Tricyclic Antidepressants
Benzodiazepine
Cannabinoids
Opiates
TAT
5
DAYS
DOAP
ALCOHOL PROFILE
LFT
Alcohol Level
CDTMCV
B
TAT
3
DAYS
AP
A B G
ALCOHOL PROFILE 2
LFT
Alcohol Level
CDTMCV
Urine Ethyl Gluconaride (EtG)
Urine Ethyl Sulfate (EtS)
DRUGS OF ABUSE FROM HAIR SAMPLES –
Amphetamines
Barbiturates
Benzodiazepines
Cocaine
Cannabis
Opiates
Methadone
RU
TAT
21
DAYS
TAT
3
DOAH
DAYS
Without Chain of Custody
ALCP
A B G WITH GCMS
CONFIRMATION
DAYS
DOAL
1,2
5
DAYS
HAIN
Please contact the laboratory for information and sample
collection instructions.
117
Occupational health
Chain of custody refers to the system of controls governing the entire urine collection, processing and storage
of sample to ensure that a particular urine specimen originated from a particular individual and that the
reported results relate, beyond doubt, to that specimen. Chain of custody requires attention to detail so that
it is possible to prove that there has been no opportunity for the sample to be accidentally or maliciously
adulterated. Sample collection should be undertaken by collectors who are well versed in the protocols of
chain of custody.
Samples submitted for analysis will undergo initial screening. Urinary creatinine is routinely measured during
testing to verify the validity of the sample submitted. Creatinine levels below normal occur when the urine
has been diluted, either directly or by drinking large amounts of water before providing the urine sample.
Chain of custody containers, forms, seals and barcodes are provided by TDL on request. All Chain of
Custody, and non-chain, samples with positive findings will proceed to identification/confirmation by Gas
Chromotography/Mass Spectrometry.
OCCUPATIONAL HEALTH – TRACE METALS IN BLOOD
TEST
CODE
Aluminium
Arsenic
Cadmium
Chromium
Cobalt (Serum)
Copper (Serum)
Lead
Lead Profile (Hb, ZPP, Lead)
Magnesium
Manganese (Serum)
Mercury
Nickel
Silver
Trace Metal (Blood) Profile
Zinc (Serum/Plasma)
ALUM
ARS
CADM
CHRO
COBB
COPP
LEAD
LEAZ
MG
MANG
MERC
NICK
SILV
TRAC
ZINC
SAMPLE REQS
TAT
K
A or H
A or H
A
B
B
A
A 13
B
B
A or H
B
B
B H K K
7 days
5 days
5 days
5 days
5 days
5 days
5 days
3-5 days
4 hrs
5 days
5 days
5 days
5 days
7-10 days
1 day
TRACE METAL (BLOOD) PROFILE
Aluminium
Manganese
Iron
Calcium
Zinc
Magnesium
Copper
Cadmium
Mercury
Lead
Chromium
TAT
7-10
DAYS
TRAC
B H K
118
Occupational health
OCCUPATIONAL HEALTH – TRACE METALS IN URINE
TEST
CODE
Arsenic
Cadmium
Chromium
Cobalt
Copper
Lead
Magnesium
Mercury
Nickel
Silver
Zinc
ARSE
URCD
URCR
COBA
URCU
URPB
URMG
URHG
NICU
USIL
URZN
SAMPLE REQS
RU
RU 30
RU 30
RU 30
CU
RU
PU
RU 1
RU
RU
CU
30
TAT
5 days
5 days
5 days
5 days
5 days
5 days
1 day
5 days
5 days
5 days
5 days
OCCUPATIONAL HEALTH – TESTS FOR SPECIFIC EXPOSURE
TEST
CODE
Doxepin Level (Sinequan)
Pethidine – Urine
B2MG
UB2M
CHRC
CHPS
DOXE
UPET
SAMPLE REQS
TAT
B
RU
H
B A
RU
2 days
3 days
5 days
3 days
10 days
4 weeks
OCCUPATIONAL HEALTH – MICROBIOLOGY
TEST
CODE
Food
Food Handler Screen 1
Needle Stick Injury Profile
FOOD
OFH1
OFH2
OFH3
NSI
SAMPLE REQS
TAT
Submit sample
B RF, STM
A B G RF, STM
A B B G RF,2x STM
B B
10 days
2 days
2 days
2 days
4 hrs
119
Occupational health
FOOD HANDLER SCREEN 1
LFT
Nasal Swab
Stool for o/c/p and culture
B RF
STM
FOOD HANDLER SCREEN 2
TAT
2
FBC/ESR
Nasal Swab
DAYS
OFH1
OFH2
A B G RF FOOD HANDLER SCREEN 3
STM
NEEDLE STICK INJURY PROFILE
(Donor – Not recipient)
Hep Bs.Ag
Hep C Abs
HIV 1+2 Abs/p24 Antigen
Serum saved for 2 years
TAT
TAT
DAYS
HOURS
2
4
OFH3
A B B G RF 120
STM
2
DAYS
FBC/ESR
Nasal Swab
Throat Swab
Hep B Surface Antigen
Hep C Abs
TAT
STM
NSI
B B Ensure all specimens and forms are labelled with given Full Name, Surname, DOB, Date and Time
Alphabetical test index
TEST
CODE
SAMPLE REQS
TAT
1,25 Vitamin D
5 HIAA
D3
RU5H
B (Frozen)
PU 1
5-8 days
5 days
7 STI’s by PCR
PP12
FCRU/PCR/TPV/Semen
2 days
ACTH (Adreno Corticotrophic Hormone)
Activated Protein C Resistance
Acute Viral Hepatitis Screen
Adrenal Cortex Antibodies
Albumin
Alcohol (Legal) Police Blood Sample
Alcohol (Medical)
Alcohol (Urine)
Alcohol Profile
Alcohol Profile 2
Aldolase
Aldosterone
Allergen Component Profiles
Allergy – Individual Allergens
Allergy Profile (Mediterranean)
Allergy Profile (Middle East)
Allergy Profile (UK)
Allergy Profile 1 (Food & Inhalants)
Allergy Profile 2 (Inhalants)
Allergy Profile 3 (Food)
Allergy Profile 4 (Nuts & Seeds)
Allergy Profile 5 (Children’s Panel)
Allergy Profile 6 (Shellfish)
Allergy Profile 7 (Finfish)
Allergy Profile 8 (Cereal – singles)
Allergy Profile 9 (Antibiotics)
Allergy Profile 10 (Insects)
Allergy Profile 11
(Combined Shellfish/Finfish)
Allergy Profile 12 (Milk & Milk Proteins)
Allergy Profile 13
(Stone fruit/Rosaceae family)
Alpha 1 Antitrypsin (Serum)
Alpha 1 Antitrypsin (Stool)
Alpha 1 Antitrypsin Genotype
– PI*M, PI*S, PI*Z
Alpha Feto Protein
ALT (Alanine Aminotransferase)
17OH
ACTH
APCR
AHSC
ADAB
ACTX
ALB
LALC
ALCO
UALC
AP
ALCP
ALDO
ALDN
ALP
B
J 1
C (Frozen) 4,18
B
B
B
B
Police Sample
G 1
RU
A B G
A B G RU
B
B
B
5 days
1 day
3 days
4 hrs
2 days
2 days
4 hrs
3 weeks
4 hrs
4 hrs
3 days
3 days
5 days
5 days
4 hrs
ALLE
ALMD
ALME
ALUK
1A
2A
3A
4A
5A
6A
7A
8A
9A
10A
B
B
B
B
BB
B
B
B
B
B
B
B
B
B
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
2 days
98
19
45, 51,
70, 111
31
31
25
53, 62
53, 68
53
19
19
19
19
117
117
19
31
19
104
101, 105
100-101
100-101
100-101
101-102
101-102
101-102
101-102
101-102
101, 103
101, 103
101, 103
101, 103
101, 103
11A
B
2 days
101, 103
12A
B
2 days
101, 103
13A
B
2 days
101, 103
A1AT
A1AF
B
RF
1 day
10 days
19
19
GENE
A 9
3 weeks
19
AFP
ALT
B
B
4 hrs
4 hrs
PAGE
31, 71
19
121
TEST
Alternaria Components
Aluminium
Amenorrhoea Profile
Amikacin Level (State dose)
Amino Acid (Serum/Plasma)
Amino Acid Quantitative (Urine)
Amitriptyline
Ammonia
Amniocentesis – rapid BOBs aneuploidy
diagnosis for all chromosomes (5 days)
+ culture (10-15 days)
Amoebic (E. histolytica) Antibodies
Amoebic (E. histolytica) Antigen
Amylase
Anaemia Profile
Anafranil (Clomipramine)
ANCA (Anti-Neutrophil Cytoplasmic Abs)
Andropause Profile
Androstenedione
Angiotensin Converting Enzyme
Antenatal Profile
Anti Sla (Soluble Liver Antigen) Abs
Anti-Ri Antibodies
CHANGE Antimullerian Hormone (Elecsys/Roche)
Antinuclear Antibodies (titre & pattern)
Antioxidant Status (total/activity)
Antistaphylolysin Titre (SGOT)
Antistreptolysin Titre/ASOT
Antithrombin Ill
Apolipoprotein A1 (12 hrs fasting)
Apolipoprotein B (12 hrs fasting)
Apolipoprotein E
Apolipoprotein E genotype – E2, E3, E4
Apple Components
APTT/KCCT
Arsenic (Blood)
