Blood Science Test Repertoire

1 (2) | 2 (1) | 5 (1) | A (35) | B (19) | C (54) | D (7) | E (10) | F (17) | G (18) | H (17) | I (18) | J (2) | L (13) | M (19) | N (6) | O (8) | P (33) | Q (1) | R (7) | S (14) | T (20) | U (6) | V (13) | W (1) | Z (1)

Aluminium

Last update: Sat, 07/14/2012 - 08:51

Body:

Assay	Aluminium
Key Words	Aluminium,
Specimen Collection	Whole blood sample sent (do not centrifuge), Plain white 10ml bottle.
Turnaround Time	This test is referred to another centre for analysis: Department of Clinical Chemistry Northern General Hospital Herries Road Sheffield S5 7AU Tel: 0114 243 4343 Fax: 0114 256 0472
Test Indications	Used in the investigation of aluminium toxicity
Limitation/Interference	Contact referal laboratory
Reference Range	Contact referal laboratory
Analytical Error	N/A
Reference Change Value	N/A

Arsenic

Last update: Sat, 07/14/2012 - 08:53

Body:

Assay	Arsenic
Key Words	Arsenic, ARS
Specimen Collection	Blood: 7.5ml EDTA (red top) tube Urine: 20ml sterile universal container
Turnaround Time	This test is referred to another lab for analysis:Medical Toxicology Unit 3rd Floor, Block 7 South Wing St Thomas' Hospital Lambeth Palace Road London SE1 7EH Tel: 020 7188 8783
Test Indications	Used in the investigation of arsenic poisoning
Limitation/Interference	Contact referal laboratory
Reference Range	Contact referal laboratory
Analytical Error	N/A
Reference Change Value	N/A

Apolipoprotein E Genotyping

Last update: Sat, 11/17/2012 - 06:18

Body:

Assay	Apolipoprotein E Genotyping
Key Words	Apo E genotyping
Specimen Collection	4.7 ml EDTA tube (red top tube). Upon arrival in the laboratory the whole blood sample is stored at 4^oC prior to referral (do not centrifuge)
Turnaround time	This test is referred to another centre for analysis: Centre for Haemostasis and Thrombosis 1st Floor North Wing St. Thomas' Hospital Lambeth Palace Road London SE1 7EH Tel: 020 718 2779
Test indications	Used in the investigation of lipoprotein disorders
Interferences	Contact referal laboratory for information
Reference Range	Contact referal laboratory for information
Analytical error	N/A
Reference change value	N/A

Allergy Tests

Last update: Mon, 03/03/2014 - 20:50

Body:

See Immunoglobulin E (Specific), Immunoglobulin G (Specific) and tryptase

Anti-Nuclear Antibodies (ANA)

Last update: Mon, 03/03/2014 - 20:51

Body:

See Nuclear Antibodies

ANCA

Last update: Thu, 03/06/2014 - 14:10

Body:

See Neutrophil cytoplasm antibodies

Aldosterone

Last update: Tue, 12/29/2015 - 15:33

Body:

Assay	Aldosterone
Key Words	Aldosterone, Renin, PRA, ALDO
Specimen Collection	1x EDTA Plasma (red top) for Aldosterone AND 2 x EDTA plasma (red top bottle) for Renin AND 1 x Serum gel (brown top tube) for U&E. Upon arrival in the laboratory the EDTA samples are centrifuged and the plasma stored frozen prior to referral.
Turnaround time	This test is referred to another centre: Department of Clinical Chemistry Level 4 Addenbrookes Hospital NHS Trust [TPP] Hills Road Cambridge CB2 2QQ Tel: 01223 217157 Fax: 01223 216520 Expected turnaround time: 6 weeks
Test Indications	Used in the investigation of suspected disorders of the adrenal glands
Limitations/Interferences	Contact referal laboratory
Reference Range	100-450 pmol/L (Adults recumbent overnight). 100-800 pmol/L (Random sample or upright).
Analytical Error	N/A
Reference Change Value	N/A

