The Leeds Teaching Hospitals NHS Trust

Pathology

Clinical Immunology Useful Information

The majority of tests for general immunology, allergy and protein chemistry in adult patients can be performed on a single 4ml clotted blood sample collected in a gel clotted tube (please refer to Tests and Tubes for sample requirements). In cases of difficulty with paediatric samples please discuss with the laboratory. It may be possible to use smaller sample volumes.

Particular care is required in taking samples for the investigation of cryoglobulinaemia or for tryptase determination - please refer to specific policies below.

Samples from the St James's site should be sent to Pathology Specimen Reception where they will be transported to the LGI for testing. Outside trusts should send serum samples by courier or by first class mail to the Pathology Laboratory at the Old Medical School, Leeds General Infirmary.

On the request form, please include sufficient clinical detail in addition to patient's name, hospital number, date of birth, ward and sex to enable meaningful interpretation of results. Hazardous samples which pose a risk to laboratory staff must be clearly identified with a 'danger of infection' sticker.

Test Limitations

Key factors which are known to affect the performance of the test or the interpretation of the results:

  • Grossly lipemic, haemolyzed or microbially contaminated samples may give poor results for all assays performed in Immunology.
  • More detailed information on specific tests can be found on Tests and Tubes.

Requesting additional tests

If clinically indicated additional tests may be performed. Samples are held in cold storage in the department for 7 days. Some labile assays must be performed on samples stored frozen, please refer to the Tests and Tubes database. If you wish to request any additional tests to samples already received by the laboratory, please contact the lab on 0113 3923414.

Patient Consent

For samples received into the Immunology laboratory and for those when referral is needed it is a requirement that there is patient consent to disclose clinical information and family history to relevant healthcare professionals as required for the purposes of diagnosis and patient management. On receipt of samples for testing the Immunology laboratory assumes that this consent has been given.

Laboratory Policies    

Urgent Samples (Including ANCA and GBM Ab)

Cryoglobulin Determination

Tryptase Determination

Specific Policies for Test Acceptance in Clinical Immunology

This policy includes details of:

  • Anti-nuclear antibodies: (Myositis and Scleroderma Immunoblots)
  • Autoimmune Liver Disease and Pernicous Anaemia
  • Coeliac Antibodies
  • Anti-Phospholipid Antibodies
  • Purkinje Cell (PNS) Antibodies
  • Aquaporin 4 Antibodies
  • Complement Deficiency Assays
  • C1 inhibitor Function
  • Haemolytic Complement
  • C3 Nephritic Factor
  • Other Complement Proteins
  • Allergy Requests
  • AAT Phenotype and Genotype
  • Immunoglobulins and Serum electrophoresis
  • IgD
  • Extended Lymphocyte Subset Analysis

Clinicians asking the laboratory to carry out tests outside these criteria should contact a Consultant Immunologist.

Specific requesting procedures / request forms

All Immunology tests should be requested through the Leeds ICE system. Manual requests may be accepted in certain circumstances, please contact the lab. All external requests should be fully labelled according to the Pathology Labelling Policy.

Aquaporin-4 (NMO) Ab request form.  Samples received without a complete Diagnostic and Advisory Service for Neuromyelitis Optica (NMO) referral form will not be referred for this test.  Samples will be retained in the Immunology Laboratory.

General overview of the investigation of Primary Immunodeficiency, Autoimmune disease, Allergic disease.

Autoimmune Disease

Primary Immunodeficiency

Investigation of Allergy