Arsenic (Urine)
Aspergillus Components
Aspergillus Precipitins
AST (SGOT)
Atypical Antibody Screen
(handwritten tube label)
122
CODE
SAMPLE REQS
TAT
ZZ1
ALUM
AMEN
AMIK
AMIN
UAAQ
AMTR
AMMO
B
K
B
B 4
B
RU
A 4
A (Frozen) 15
3 days
7 days
4 hrs
4 hrs
7 days
7 days
5 days
4 hrs
AF 9
5-15 days
AFAT
AMAG
AMY
ANAE
CHLO
ANCA
ANDP
ANDR
ACE
ANTE
CCP
LSA
RIAB
AMH
ANAB
FRAD
ASTT
ASLT
A111
APOA
APOB
APOE
APEG
ZZ36
KCCT
ARS
ARSE
ZZ2
ASPP
AST
B
RF
B
A A B
A
B
B B
B (Frozen) B
A A 33 B B B G
B
B
B
B
B
B
B
B
C (Frozen) 4,9,18
B
B
B (fasting)
A 9
B
C 18
A or H
RU 30
B
B
B
2 days
2 days
4 hrs
2 days
7 days
2 days
8 hrs
1 day
4 hrs
3 days
2 days
10 days
3 days
4 hrs
2 days
7 days
2 days
2 days
3 days
3 days
3 days
5 days
5 days
3 days
4 hrs
5 days
5 days
3 days
5 days
4 hrs
59
59
19
25, 27
96
53
31, 34
31
19
25, 27
53
53
53
19, 31, 34
53
98
53
53
25
19
19
19
79
104
25
19, 118
19, 119
104
68
19
AASC
A 22,33
2 days
25
ABK
PAGE
104
19, 118
31, 35
95
19
19
96
19
79
TEST
CODE
AUTO
Autoantibody Profile I
ENDO
Autoantibody Profile II
B12F
B12 (Active)/Red Cell Folate
RBJP
Bence-Jones Protein
B2MG
UB2M
HCGQ
Beta HCG (Oncology)
QHCG
Beta HCG (Quantitative)
HCO3
Bicarbonate
Bilharzia (Schistosome) Antibody Screen BILH
SHAG
Bilharzia (Schistosome) Antigen
USCH
Bilharzia (Urine)
DBIL
Bilirubin (Direct/Conjugated)
BILI
Bilirubin (Total/Indirect/Conjugated)
UBIL
Bilirubin (Urine)
Birch Components
ZZ3
BISM
Bismuth
Blood Culture
BCUL
FILM
Blood Film Examination
ABO
Blood Group †
BNP
BNP (NT-pro BNP)
BONE
Bone Screen
BON2
Bone Screen (Bloods only)
Borrelia Antibodies (Lyme Disease)
BORR
IgG, IgM
Borrelia Antibodies (Lyme Disease) IgM BORM
BORC
Borrelia Confirmation (Immunoblot)
Brazil Components
ZZ4
Breast/Ovarian Cancer – BRCA1 + BRCA2
GENE
CHANGE
full screening + deletions/duplications
Breast/Ovarian Cancer NGS Panel –
GENE
full sequencing across 39 genes +
NEW
BRUC
Brucella Confirmation
Bupa Cromwell Hospital Screening Profiles CP1-CP12
CPEP
C Peptide
CRP
C Reactive Protein
HCRP
C Reactive Protein (High Sensitivity)
C1EI
C1 Esterase Inhibitor
C3
C3 Complement
COMP
C3/C4 Complement
C4
C4 Complement
C153
CA 15-3
C199
CA 19-9
SAMPLE REQS
TAT
B
B
A B
1 x 30mls (RU)
B
RU
B
B
B
B 14
B
RU 14
B
B
RU
B
B
2x BC 4
A
A 22,32
B
B CU
B
2 days
2 days
2 days
5 days
2 days
3 days
4 hrs
4 hrs
4 hrs
2 days
3 weeks
8 hrs
4 hrs
4 hrs
1 day
3 days
5 days
5 days +
4 hrs
2 days
4 hrs
4 hrs
4 hrs
53, 57
53, 57
25-26, 98
19
19, 119
19, 119
71
31
19
59
59
59
19
19
19
104
19
28
25
25
19, 31
19, 24
19, 24
B 9,14
2 days
53-54, 59
B
B 9,14
B
2 days
10 days
3 days
53-54, 59
53
104
A A 9,11
3 weeks
71
A A 9,11
6 weeks
71
B 9
2-3 weeks
B
B
B
B B
B
B
B
B
3 days
4 hrs
4 hrs
5 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
PAGE
53
16-17
31
19
19
53
53
53
53
71
71
123
TEST
CA 50
CA 125
Cadmium
Cadmium
Calcitonin
Calcium
Calcium (24 hr Urine)
Calcium/Creatinine Ratio
Calprotectin
Calprotectin/Elastase Profile
Carbamazepine (Tegretol)
Carbohydrate Deficient Transferrin (CDT)
Carcino Embryonic Antigen
Cardiac Enzymes (not chest pain)
Cardiolipin Antibodies (IgG+IgM)
Cashew Components
Cat Components
Catecholamines (Plasma)
Catecholamines (Urine)
Category 1
Category 2
Category 3
Category 4
Category 5
CCP Antibodies (RF)
CD3/CD4/CD8
CD5 T+B Cells
CD16
CD19 B Cells
CD20
CD25
CD56
CD69/CD16/CD56 (NK Cells)
Celery Components
Centromere Autoantibodies
Ceruloplasmin
CH50 (Classical pathway)
Chest Pain Profile
Chlamydia (PCR swab)
Chlamydia (Urine)
124
CODE
CA50
C125
CADM
URCD
CATO
CA
UCA
CACR
CALP
CEP
CARB
CDT
CEA
CENZ
ACAB
PP10
PP11
ZZ35
ZZ5
CATE
UCAT
CAT1
CAT2
CAT3
CAT4
CAT5
CCP
LYSS
CD5
CD16
CD19
CD20
CD25
CD56
CD69
ZZ6
CAB
CERU
CH50
CPP
SPCR
TPCR
CPCR
SAMPLE REQS
TAT
B
B
A or H
RU 30
B (Frozen) 4
B
PU
RU B
RF
RF
B
B 4
B
B
B
B B
B B B C 34
B
B
A A (Plasma Frozen) 4
PU1
Single small
Small medium
Medium
Large
Large complex
B
A 10/Chex
A 4
A 4
A 4
A 10/Chex
A 10/Chex
A 4
H 5,34
B
B
B
B (Frozen) 4
B
PCR
TPV
FCRU
5 days
4 hrs
5 days
5 days
1 day
4 hrs
4 hrs
4 hrs
5 days
5 days
4 hrs
3 days
4 hrs
4 hrs
2 days
3 days
3 days
3 days
3 days
5 days
5 days
from 3-5 days
from 3-5 days
from 3-5 days
from 3-5 days
from 3-5 days
2 days
1 day
1 day
1 day
1 day
2 days
2 days
1 day
2 days
3 days
2 days
1 day
4 days
STAT
2 days
5 days
2 days
PAGE
71
71
19, 118
19, 118
31
19
19
19
53
53, 57
96
20
71
20
53
17, 20, 24
17, 20, 24
104
104
31
31
115
115
115
115
115
53
25-26
25
25
25
25
25
25
25
104
53
20, 98
53
20, 24
28, 45
28, 45, 111
28, 45
TEST
CODE
Chlamydia Species Specific Ab Screen
Chlamydia trachomatis by PCR (Semen)
Chlamydia/Gonorrhoea (Rectal)
Chlamydia/Gonorrhoea (Thin Prep)
Chlamydia/Gonorrhoea (Throat)
Chloride
Cholesterol
Cholesterol (Familial
Hypercholesterolaemia)
Chromium (Blood)
Chromium (Urine)
Chromosome Analysis (Blood)
Chromosome Y Deletion
– AZFa, AZFb, AZFc + SRY
Chronic Fatigue Syndrome Profile
Citrate (Urine)
CK (MB Fraction)
Clobazam
Clomipramine (Anafranil)
Clonazepam
Clostridium Difficile Toxin
Cobalt (Blood)
Cobalt (Serum)
Cobalt (Urine)
Coeliac Disease – HLA DQ2/DQ8 Genotype
Coombs (Direct Antiglobulin Test)
Copper (Serum)
Copper (Urine)
Cortisol
Cortisol (Urine)
Cotinine (Serum)
Cotinine (Urine)
CHAB
UPCR
TPCR
SCG
RSCG
TCG
TSCG
CCG
CL
CHO
SAMPLE REQS
TAT
B
Semen
TPV
PCR
PCR
TPV
PCR
FCRU
B
B
2 days
5 days
5 days
2 days
2 days
5 days
2 days
2 days
4 hrs
4 hrs
PAGE
53, 57
28
28, 111
45
45
45, 111
45
45
20
20
83
CHRC
CHPS
CHRO
URCR
KARY
H
B
A
RU 30
H9
YDEL
A
VIP1
UCIT
CKMB
CLOB
CHLO
CLON
CLOS
CLPF
CLOT
COB
COBB
COBA
Q2Q8
GSA3
GSA2
GSA3
GSA
A or Chex + B CU (Frozen)
B
A
A
A
RF*
C 18
A C 18
A
B
RU 30
A9
A B
A B
A B
B
5 days
3 days
5 days
5 days
5-15 days
9
10
20, 119
20, 119
20, 118
20, 119
81
5 days
81
5 days
5 days
4 hrs
5 days
7 days
7 days
2 days
4 hrs
4 hrs
5 days
5 days
5 days
10 days
10 days
10 days
10 days
2 days
53, 57
20
20
96
96
96
28
25, 27
25, 27
20
20, 118
20, 119
56
53-54, 56
53-54, 56
53-54, 56
53, 56
COOM
A 22,33
2 days
25
COPP
URCU
CORT
UCOR
COT
COTT
B
CU
B
CU
B
RU
5 days
5 days
4 hrs
5 days
2 days
2 days
20, 98, 118
20, 119
31
31
53
53
125
126
TEST
CODE
SAMPLE REQS
TAT
Cow’s Milk Components
Creatine Kinase (CK, CPK)
Creatinine
Creatinine (Urine)
Creatinine Clearance
Crosslaps (Serum DPD)
Cryoglobulins
Cryptococcal Antigen
Cryptosporidium
Cryptosporidium Antigen Detection
CSF – Viral PCR
CSF for Microscopy and Culture
Cyclosporin (Monoclonal)
Cyfra 21-1
Cystic Fibrosis – 139 common mutations
Cytomegalovirus (IgG/IgM) Antibodies
Cytomegalovirus (PCR)
Cytomegalovirus Avidity
Cytomegalovirus IgM
D-Dimers
Dengue Virus Serology