Amiodarone

Last update: Tue, 12/29/2015 - 16:32

Body:

Assay	Amiodarone
Key Words	Amiodarone, AMIO
Specimen Collection	Serum (Brown). Upon receipt the sample is centrifuged and stored refrigerated prior to referral.
Turnaround Time	This test is referred to another lab for analysis: Toxicology Laboratory The Academic Centre Llandough Hospital Penarth CF64 2XX Tel: 029 2071 6894 Expected turnaround time: 6 weeks
Test Indications	Used in the therapeutic drug monitoring of amiodarone
Limitation/Interference	Contact referal laboratory
Reference Range	Contact referal laboratory
Analytical Error	N/A
Reference Change Value	N/A

Amino Acids

Last update: Fri, 06/08/2018 - 15:25

Body:

Assay	Amino Acids
Key Words	Amino Acids, plasma, urine, urea cycle, AMINP, AMINU, metabolic screen
Specimen Collection	Blood - li-hep plasma (orange bottle), Urine - 20ml universal container. Store refridgerated prior to referral Please note: serum (brown bottle) is not a suitable specimen type
Turnaround time	This test is referred to another centre: Department of Clinical Chemistry Level 4 Addenbrookes Hospital NHS Trust [TPP] Hills Road Cambridge CB2 2QQ Tel: 01223 217157 Fax: 01223 216520 Expected turnaround time: 6 weeks
Test indications	Used in the the investigation of amino acid disorders, including urea cycle defects and some organic acid disorders. Please note: Urine amino acids is no longer used as a metabolic screen (please use plasma amino acids). It is available for the investigation of renal transport disorders (e.g. cystinuria), the assessment of renal tubular dysfunction (e.g. Fanconi syndrome, mitochondrial disease) and for some other specific disorders (e.g. hypophosphatasia).
Interferences	Contact referral laboratory
Reference Range	Contact referral laboratory
Analytical error	N/A
Reference change value	N/A

Alpha-1-Antitrypsin

Last update: Mon, 06/14/2021 - 11:53

Body:

Assay	Alpha-1-Antitrypsin
Key Words	AAT
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround Time	72hrs
Test Indications	AAT levels are primarily used when assessing a diagnosis of acute hereditary AAT deficiency as a cause of neonatal hepatitis accompanied by progressive liver cirrhosis in early childhood, or when severe pulmonary emphysema occurs in adults due to the prevalence of leukocyte elastase, which can lead to unrestrained proteolytic degradation of the pulmonary parenchymal cells. Samples with low AAT levels are referred for AAT phenotyping to exclude hereditary AAT deficiencies.
Limitations/Interferences	Elevated oestrogen levels (oral contraceptives; third trimester of pregnancy) give rise to increased values.
Reference Range	0.9-2.0 g/L
Analytical Error	5.5%
Reference Change Value	22.3%

Alpha1-fetoprotein

Last update: Tue, 06/15/2021 - 09:47

Body:

Assay	Alpha-fetoprotein
Key Words	AFP
Specimen Collection	Serum (brown) Plasma (orange)
Turnaround Time	72hrs
Test Indications	AFP is an albumin like glycoprotein. AFP is used as a tumour marker for germ cell/testicular tumours and hepatocellular carcinomas. Germ cell/testicular tumours – used in diagnosis, prognosis, detecting recurrence and monitoring treatment. Hepatocellular carcinoma – used in screening at risk groups (patients with chronic hepatitis B/C or cirrhosis, in conjunction with ultrasonography), diagnosis (in conjunction with liver imaging a-fetoprotein levels of >200mg/L are virtually diagnostic in patients with hypervascular lesions), prognosis, detecting recurrence and monitoring treatment. Also raised in other cancers (colorectal, gastric, lung, pulmonary) and some benign conditions (liver regeneration).
Limitations/Interferences	No known common methodological interferences.
Reference Range	Less than 7 ng/mL
Analytical Error	4.5%
Reference Change Value	36.6%
Minimum retesting interval	Requests made within 14 days of a previous result on a patient are intervened