Deoxypyridinoline (DPD) – Serum
Deoxypyridinoline (DPD) – Urine
DHEA
DHEA Sulphate
Diabetic Profile 1
Diabetic Profile 2
Diazepam (Valium)
Digoxin
Dihydrotestosterone
Direct Antiglobulin Test (Coombs)
DNA (Double Stranded) Antibodies
DNA (Single Stranded) Antibodies
DNA Extraction & Storage
– 3 years (longer upon request)
Dog Components
Down Syndrome Risk Bloods only
(Risk to be calculated by clinician)
Down Syndrome Risk Profile
(2nd trimester) Quad
Down Syndrome Risk Profile with risk
calculation first trimester
ZZ7
CKNA
CREA
UCR
CRCL
SDPD
CRYO
CRYC
CRPO
CRPA
VPCR
CSF
CYCL
CY21
CFS
CMV
CMVU
CMAV
CMVP
CMVM
DDIT
DENG
SDPD
DPD
DHEX
DHEA
DIAB
DIA2
DIAZ
DIGO
DHT
B
B
B
CU
B CU
B
J 6
Serum or CSF
RF
RF
CSF
CSF
A
B
A 9
B
RU
B
A
B
C 4
B 9,14
B
EMU
B
B
A G
A G RU
A
B
B B
3 days
4 hrs
4 hrs
4 hrs
4 hrs
4 days
10 days
1 day
2 days
1 day
5 days
2-3 days
1 day
4 days
5 days
4 hrs
5 days
10 days
5 days
4 hrs
1 day
5 days
4 days
4 days
7-10 days
4 hrs
8 hrs
2 days
7 days
4 hrs
7 days
COOM
A 22,33
2 days
25
DNAA
DNAS
B
B
2 days
5 days
53
53
XDNA
A 9,11
10 days
82
ZZ8
HCGF/
PAPA
B
3 days
104
B
4 hrs
31
DRP
B,DRP form 7,8
2 days
31
DRP
B,DRP form +
image of scan 7,8
2 days
31
PAGE
104
20
20
20
20
20
53
28
28
59
69
28
20
71
82
68
68
68
68, 70
68
25
59
20
20
31
31
20, 24
20, 24
96
96
31
TEST
CODE
SAMPLE REQS
TAT
Doxepin Level (Sinequan)
Drugs of Abuse Profiles
DOXE
A
10 days
DVT/Pre-travel Screen
DVT1
A A B 9
5 days
Early CDT-Lung
Early Detection Screen
(10 days post exposure)
Early Detection Screen with Syphilis
ECG
Eczema Provoking Profile
Egg Components
Elastase (Faecal)
Elastase / Calprotectin Profile
Electrolytes
Electrolytes (Urine)
ELF/Enhanced Liver Fibrosis
Endomysial Antibodies (IgA)
Endothelial Nitric Oxide Synthase (eNOS)
8-786C mutation
Endothelial Nitric Oxide Synthase (eNOS)
G894T (Glu294Asp) mutation
Enteric Organism Rapid Detection
Enterovirus by PCR
Enterovirus Screen
Epanutin (Phenytoin)
Epstein-Barr Virus (EBV-DNA)
Epstein-Barr Virus Antibodies IgG/IgM
Erythropoietin
ESR
Essential Fatty Acid Profile (Red Cell)
Ethosuximide
Extractable Nuclear Antibodies
(nRNP, Sm, Ro ,La, Jo1, Scl70)
Eye Swabs – Viral PCR
Factor V Leiden
Factor VII Assay
Factor VIII Assay
Factor IX Assay
Factor X Assay
Factor XI Assay
Factor XII Assay
Factor XIII Assay
CDTL
B
7 days
STDX
A 10mls or 2 x 4mls
3 days
STXX
ECG
EFAT
ALEC
ZZ9
ELAS
CEP
ELEC
UELE
ELF
AEAB
X
B 9,14
B
B
RF
RF
B
CU
B
B
3 days
2 days
2 days
2 days
3 days
5 days
5 days
4 hrs
4 hrs
6 days
2 days
96, 119
117
25, 27, 56, 59-60
71
45, 51,
62, 66, 70
45, 51
95
53, 59
101
104
53
53, 57
20
20, 22
20-21
53
18RF
A A A 2 weeks
33
19RF
A A A 2 weeks
33
EORD
ENPC
ENTO
PHEN
EBVQ
EBVA
IMPO
ERY
ESR
EFAR
ETHO
RF
A/RF/PCR
B
B
A
B
A B B G
B
A
A A 4
A
2 days
5 days
2 days
4 hrs
7 days
2 days
3 days
4 days
4 hrs
5-7 days
7 days
59-60
70
68-69
96
70
68
31, 34
25, 96
25
98
96
ENA
B
2 days
53
VPE
FX2
FX5
FAC7
FAC8
F1X
FX
FX1
FX11
FA13
PCR
A 9
A 9
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen) 9,18
C (Frozen)9,18
C (Frozen)9,18
C (Frozen)9,18
4 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
5 days
69
25
25
25
25
25
25
25
25
25
PAGE
127
TEST
CODE
SAMPLE REQS
TAT
PAGE
Faecal Elastase
Faecal Fat (1 Day Collection)
Faecal Occult Blood/FOB
(immunochemical/FIT)
Faecal Urobilinogen
Familial Hypercholesterolaemia –
comprehensive LDLR + APOB + PCSK9
+ LDLRAP1 sequencing
FASTest Sexual Health Screening Tests
Ferritin
Fibrinogen
Fibrotest (Liver Fibrosis)
Filaria (Lymphatic and Non-Lymphatic)
Antibodies
Filaria Antigen
ELAS
TFFA
RF
LF 6
5 days
5 days
53
20
FOB
RF
1 day
28
FURO
RF
5 days
20
GENE
A A 9
4 weeks
83
FIP
FERR
FIB
FIBT
B
B
C 4,18
B 4 hrs
4 hrs
4 hrs
2 weeks
48-49
31, 34
20
25
20-21
FIFA
B 9,14
10 days
59
A A
4 days
59
31, 35
First Trimester Antenatal Screen
Fish Components
FK506 (Tacrolimus/Prograf)
Flecainide (Tambocor)
Fluid Culture
Fluid Cytology
Fluid for Crystals
Fluoxetine (Prozac)
Folate (Red Cell)
Folate (Serum)
Food Microbiology
Fragile X Syndrome screen
– FMR1 repeat analysis PCR (3 weeks) +
Southern Blot (8 weeks) if required
Free T3
Free T4
Fructosamine
FSH
FTA (IgG)
Full Blood Count
Fungal ID + Sens
G6PD
Gabapentin
Gall Stone Analysis
Gamma GT
128
FIAG
HCGF/
PAPA
ZZ10
FK5
FLEC
FLUD
CATF
FLU2
PROZ
RBCF
FOLA
OFH1
OFH2
OFH3
FOOD
B
4 hrs
B
A 4
A
SC
Fluid 4
SC
A 4
A
B
B RF, STM
A B G RF, STM
A B B G RF,2x STM
Submit sample
3 days
1-2 days
5 days
2-7 days
3 days
1 day
5 days
2 days
1 day
2 days
2 days
2 days
10 days
GENE
A A A 9
3-8 weeks
83
FT3
FT4
FRUC
FSH
FTA
FBC
FUID
G6PD
GABA
RSTA
GGT
B
B
B
B
B
A
Fungal sample/STM
A
B 4
STONE
B
4 hrs
4 hrs
3 days
4 hrs
2 days
4 hrs
14 days
5 days
5 days
10 days
4 hrs
31
31
20
31
53
25
28
26
96
20
20
104
96
96
28
115
28
96
25, 98
25, 98
119-120
119-120
119-120
28, 119
TEST
CODE
SAMPLE REQS
TAT
Ganglioside GM1, GD1B, GQ1B Abs
Gastric Parietal Autoantibodies
GENETIC TESTS
Gentamicin Assay
Gliadin Antibodies (IgA + IgG)
Globulin
Glomerular Basement Membrane Abs
Glucose
Glucose Tolerance (2 hrs)
Glucose Tolerance + Insulin
Glucose Tolerance Test
Glucose Tolerance Test (Extended)
Glucose Tolerance Test (Short)
Gluten Sensitivity Evaluation
Glycan Determinants
Glycosylated HB
Gonorrhoea (Culture)
Gonorrhoea (PCR swab)
Gonorrhoea (Thin Prep)
Gonorrhoea (Urine)
Group B Strep
Growth Hormone (Fasting)
H. pylori Antibodies (IgG)
H. pylori Antigen (Stool)
H1N1 (Swine Flu)
Haematology Profile
Haemochromatosis – HFE common
mutations C282Y+H63D
Haemoglobin
Haemoglobin Electrophoresis
Haemophilus Influenzae B Antibodies
GANG
GVPC
GASP
B
FCRU / PCR / TPV
B
5 days
5 days
2 days
GENT
GIAG
AGAB
GLOB
AGBM
RBG
GTTS
GTTI
GTT
GTTE
GTT3
GSA
GSA2
GSA3
ZZ27
GHB
GONN
SGON
TGON
CGON
GBS
GH
HBPA
HBQT
HBAG
H1N1
PP3
B 4
RF 9,14
B
B
B
G
G G 2x RU
X
G G G G G 5x RU(X)
G G G G G G 6x RU(X)
G G G 3x RU(X)
B
A B
A B
B
A
STM
PCR
TPV
FCRU
2x STM
B 7,35
B
J (Blowbag kit) 1
RF
2x PCR
A
4 hrs
2 days
2 days
4 hrs
2 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
2 days
10 days
10 days
3 days
6 hrs
2-3 days
2 days
5 days
2 days
3 days
4 hrs
2 days
2 days
3 days
1 day
4 hrs
54
45, 111
54
75
95
54, 59
54
20
54
20
95
95
95
95
95
54
53-54, 56
53-54, 56
104
20
28, 45
45
45, 111
45
28
31
54
54, 95
54
70
16, 26-27
HMD
A 9
3 days
21, 26, 83
HB
HBEL
HINF
4 hrs
4 days
7 days
26
26
61
Hair Mineral Analysis
HMA
A
A
B
2g (2 tbsp) of hair close to scalp 10 days
98
Harmony™ Prenatal Test (Non-Invasive
Prenatal Testing) – common aneuploidy
screening from maternal blood
Hazelnut Components
HbA1c
HDL Cholesterol
HE4 + ROMA
PAGE
NIPT
J/Special tubes 1
up to
10 days
83
ZZ11
GHB
HDL
HE4
B
A
B
B
3 days
6 hrs
4 hrs
1 day
104
21
21
71
129
130
TEST
CODE
SAMPLE REQS
TAT
Hepatitis (Acute) Screen
Hepatitis A (IgM)
Hepatitis A Profile
Hepatitis A, B & C Profile
Hepatitis B ‘e’ Antigen and Antibody
Hepatitis B (PCR) Genotype
Hepatitis B Core Antibody – IgM
Hepatitis B Core Antibody – Total
Hepatitis B Immunity
Hepatitis B Profile
Hepatitis B Resistant Mutation
Hepatitis B sAg
Hepatitis C Abs Confirmation (RIBA)
Hepatitis C Genotype
Hepatitis Delta Antibody
Hepatitis Delta Antigen
Hepatitis Delta RNA
Hepatitis E IgG/IgM
Hepatitis G (PCR)
Herpes I/II Antibody Profile (IgG)
Herpes Simplex I/II from
symptomatic lesion
Herpes Simplex I/II IgM
HFE gene (Haemochromatosis) –
common mutations C282Y + H63D
Hirsutism Profile
HIV 1 & 2/p24Ag
HIV Confirmation of Positive Screens
(Using 3 methodologies)
HIV Drug Resistance Genotyping
HIV Screening: HIV1&2 Abs/p24 Ag
with Syphilis
AHSC
HAVM
HAIM
HEPA
ABC
HEPE
BGEN
HBCM
HBC
DNAB
HBIM
HEPB
HBRM
AUAG
RIBA
HEPC
HCAG
CGEN
QPCR
HEPD
HDAG
DRNA
HBE
HEPG
HERP
HERD
HERS
B
B
B
B
B
B
A
B
B
A
B
B
A or B
B
B
B
B
A
A
B
B
A (Frozen plasma)
B
A (Frozen plasma)
B
FCRU / PCR/ TPV PCR
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
7 days
4 hrs
4 hrs
5 days
4 hrs
4 hrs
7 days
4 hrs
5 days
4 hrs
4 hrs
5 days
5 days
5 days
5 days
5 days
5 days
2 weeks
2 days
5 days
5 days
53, 62
62
61-62
45, 62
62
62
62
62
62
62, 70
61-62
62
62
45, 62
62
45, 62
45, 62
62
62, 70
62
62
62
62
62
68
45, 68, 111
45, 68
PAGE
HERS
PCR
5 days
69
HERM
B
2 days
68
HMD
A 9
3 days
21, 26, 83
HIRP
CURT
HDUO
IDSQ
HIV2
B
B
B
A A
4 hrs
10-14 days
4 hrs
5 days
5 days
31, 35
54-55, 101
45, 66
66, 70
66
HIVC
B
1 day
66
HIVD
HDUO
STDX
A
B
A 10mls or 2 x 4mls
7 days
4 hrs
3 days
66
45, 66
45, 51, 62, 66, 70
STXX
3 days
45
TEST
CODE
SAMPLE REQS
TAT
HLA DR Antigens
HLA DQ Alpha Antigens
HLA DQ Beta Antigens
House Dust Mite Components
HPV (individual low & high risk
DNA subtypes)
HPV (HR DNA type 16, 18 + others)
HPV DNA types 16, 18 + collective
reporting of 12 other High Risk DNA
subtypes
HPV DNA types 16, 18 + all other
High Risk DNA subtypes
HPV mRNA only
HPV Typed DNA
HRT Profile 1
HRT Profile 2
HTLV 1&2 Abs. (Human T Lymphotropic
Virus Type I-II)
Hughes Syndrome
Human Herpes Virus – 6 (IgG/IgM) Ab
Human Herpes Virus – 8 (IgG)
HVS (inc. Mycoplasma + Ureaplasma)
9RF
10RF
11RF
HOMO
ZZ12
A A
A A
A A
B 17
B
2 weeks
2 weeks
2 weeks
1 day
3 days
33
33
33
21, 26
104
HP20
PCR/TPV
5 days
45, 70
HPVT
HPV
TPV
TPV
5 days
2 days
45, 70
45, 70, 114
HPV
TPV
2 days
114
HPV
TPV
2 days
45, 70, 114
HPVR
HP20
HRT
HRT2
TPV
TPV/PCR
B
B G
3 days
5 days
4 hrs
4 hrs
114
114
31, 35
31, 35
HTLV
B
8 hrs
66
LUPA
HSV6
HHV8
HVS
IgE (Total)
IGE
IGF-1 (Somatomedin)
IGF-BP3
IgG Subclasses
Imipramine
Immunoglobulin A
SOMA
IGF3
IGSC
IMIP
IGA
Immunoglobulin E – Total
IGE
Immunoglobulin G
Immunoglobulin M
Impotence Profile
Influenza Screen
Inhibin B
INR
Insect/Worm/Ova/Cysts
Insulin
Insulin Antibodies
Insulin Resistance (Fasting)
Interleukin 1 Beta
IGG
IGM
IMM
IMPO
INFL
INIB
PTIM
FLEA
INSU
INAB
FIRI
ILB
B C 4,18
B
B
STM
2 days
2 days
10 days
2-3 days
B
1 day
B (Frozen) 4
B (Frozen) 4
B
A 4
B
1 day
5 days
4 days
4 days
4 hrs
B
1 day
B
B
B
A B B G
B
B (Day 3 of cycle,frozen)
C 18
Send Specimen 9,14
B
B
B G
B (frozen) 4,7
4 hrs
4 hrs
4 hrs
3 days
2 days
5 days
4 hrs
5 days
4 hrs
5 days
4 hrs
1-2 weeks
PAGE
26
68-70
68
28
21-22,
54-55, 101
31-32
31
21
96
21
21-22,
54-55, 101
21
21
21, 54
31
54
31
26
59
31
54
31
54
131
132
TEST
CODE
SAMPLE REQS
TAT
Interleukin 2
Interleukin 4
Interleukin 6
Interleukin 8
Interleukin 10
Intrinsic Factor Antibodies
Iron
Iron Binding Capacity
Iron Overload Profile
Iron Status Profile
ISAC Panel
IUCD for Culture
JAK 2 – V617F common mutation
Jewish Carrier Screen
KIR (Killer-like Immunoglobulin-like
Receptors) Genotyping
Kiwi Components
Lactate (Plasma)
Lactate Dehydrogenase (LDH)
Lactose Tolerance Test
Lamotrigine
Latex Components
Lead (Blood)
Lead
Lead Profile (Hb, ZPP, Lead)
Legionella Antibodies
Leishmania Blood Film
Leucocyte Antibody Detection MALE
Leucocyte Antibody Detection FEMALE
Levetiracetam (Keppra)
Lipase
Lipid Profile
Lipid Transfer Proteins
Lipocalins
Lipoprotein (a)
Liver Fibrosis
(Enhanced Liver Fibrosis ELF)
Liver Fibrosis Fibrotest
Liver Function Tests
Liver Kidney Microsomal Antibodies
IL2
IL4
IL6
IL8
IL10
IFAB
FE
TIBC
IOP
ISP
ISAC
ICAB
IUCD
JAK2
GENE
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B (frozen) 4,7
B
B
B
A A B 9
B
B
B
Send Device
A 9
A 9
1-2 weeks
1-2 weeks
1-2 weeks
1-2 weeks
1-2 weeks
2 days
4 hrs
4 hrs
3 days
4 hrs
3 days
2 days
10 days
17RF
A A A 2-3 weeks
33
ZZ32
LACT
LDH
LTT
LAMO
ZZ13
LEAD
URPB
LEAZ
LEGO
LEGA
LEIS
LEIF
7RF
8RF
LEVE
LIPA
LIPP
ZZ23
ZZ28
LPOA
LITH
B
G 16
B
J 1
B 4
B
A
RU
A 13
B
RU
B
A
H H H 3,4,6
B 3,4,6
B 4
B
B
B
B
B
B
3 days
1 day
4 hrs
8 hrs
5 days
3 days
5 days
5 days
3-5 days
2 days
1 day
2 days
8 hrs
1 week
1 week
3 days
4 hrs
4 hrs
3 days
3 days
4 hrs
4 hrs
104
21
21
95
96
104
21, 118
21, 119
118
54
28, 54
59
26
33
33
96
21
21, 23
104
104
21
21, 96
ELF
B
6 days
20-21
FIBT
LFT
LKM
B B
B
2 weeks
4 hrs
2 days
20-21
21, 23
54
10 days
4 weeks
PAGE
54
54
54
54
54
54
21
21
21, 23, 93
21, 23
101
54
28
84
93
TEST
Lorazepam
NEW Lp-PLA2 (PLAC) Test
Lupus Anticoagulant and
Anticardiolipin Abs
Lupus Anticoagulant only
Luteinising Hormone (LH)
Lyme Disease (Borrelia Abs) IgG, IgM
Lyme Disease (Borrelia Abs) IgM
Lymphocyte Immunophenotyping
(Leukaemia)
Lymphocyte Subsets (CD3/CD4/CD8)
Macroprolactin
Magnesium (Blood)
Magnesium
Magnesium (Urine)
Malarial Antibodies (Pl. falciparum)
Malarial Parasites
Male Genetic Reproductive Profile
Male Recurrent Miscarriage Profile
Manganese (Serum)
Measles, Mumps, Rubella (MMR)
Meningococcal Abs
Menopause Profile
Mercury (Blood)
Mercury
Metabolic Syndrome Profile
Metanephrines (Plasma)
Metanephrines (Urine)
Methaqualone
Methotrexate
Metronidazole Level
Microalbumin (Urine)
Microfilaria Blood Film
Mineral Screen
Mineral Screen – Whole blood
Mineral Screen and Rbc Industrial
Heavy Metal Screen (Trace Metals)
Miscarriage/Thrombotic Risk Profile
MRSA (Rapid PCR) one swab per site
MRSA Culture one swab per site
CODE
LORA
PLA2
SAMPLE REQS
TAT
A 4
B
10 days
2 days
PAGE
96
21-22
LUPA
B C 4,18
2 days
26, 54
LUPC
LH
BORR
BORM
C C B
B 9,14
B
2 days
4 hrs
2 days
2 days
26
31
53-54, 59
53-54, 59
LYPT
A 4,5
5 days
26
18
LYSS
PRLD
RCMG
MG
URMG
MALA
MALP
GRP
MIPR
MRMP
MANG
MEAS
MEAM
MMR
MENI
MENO
MERC
URHG
METS
PMET
UMEX
METQ
METX
METR
UMA
MICF
MINE
RMIN
A 10/Chex
B
A or H
B
PU
B 9,14
A 4,9,14
A H 9
B
Semen
B
B
B 9
B
B
B
A or H
RU 1
A B B G
A (Frozen plasma)
PU 1
RU
B
B 4
RU
A
B K
H H 2 days
4 days
4 days
4 hrs
1 day
2 days
STAT
15 days
4 hrs
15 days
5 days
1 day
2 days
1 day
2-4 weeks
4 hrs
5 days
5 days
9 days
7 days
5 days
5 days
2 days
7 days
4 hrs
STAT
5 days
5 days
25-26
31
98
21, 118
21, 119
59
26
43, 93
31, 34, 43
43
21, 118
61, 68
61, 68
61
54
32, 35
21, 118
21, 119
32, 35
32
32
21
96
95
21
26
97-98
97-98
TRAC
B H K
7-10 days
98, 118
PROP
AMIT
MRSA
MRSW
A A B C C C B
Blue Micro Swab
Blue Micro Swab
18
5 days
2 days
4 hrs
2 days
26-27, 93
54
28, 70
28
133
TEST
CODE
SAMPLE REQS
TAT
PAGE
MTHFR – common C677T mutation
MTHFR – common C677T + A1298C
mutations
Mumps Antibodies (IgG)
Mycobacterium tuberculosis – DNA
Mycology/Skin Scrapings
Mycoplasma pneumoniae IgM and IgG
Mycoplasma/Ureaplasma Culture
Myeloma Screen
Myeloperoxidase Antibodies
Myoglobin (Serum)
Myositis Panel
Mysoline (Primidone)
N. Gonorrhoea
Nail Clippings
Needle Stick Injury Profile
MTHF
A 9
5 days
85
GENE
A 3 weeks
85
B
B
A
Submit Sample
FCRU / PCR / TPV
B
RU,Swab
A B G RU
B
B
B
B 4
TPV
Nail clippings
A A H 10
B B
1 day
1 day
5 days
3-4 weeks
5 days
2 days
2-3 days
3 days
2 days
4 hrs
5 days
3 days
5 days
3-4 weeks
2 days
4 hrs
TPV/PCR
5 days
B B
B
B
B
RU
2 days
5 days
5 days
5 days
5 days
Send Mon-Thurs
only
Send Mon-Thurs
only
1 week
2 weeks
1 week
1 week
Send Mon-Thurs
only
Send Mon-Thurs
only
MUMP
MUMM
TBPC
SKSC
MGEN
MYCO
MYCS
MYEL
MPO
SMYO
MYOS
PRIM
TGON
SKSC
NK1
NSI
TGON/
Neisseria Gonorrhoea – DNA
SGON
NVIR
Neurological Viral Screen
Neuronal Antibody (Hu, Ri, Yo, Cv2, Ma2) NEUR
NSE
Neurone Specific Enolase
NICK
Nickel (Serum)
Nickel
NICU
61
61, 68
70
28
45, 70, 111
68
28-29
21, 23
54
21
54
96
45, 111
28
26-27
119-120
70
68-69
54
71
21, 118
21, 119
NK (CD69) cell Assay
CD69
H 5,34
NK (CD69) and NK Cytotoxicity
69C
HHH 5,34
NK Assay/Cytotoxicity Panel
NK Assay Endometrial Biopsy (tissue)
NK Assay Follow-Up Panel
NK Assay Panel + Intralipids
4RF
15RF
5RF
16RF
H H H
Tissue
H H H
H H H
NK Cytotoxicity Assay
HSNK
HHH 5,34
NKCY
HHH 5,34
69CI
HHH 5,34
Send Mon-Thurs
only
33
NIPT
J/Special tubes 1
up to 10 days
86
DNA
OEST
B
B
2 days
4 hrs
54
32
NK Cytotoxicity w. suppression, steroid,
IVIg & Intralipin
NK Cytotoxicity with suppression with
steroid, IVIg and intralipin, and NK
(CD69) cell assay
Non-Invasive Prenatal Testing – common
aneuploidy screening from maternal blood
Nucleic Acid Antigen Antibodies
Oestradiol (E2)
134
9
33
33
33
33
33
33
33
33
TEST
Oestriol (Estriol)
Oestrone
Olanzapine
Oligoclonal Bands
Olive Components
Omega 3/Omega 6
Osmolality (Serum)
Osmolality (Urine)
Osteocalcin
Osteoporosis Screen
Ovarian Autoantibodies
Oxalate (Urine)
Oxidative Stress in Semen (ROS)
PAI1 4G/5G Polymorphism
PAP – Thin Prep (Cervical Cytology)
Paracetamol
Parathyroid Hormone (Whole)
Parvalbumins
Parvovirus Antibodies (IgM)
Parvovirus IgG Antibodies
Parvovirus IgG/IgM Abs
Paternity Testing (postnatal and
prenatal) – sample required from each
person being tested (3 people)
Paul Bunnell (Monospot)
PCA3 (Molecular test for the detection
of prostate cancer from urine)
Peach Components
Peanut Components
Pemphigus/Pemphigoid Autoantibodies
Pertussis (Whooping Cough) Antibodies
Pertussis by PCR
Pethidine – Urine
Phencyclidine (PCP)
Phenobarbitone
Phenytoin (Epanutin)
Phosphate
Phosphate (24 hr Urine)
Phospholipid Antibodies
NEW PLAC Test (Lp-PLA2)
Plasma Viscosity
Platelet Count
Pleural Fluid for Culture
CODE
SAMPLE REQS
TAT
E3
E1
OLAN
CSFO
ZZ14
OMG3
OSMO
ROSM
OST
OPS
OVAB
UOXA
SROS
PAIP
PAPT
PARA
PTHI
ZZ29
PARV
PARG
PARP
B B
B B
A 4
CSF+B
B
A 4
B
RU
B (Frozen) 4
B B
B
PU
Semen 1
A
TPV
B
B 4
B
B
B
B
4 days
4 days
5 days
5 days
3 days
4 days
1 day
1 day
4 days
4 days
2 days
5 days
1 day
10 days
2-3 days
4 hrs
1 day
3 days
2 days
2 days
2 days
Contact
Lab
A/AF/CVS 9,11,12
5 days
86
A or B
8 hrs
26
7 days
71
3 days
3 days
2 days
5 days
5 days
4 weeks
5 days
4 hrs
4 hrs
4 hrs
4 hrs
2 days
1 day
2 days
3 days
4 hrs
2 days
104
104
54-55
61
70
119
22
96
96
22
22
54
32, 35
21-22
26
26
28
PAUL
PCA3
ZZ15
ZZ16
SKAB
PERS
PERP
UPET
DUST
PHB
PHEN
PHOS
UPH
PLIP
PITF
PLA2
VISC
PLTS
FLUP
J 1,6
B
B
B
B Throat swab PCR
RU
RU
B
B
B
PU
B
B B
B
A 4
A
SC
PAGE
32
32
96
54
104
98-99
21
21
32, 71
21, 24
54
21
41
26
111
96
32
104
68
68
68
135
136
TEST
CODE
SAMPLE REQS
TAT
Pneumococcal Antigen
Pneumocystis Examination
Pneumonia (Atypical) Screen
Polcalcins
Polio Virus 1, 2, 3 Antibodies
Polycystic Ovary Syndrome Profile
Porphyrin (Blood)
Porphyrins (Faeces)
Porphyrins Screen (Total: Urine, Stool,
Blood)
Porphyrins Screen (Urine)
Potassium
PR-10 Proteins
PNEU
PNAG
PCYS
APS
ZZ25
POLO
PCOP
PORP
FPOR
B
RU
BAL*
B
B
B 9
A B B B G 7
A 3
RF 3
7 days
1 day
1 day
2 days
3 days
5 days
5 days
15 days
15 days
54, 61
28
28
68-69
104
61
32, 35
22
22
PORS
A RU, RF 3
15 days
22
RPOR
PTS
PTS2
K
ZZ22
RU A A B G 14
A A B B B G 14
B
B
15 days
10 days
10 days
4 hrs
3 days
DVT1
A A B 9
5 days
Pregnancy Test (Urine)
Pregnenolone
Primidone (Mysoline)
Procalcitonin
Profilins
Progesterone
Proinsulin
Prolactin
Prolactin (Macro)
Propanalol
Propoxyphene
Prostate Profile (Total & Free PSA)
Prostate Specific Antigen (Total)*
Protein (Urine)
Protein C
Protein S Free Ag
Protein Total (Blood)
Protein/Creatinine Ratio (Urine)
Proteinase 3 Ab
Prothrombin Time
Prothrombin Time + Dose
Q Fever (C Burnetti) Antibodies
Rabies Antibody
QHCG
PREG
PREN
PRIM
PCAL
ZZ24
PROG
PROI
PROL
PRLD
PRO
DPRO
PR2
PSPA
UPRT
PRC
PRTE
FPRS
PROT
UCPR
PR3
PTIM
PT+D
QFEV
RABI
B
RU
B
B 4
B (Frozen) 4,7
B
B
B (Frozen)
B
B
B 4
RU
B
B
CU
C (Frozen) 4,9,18
B
C (Frozen) 4,9,18
B
RU
B
C 18
C 18
B 9
B
4 hrs
4 hrs
5 days
3 days
1 day
3 days
4 hrs
5 days
4 hrs
4 days
7 days
5 days
4 hrs
4 hrs
4 hrs
3 days
2-4 days
3 days
4 hrs
4 hrs
2 days
4 hrs
4 hrs
3 days
10 days
22
59-60
59-60
22
104
25, 27, 56, 59-60
22, 32
22
32
96
22
104
32
32
32
32
96
22
71
71
22
26
22
26
22
22
54
26
26
68
61
3
PAGE
TEST
CODE
Rapid Strep (incl. m/c/s)
Recurrent Miscarriage Profile (Female)
Renal Stone Analysis
Renin
Reproductive Immunophenotype Panel
RAPS
RMP
RSTA
RENI
3RF
SAMPLE REQS
TAT
2 days**
10-15 days
10 days
5 days
1 week
RSV
RESP
ARAB
RETC
RTRO
RT3
RF
RH
RH2
RH3
RH4
RH5
RH6
STM**
A A B C C C H 9,18
STONE
H H H
PCR or as
specified
B
B
B
A
Contact Lab
B 7,37
B
A B
A A B B
A B
A B B
A A B B
B
Respiratory Samples – Viral PCR
VPR
Respiratory Synctial Virus
Respiratory Viral Screen
Reticulin Antibodies (IgA)
Reticulocyte Count
Retrograde Ejaculation
Reverse T3
Rheumatoid Factor (Latex Test)
Rheumatology Profile 1 (Screen)
Rheumatology Profile 2 (Connective tissue)
Rheumatology Profile 3 (Rheumatoid/Basic)
Rheumatology Profile 4 (Systemic Lupus)
Rheumatology Profile 5 (Mono Arthritis)
Rheumatology Profile 6 (Rheumatoid Plus)
Rheumatology Profile 7
(Srogren’s syndrome)
Rhinitis Provoking Profile
Rickettsial Species Antibodies
Risperidone
Rotavirus in Stool
Rubella Virus – RNA by PCR
S100 Malignant Melanoma
Salicylates
Salivary Duct Antibodies
Schistosoma (Urine)
Schistosome (Bilharzia) Antibodies
Schistosome Antigen
Screening Profile 1 – Biochemistry
Screening Profile 2 – Haematology/
Biochemistry
Screening Profile 3 – Haematology
Screening Profile 4 –
Haematology/Biochemistry (Short)
Haematology/Biochemistry (Postal)
Screening Profile 6 – Well Person
RH7
PAGE
28
93
22
32, 95
33
5 days
69
2 days
2 days
2 days
4 hrs
2 days
10 days
1 day
2 days
3 days
2 days
2 days
3 days
2 days
68
68-69
54
26
41
32
55
55, 58
55, 58
55, 58
55, 58
55, 58
55, 58
B
2 days
55, 58
B
B
A 4
RF
B
B
A/Amniotic Fluid
B
B
B
Mid-morning terminal urine
B 14
B
B G
2 days
2 days
7 days
8 hrs
4 hrs
4 hrs
5 days
4 days
4 hrs
2 days
8 hrs
2 days
3 weeks
4 hrs
101
55, 59
96
28
61, 68
61, 68
61, 70
71
22
55
28
59
59
16
PP2
A B G
4 hrs
16
PP3
A 4 hrs
16, 26-27
PP4
A B G
4 hrs
16
PP5
A B G
4 hrs
16
PP6
A B G
4 hrs
16
ALRN
RICK
RISP
ROTA
RUBE
RUBM
RUBP
S100
SALI
SAB
USCH
BILH
SHAG
PP1
137
138
TEST
CODE
SAMPLE REQS
TAT
PAGE
Screening Profile 7 – Well Man
Screening Profile 8 – Well Woman
Screening Profile 9F – Senior Female
Screening Profile 9M – Senior Male
Cardiovascular Risk 1
Cardiovascular Risk 2
Seed Storage Proteins
Selenium (Blood)
Selenium (Serum)
Sellotape Test
Semen Analysis
Semen Analysis, Comprehensive
Semen Analysis, Post-Vasectomy**
Semen Analysis, Vasectomy Reversal
Semen Culture
Semen Fructose
Semen Leucocytes
Semen Parameters
Serotonin
Serum Albumins
PP7
PP8
PP9F
PP9M
A B G
A B G TPV
A B B G RU RF 4
A B B G RU RF 4
4 hrs
4 hrs
2 days
2 days
16
17
17
17
PP10
B B
3 days
17, 20, 24
PP11
B B B C 34
3 days
17, 20, 24
PP12
FCRU/PCR/TPV/Semen
2 days
ZZ26
SELR
SELE
SELL
B
A or H
B
Send Sample***
3 days
4 days
4 days
1 day
SPER
PVAS
SPER
SPCU
SPCF
PMNS
SPOD
SERT
ZZ30
SHBG
Semen 1
Semen 1
Semen 1
Semen
Semen
Semen
Semen 1
H (Frozen whole blood) 1
B
B
2 days*
2 days
2 days*
2-3 days
2 days
2 days
1 day
10 days
3 days
4 hrs
PP12
FCRU/PCR/TPV/Semen
2 days
Shigella Abs
Shrimp Components
Sickle Cells
Silver (Blood)
Silver (Urine)
Sinequan (Doxepin)
Sirolimus
Skin (Pemphigus/Pemphigoid)
Autoantibodies
Skin Scrapings/Mycology
Skin/Mucosal Swab
Sodium
Somatomedin (IGF-1)
Soybean Components
Specific Gravity (Urine)
SHIG
ZZ17
SICK
SILV
USIL
DOXE
SIRO
RH7
B
B
A
B
RU
A
A
B
5 days
3 days
4 days
5 days
5 days
10 days
3 days
2 days
45, 51,
70, 111
104
22, 98
22, 98
28
40
41
41
41
28, 41
41
41
41
32
104
32
45, 51,
70, 111
59
104
26
22, 118
22, 119
96, 119
96
55, 58
SKAB
B
2 days
54-55
SKSC
VPSK
ASMO
NA
SOMA
ZZ18
USG
Send Sample
PCR
B
B
B (Frozen) 4
B
RU
3-4 weeks
5 days
2 days
4 hrs
1 day
3 days
8 hrs
28
69
55
22
31-32
104
28
TEST
CODE
SAMPLE REQS
TAT
Sperm Antibodies (Serum)
Sperm Antibodies /MAR Test (Semen)
Sperm DNA Fragmentation (SCSA)
Sperm Morphology (Kruger strict criteria)
Sports/Performance Profile
Sputum for Routine Culture
Sputum for TB Culture (AFB)
Squamous Cell Carcinoma
STD Profiles STD1-STD9
STD Quad
Steroid Cell Antibody
Stool for OCP and Culture
Stool for OVA Cysts & Parasites
Streptomycin Levels
Striated/Skeletal Muscle Antibody
Sulpiride
Suppression with steroid, IVIg and
intralipin, NK (CD69) cell assay,
TH1/TH2 cytokines Swab for Culture (Any Site)
Synacthen Stimulation Test
Synovial Fluid (For Crystals)
Syphilis by PCR (chancre)
Syphilis IgG/IgM
T3
T3 (Reverse)
Tacrolimus/Prograf (FK506)
Tay Sachs Screen – 5 common mutations
TB (pleuralfluid)
TB Culture
TB Culture (Urine)
TB Quantiferon®-TB Gold
TB Slopes – Confirmation and Sensitivity
Tegretol (Carbamazepine)
Teicoplanin Assay
Telomere Analysis Technology (Life Length)
Temazepam
Testicular Autoantibodies
Testicular Tumour Profile
Testosterone
Testosterone (Free)
Tetanus Screen
SPPL
ASAB
ASPA
SEXT
MRPH
SPOR
SPU1
SPU2
SCC
Semen 1
B
Semen
Semen 1
Semen 1
A A A B B B B G K 4
SC
SC
B
4-6 weeks
5 days
1 day
2-3 weeks
2 days
5 days
2-3 days
up to 8 weeks
4 days
STDQ
SCA
SPAR
OCP
STRM
STRA
SULP
B FCRU
B
RF
RF
F
B
B 4
2 days
2-3 days
1 day
5 days
2 days
4 days
NCIT
HHH 5,34
SWAB
SYNA
FLU2
SYPS
SERJ
T3
RT3
FK5
GENE
TBCU
SPU2
TBUR
TBQ
TBSL
CARB
TEIC
TSPA
TEMA
TAB
TTP
TEST
FTES
TETA
STM
X
SC
PCR
B
B
B 7,37
A 4
A 9
SC
SC
3x EMU
J/special tubes 1
TB slope (LJ medium-green) 6
B
B
HHH
B 4
B
B
B
B
B
TH1/TH2 cytokine profile
1TH2
HHH 5,34
Send Mon-Thurs
only
2-3 days
4 hrs
1 day
5 days
4 hrs
4 hrs
10 days
1-2 days
3 weeks
up to 8 weeks
up to 8 weeks
up to 8 weeks
3 days
up to 8 weeks
4 hrs
5 days
4 weeks
4 days
2 days
4 hrs
4 hrs
3 days
5 days
Send Mon-Thurs
only
PAGE
41
41, 55
41
41
41
97-98
28
28
71
50-51
51
55
29
29
96
55
96
33
29, 45
95
29
45
45, 55
32
32
96
87
29
29
29
55
29
96
95
97
96
55
71
32
32
61
33
139
140
TEST
CODE
TH1/TH2 Cytokine Ratio
Thalassaemia Screen
Theophylline
Thiopurine Methyl Transferase
Thrombotic Risk Profile
Thyroglobulin Abs
Thyroglobulin Assay
Thyroid Abs (incl. TGAB + TPEX)
Thyroid Peroxidase
Thyroid Peroxidase Antibodies/Anti TPO
Thyroid Profile 1
Thyroid Profile 2
Thyroid Profile 3
Thyroxine (T4)
Timothy Grass Components
Tissue for culture
Tissue Transglutaminase IgA (Coeliac)
Tissue Transglutaminase IgG
Tobramycin Assay
Topiramate (Topamax)
Torch Screen
Total IgE
Trace Metal (Blood) Profile
Transferrin
Trichomonas vaginalis (Genital) Culture
Triglycerides
Trimipramine
Tropical Screen
Tropomyosins
Troponin T
Tryptase
TSH
Urate (Uric Acid)
Urea
Urea (Urine)
Urea Electrolytes (Urine)
Ureaplasma urealyticum
Ureaplasma/Mycoplasma Culture
Uric Acid (Serum)
6RF
THSC
THEO
TPMT
PROP
TGAB
TGA
THAB
TPEX
TPEX
TF
TF2
TF3
T4
ZZ19
TISS
TAA
TAAG
TOBR
TOPI
TORC
IGE
TFAM
TRAC
TRAN
TVAG
TVPC
TRI
TRIM
TROP
ZZ31
TROT
STRY
TSH
TSI
UA
UREA
UURE
U/E
UELE
UGEN
MYCS
UA
SAMPLE REQS
TAT
H H H 5
A
B
A 5
A A B C C C 18
B
B
B
B
B
B
B
B
B
B
Tissue sample
B
B
B
B 4
B
B
B 9
B H K B
Blue Micro Swab
FCRU / PCR / TPV
B
A
B B 9,14
B
B
B
B
B
B
B
CU
B
CU
FCRU / PCR / TPV
RU,Swab
B
1 week
4 days
4 hrs
5 days
5 days
1 day
1 day
1 day
1 day
1 day
4 hrs
2 days
4 hrs
4 hrs
3 days
up to 7 days
2 days
5 days
3 days
4 days
2 days
1 day
4 hrs
7-10 days
1 day
2 days
5 days
4 hrs
5 days
10 days
3 days
4 hrs
5 days
4 hrs
4 days
4 hrs
4 hrs
4 hrs
4 hrs
4 hrs
5 days
2-3 days
4 hrs
PAGE
33
26
96
22
26-27, 93
32
32
32, 55
32
55
32, 34
32, 34
32, 34
32
104
29
55
55
95
96
55, 68-69
21-22, 54-55, 101
59, 68
118
22
45
45, 111
22
96
59-60
104
22
22
32
32, 55
22
22
22
22-23
20, 22
45, 70, 111
28-29
22
TEST
CODE
SAMPLE REQS
TAT
PAGE
Uric Acid (Urine)
Urine (Microscopy Only)
Urine Cytology (Urine cytology containers
available from TDL Supplies)
Urine for Microscopy and Culture
Urobilinogen (Urine)
Urticaria Test (Histamine Releasing)
Valium (Diazepam)
Valproic Acid (Epilim)
Vancomycin Hydrochloride
VDRL (RPR)
Venom Components
Vigabatrin (Sabril)
Viral Antibody Screen
Viscosity (Plasma)
Vitamin A (Retinol)
Vitamin B Profile
Vitamin B1 (Thiamine)
Vitamin B2 (Riboflavin)
Vitamin B3 (Nicotinamide)
Vitamin B6 (Pyridoxine)
Vitamin B9 (Folic acid) – Red cell
Vitamin B9 (Folic acid) – Serum
Vitamin C (Active)
Vitamin D (1, 25 Dihydroxy)
Vitamin D (25-OH)
Vitamin E (Alpha Tocopherol)
Vitamin Profile 1
Vitamin Profile 2
VMA
Von Willebrand Profile
Wall Pellitory Components
Walnut Components
Wheat Components
Y chromosome microdeletions
– AZFa + AZFb + AZFc + SRY
Zinc (Blood)
Zinc (Serum/Plasma)
Zinc (Urine)
UURI
UMIC
CU
RU
4 hrs
1 day
22
29
URCY
Urine 21
2 days
115
UCEM
UURO
CURT
DIAZ
VALP
VANC
VZOS
VZOM
VDRL
ZZ33
VIGA
VIRA
VISC
VITA
VBP
VIT1
B12
B12F
VIB2
VIB3
VITB
RBCF
FOLA
VITC
D3
VITD
VITE
VITS
VIT2
UVMA
FVWF
ZZ20
ZZ34
ZZ21
RU
RU
B
A
B
B
B
B
B
B
A
B B
A 4
B
A A B 13
A 13
B
A B
A 13
B A 13
A
B
B (Frozen) 7
B (Frozen) B
B A B B 7,13
A A A B B 7,13
PU 1
C (Frozen) 4,12
B
B
B
1-2 days
1 day
10-14 days
7 days
4 hrs
4 hrs
1 day
2 days
2 days
3 days
10 days
2 days
3 days
5 days
5 days
5 days
1 day
2 days
5 days
5 days
5 days
2 days
1 day
5 days
5-8 days
4 hrs
5 days
5 days
5 days
5 days
5 days
3 days
3 days
3 days
YDEL
A 9
5 days
88
RBCZ
ZINC
URZN
A or H
K
CU
5 days
1 day
5 days
98
98, 118
98, 119
29
22
54-55, 101
96
96
95
61, 68
61, 68
55
104
96
68-69
26
98
97-98
98
22, 26, 98
25-26, 98
98
98
98
98
25, 98
98
98
22, 98
98
97-98
97-98
22
26-27
104
104
104
141
TDL Referral labs
For certain specialist tests TDL has developed a selected network of reference laboratories.
The quality of these laboratories is recognised by CPA, or similar accreditation bodies for
laboratories outside the UK.
ABS Laboratories Ltd
Academic Medical Centre
Addenbrooke’s Hospital –
BGU and Immunology
Alan E Beer Lab
Alder Hey Liverpool
Anthony Nolan Lab
Biolab Medical Unit
Biomnis
Royal Free Hospital
– Department of Microbiology
Hospital For Tropical Diseases –
Clinical Parasitology Department
Royal Free Hospital –
Haematostasis Department
Independent Histopathology Services
Royal Free Hospital –
Virology Department
Institute of Neurology –
Department of Neuroimmunology
Institute of Neurology –
Neurogenetics Unit
Royal Surrey County Hospital –
SAS Peptide Hormone Section
Royal Victoria Infirmary
SAS Leeds – Steroid Hormone Centre
Bioscientia
Institute of Neurology Pharmacology
& Therapeutics Unit
Brucella Special Diagnostics Unit
IQUR Ltd
Kennedy Galton Centre
– Northwick Park Hospital
SCSA Diagnostics
Cambridge Life Sciences
Cambridge Nutritional Science Ltd
Cardiff & Vale Immunology
Cardiff Toxicology Laboratory
Cerba
Charing Cross Hospital –
Chemical Pathology Department
Infection and Immunity
Medical Oncology
Chelsea and Westminster Hospital
Childlab
Churchill Hospital –
Immunology Department
Laboratory of The Government
Chemist (LGC)
Latis Scientific
Life Length
London School of Hygiene
& Tropical Medicine –
Diagnostic Parasitology Lab
Manchester Royal Infirmary –
Meningococcal Ref Unit
Mayo Medical Laboratories
Micropathology Ltd
Mycology Reference Centre –
Department of Microbiology, Leeds
Schottdorf
Sheffield Children’s NHS Trust –
Clinical Chemistry
Sheffield Northern General Hospital –
Protein Ref Laboratory
Singleton Hospital –
Toxoplasma Reference Lab
Southmead Hospital –
Antimicrobial Ref Lab
St Barts – Antenatal Screening
Service DEPM
St George’s Hospital – Cell Markers
St Helier – Biochemistry Department
St Helier – Immunology Department
St Mary’s Hospital – Virology Department
Synergy Health Laboratory Services
City Hospital, Birmingham –
Clinical Biochemistry Department
National Blood Service –
Red Cell Immuno Haematology
Department
CNC forensic toxicology
National Mycobacterium Reference Lab
Trace Laboratories Ltd
Cromwell Hospital
UCLH Biochemistry
The European Laboratory of Nutrients
Nutritional Analytical Service
– University of Stirling
Douglass Hanly Moir Pathology
Pathcare Reference Lab
UCLH Department of Histopathology
Genoid Kft
Perinatal Centre
UCLH Haematology Department
Great Ormond Street Hospital –
Department of Chemical Pathology
PHE Brucella reference unit
UCLH Special Haematology
PHE Centre For Infections
– Enteric And Respiratory Virus Lab
UCLH Virology Department
Enzyme Unit, Chemical Pathology
Immunology Department
Paediatric Malignancy
H & I Laboratory
PHE Centre For Infections
– Virus Reference Division
PHE Mycology reference laboratory –
Bristol
PHE Rare and imported pathogens
laboratory – Porton Downs
The Royal Marsden Hospital –
Department of Haematology / Oncology
UCLH Cytology
University of Utah School of Medicine
Viapath – Guy’s Biochemical Genetics
Laboratory
Viapath – Guy’s Purine Research
Laboratory
Viapath – Kings College Clinical
Biochemistry
Hammersmith Hospital –
Molecular Endocrinology
Reflab
Reproductive Immunology Associates
Viapath – St Thomas Hospital
Haemophilia Centre
Health Diagnostic Laboratory Inc
Rosalind Franklin University
Viapath – St Thomas Immunohistology
Health & Safety Laboratory
Royal Berkshire Hospital
– Clinical Biochemistry
Warwickshire Nuffield Hospital –
Histology Lab
Heartlands Hospital
142
Homerton University Hospital –
Department of Clinical Biochemistry
Bound Edge
Bound Edge
Bound Edge
Test required:
Integrated
Antenatal Screening Service for Down’s
Antenatal
Service
forDefects
Down’s
AntenatalScreening
Screening
Service
for
Down’s
Syndrome
&
Open Neural
Tube
Syndrome &
& Open
OpenNeural
NeuralTube
TubeDefects
Defects
Combined
Quadruple
AFP Only
Test required:
Integrated
Combined
Quadruple
AFP Only
Please print name of person who discussed this option with patient
Please print name of person who discussed this option with patient
Name of Consultant/GP
Name of Midwife
Name of Consultant/GP
Name of Midwife
pATieNT DeTAilS
pATieNT DeTAilS
Surname:
Hospital No.:
Hospital No.:
Date of birth:
Date of birth:
Post code:
Post code:
Surname:
Forename:
Forename:
NHS No.:
NHS No.:
DD
MM
YY
DD
MM
YY
CliNiCAl DeTAilS (To be completed by Midwife or Doctor)
CliNiCAl
DeTAilS
be completed
Does the patient have Insulin dependent diabetes?
First
day of Last Menstrual
Period(To
(LMP)
D D by
M Midwife
M
Y Yor Doctor)
First
day of Last
Menstrual
(LMP)
Any vaginal
bleeding
in the Period
last 7 days?
DD
MM
YY
Outer
pages
when
folded
Outer
Outer
pages
pages
when
when
folded
folded
(no=0, yes=1) If yes please see overleaf)
Any vaginal bleeding in the last 7 days?
(no=0,
yes=1)
If yes(kgs)
please see overleaf)
Maternal
weight
Maternal
weight Tube
(kgs) Defect pregnancies
Previous Neural
(none=0, one=1, two or more=2)
Previous Neural Tube Defect pregnancies
(none=0, one=1,
twoSyndrome
or more=2)pregnancies (none=0,
Previous
Down’s
non-inherited=1, inherited translocation=2, type not known=3)
Previous Down’s Syndrome pregnancies (none=0,
non-inherited=1,
translocation=2,
known=3)
If
you have hadinherited
a previous
pregnancy type
withnot
Down’s
Syndrome, how old was she at the time?
If you have had a previous pregnancy with Down’s
Syndrome,
howchromosomal
old was she at
the time?(no=0, yes=1).
Previous other
pregnancy
MM
YY
If
yes egg
collection
embryo
transfer
datedate:
DD
MM
YY
embryo
If egg(s) transfer
donateddate
enter the donor’s DOB
DD
MM
YY
If
donated
donor’s DOB
If egg(s)
unknown,
enter enter
donorthe
age
DD
MM
YY
If
yes,
cigarettes
per day
Did
thenumber
patient of
take
a daily supplement
containing Folic Acid?
(no=0, before becoming pregnant=1, once she knew she was
Did
the patient take a daily supplement containing Folic Acid?
pregnant=2)
(no=0, before becoming pregnant=1, once she knew she was
pregnant=2)
Has the patient had pre-eclampsia in a previous pregnancy?
(no=0, yes=1)
Indian/Pakistani/Bangladeshi/Sri Lankan=4,
Has the patient had pre-eclampsia in a previous pregnancy?
(no=0,
yes=1) has had an amniocentesis performed prior to this
If
the patient
test please see overleaf.
If the patient has had an amniocentesis performed prior to this
test please see overleaf.
Family
origin: (Black Asian=5
Caribbean/African=1
Whiteplease
European=2
Chinese/Japanese/SE
Other=6). If other,
specify:
Indian/Pakistani/Bangladeshi/Sri Lankan=4,
Chinese/Japanese/SE Asian=5 Other=6). If other, please specify:
DD
MM
YY
DD
MM
YY
FETUS 1
FETUS 2
Nuchal translucency (NT) (mm): FETUS 1
FETUS 2
Nuchal
translucency
(NT) (mm):
Crown rump
length (CRL)
(mm):
Hospital
where
scanned
Number of
fetuses
Crown
rump length (CRL)
(mm):
Head circumference
(HC) (mm):
Number
of fetuses
If twins are
they monochorionic or dichorionic? (MC=1, DC=2)
Head circumference (HC) (mm):
Gestational age at time of scan
If
twinsBone
are they
monochorionic
Nasal
present
(no=0, yes=1)or dichorionic? (MC=1, DC=2)
Nasal Bone
present (no=0, yes=1)
Name
of Sonographer
Outer
pages
when
folded
Outer
Outer
pages
pages
when
when
folded
folded
DD
Does
patient
smoke? (no=0,
yes=1)
If yes,the
number
of cigarettes
per day
Family origin: (Black Caribbean/African=1 White European=2
Date of scan
Hospital where scanned
Is
thisegg
an IVF
pregnancy?
If yes
collection
date:
If
unknown,
enter smoke?
donor age
Does
the patient
(no=0, yes=1)
If yes, please specify abnormality and year diagnosed:
Previous other chromosomal pregnancy (no=0, yes=1).
If yes, please specify abnormality and year diagnosed:
ulTrASOuND SCAN
ulTrASOuND
SCAN
Date
of scan
(no=0, yes=1)
Does the patient have Insulin dependent diabetes?
(no=0,
Is thisyes=1)
an IVF pregnancy?
Gestational age at time of scan
EDD
weeks
DD
weeks
MM
YY
YY
Name of Sonographer
Date of sample
DD
MM
YY
EDD
Time taken
DD
MM
Blood sample taken by
Date of sample
If integrated test, date of 2nd sample
DD
DD
MM
MM
YY
YY
Time taken
Time taken
If integrated test, date of 2nd sample
DD
MM
YY
Time taken
ADDreSS TO WHiCH repOrT SHOulD Be SeNT
ADDreSS TO WHiCH repOrT SHOulD Be SeNT
Telephone No.
Fax No.
Telephone No.
Fax No.
TAP2547_CromwellLabGuide_2015_FORMS_V1.indd 1
days
days
19/11/2014 17:01
Bound Edge
LEUKAEMIC STUDIES REQUEST
Inner pages when folded
(Cytogenetics/Molecular Genetics)
THE DOCTORS
L A B O R AT O R Y
Leukaemic studies request
(Cytogenetics/Molecular Genetics)
Lab No: Priority Code:
Surname: First Name:
Hospital No.:
Date of Birth:
Consultant:
Gender:
Sample Type:
Sample WBC (x109 /l):
Sample Date:
Sample Vol. (ml):
Date Received: D D
M M
Y
Y
Y
Y
D D
Male
M M
Y
Y
Y
Y
Female
Time Received:
Sample Comments:
Amount Sample/Culture:
Check:
Referral centre/hospital:
Full postal address:
Inner pages when folded
Tel No.:
Fax No.:
Referral reason/Clinical details:
Disease stage:
Treatment stage:
Karyotype analysis required?
Yes
No
FISH required?
Yes
No
Probes:
RT-PCR Required?
Yes
No
Gene Fusion:
SAMPLE REQUIREMENTS
In preservative-free heparin and RPMI medium
Preferred volume Peripheral Blood
Adult: 10mls
Child: 2-5mls
Bone Marrow
Adult: 5-10ml
Child: 2-5mls
Optimal time in transit Peripheral Blood: 48hrs
Bone Marrow: 24hrs
19/11/2014 17:01
Bound Edge
THE DOCTORS
L A B O R AT O R Y
Genetic Request
In order to provide an efficient service for Genetic Requests, please complete the following:
PATIENT DETAILS
REFERRING DOCTOR
Surname: Name:
First Name:
Date of Birth:
Address:
/
/
Gender: M / F
Patient Number:
Ethnic Origin:
Telephone:
Gestation (if applicable):
weeksFax:
Outer pages when folded
TEST REQUEST
Disease Name:
Gene(s) to be Analysed:
Test for: Diagnosis / Carrier Screening / Known Family Mutation (please circle)
Clinical Symptoms:
Family History:
Please state any Family Gene Mutation(s) if known:
Please also provide copies of any relevant genetic or pathology (ie. haematology) reports.
INFORMED CONSENT
PATIENT OR GUARDIAN
Please cross-out where applicable:
I consent / do not consent to be tested for the genetic test(s), which have been explained to me
I consent / do not consent for the results of this test to be available to assist in testing other family members
I consent / do not consent for DNA from this sample to be stored
I consent / do not consent for DNA to be used anonymously for relevant research
Signed:
Date:
/
/
/
/
Outer pages when folded
DOCTOR /GENETIC COUNSELLOR
I have explained the purpose of obtaining a blood or tissue sample for genetic testing.
Signed:
Date:
This consent form is for use with diagnostic testing. It is important to think through the implications of genetic testing for other
family members. We strongly recommend genetic counselling for predictive testing in disorders such as Huntington’s Disease
or inherited cancers. Please contact our Consultant if you have queries about consent or counselling issues.
19/11/2014 17:01
LavenderEDTA
4ml / 10ml*
Patient details must be
hand-written on tube
SAMPLE
TYPES
VacutainerAnticoagulant Capacity
A
BT
LavenderEDTA
4ml
Gold
SST/Gel
3.5ml, 5ml
B
Light Blue
Citrate
4.5ml
C
RedNone
6ml
F
Grey
Fluoride oxalate
2ml, 4ml
G
Green
Lithium heparin
6ml
H
Dark Blue
Sodium heparin
7ml
K
* 10ml EDTA tubes are used for specific PCR assays
Streck Cyto-chex BCT Vacutainers for lymphocyte subsets (CD3/CD4/CD8)Chex
(stable for up to 7 days). They are not suitable for other CD markers.
Blood culture bottle: contact laboratory
BC
Contact laboratory for advice on sample taking
J
Test by appointment
X
Random Faeces
RF
Faecal Collection
LF
Random Urine
RU
First Catch Random Urine (for DL12/Chlamydia, etc.)
FCRU
30ml aliquot from a 24 hour urine collection – state total volume
CU
30ml aliquot from a 24 hour urine collection with 10ml of
0.1N Hydrochloric Acid added – state total volume
PU
Early Morning Urine (1st sample of the day)
EMU
Sterile 60ml container
SC
Cytyc Thin Prep Vial
TPV
Orange/Blue swab for culture – swab in transport medium
STM
Black Charcoal swab
CS
Green Viral swab
VS
PCR swab for Chlamydia/PCR Infection Screening
PCR
Tap/bottled water mouth wash – 20mls
MW
Ammotic fluid (5mls PCR – 10mls Karyotype)
AF
Chorionic Villus (medium provided by laboratory)
Urine cytology container
Dried blood spot pack: contact laboratory
TAP2547_CromwellLabGuide_2015_BackCover_V2.indd 1
CVS
UCYT
DBS
21/11/2014 10:15
Bupa Cromwell Hospital
Cromwell Road, London SW5 0TU, United Kingdom
Tel: 020 7460 2000 Fax: 020 7835 2444 E-mail: [email protected]
Web: www.cromwellhospital.com
TAP2547_CromwellLabGuide_2015_BackCover_V2.indd 2
21/11/2014 10:15

Bupa Cromwell Hospital Laboratory Guide (type:pdf size:1.67MB)

Transcription

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