Albumin (urine)

Last update: Tue, 06/15/2021 - 09:49

Body:

Assay	Albumin (urine)
Key Words	Microalbumin, MALB, albumin creatinine ratio, ACR
Specimen Collection	Random urine sample in 20ml universal
Turnaround time	72hrs
Test indications	Urine albumin creatinine ratio is the test of choice for the investigation of proteinuria.
Interferences	No known interferences
Reference Range	ACR >30mg/mmol creatinine indicates proteinuria. ACR >70mg/mmol indicates heavy proteinuria. Albumin excretion is expressed as a ratio to urinary creatinine to correct for urinary concentration.
Analytical error	3.5%
Reference change value	100.3%
Minimum retesting interval	Requests made within 30 days of a previous result on a patient are intervened

Alkaline Phosphatase

Last update: Tue, 06/15/2021 - 09:51

Body:

Assay	Alkaline Phosphatase
Key Words	ALP, ALKP
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround time	8hrs
Test indications	A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. It is also elevated in diseases of the skeletal system, such as Pagets disease, hyperparathyroidism, rickets and osteomalaecia, as well as with fractures and malignant tumours. A considerable rise in the alkaline phosphatase activity is sometimes seen in children and juveniles. It is caused by increased osteoblast activity following accelerated bone growth.
Interferences	EDTA (from FBC bottles) can cause falsely low results, please ensure the correct draw order is adhered to
Reference Range	Neonate: 70-380 U/L Infant to 16 yrs: 60-425 U/L Adult: 30-130 U/L
Analytical error	2.6%
Reference change value	16.3%
Minimum retesting interval	Liver function test requests made within 2 days of a previous request on a patient are intervened

Amylase

Last update: Tue, 06/15/2021 - 09:54

Body:

Assay	Amylase
Key Words	AMY
Specimen Collection	Serum (brown),Plasma (orange)
Turnaround time	8hrs
Test indications	Because of the scarcity of specific clinical symptoms of pancreatic diseases, amylase determinations are of considerable importance in pancreatic diagnostics. They are mainly used in the diagnosis and monitoring of acute pancreatitis. Hyperamylasaemia does not, however, only occur with acute pancreatitis or in the inflammatory phase of chronic pancreatitis, but also in renal failure (reduced glomerular filtration), tumours of the lungs or ovaries, pulmonary inflammation, diseases of the salivary gland, diabetic ketoacidosis, cerebral trauma, surgical interventions or in the case of macroamylasaemia.
Interferences	Icodextrin-based drugs may lead to decreased amylase results. Interference with the anticoagulants citrate, fluoride, and EDTA has been noted. Macro-enzymes are a potential cause of falsely low and high results and can be investigated by measuring urinary amylase.
Reference Range	<100 U/L
Analytical error	1.5%
Reference change value	19.3%

Aspartate transaminase

Last update: Tue, 06/15/2021 - 09:55

Body:

Assay	Aspartate transaminase
Key Words	AST
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround time	8hrs
Test indications	The enzyme aspartate aminotransferase (AST) is widely distributed in tissues, principally: hepatic, cardiac, muscle, and kidney. Elevated serum levels are found in diseases involving these tissues
Interferences	Haemolysed samples are not assayed. Cyanokit (Hydroxocobalamin) may cause interference with results. Sulfasalazine and sulfapyradine at therapeutic concentrations may cause falsely low or high results.
Reference Range	Male: 10-50 U/L Female: 10-35 U/L
Analytical error	1.8%
Reference change value	26.8%

Androstenidione

Last update: Thu, 09/09/2021 - 13:36

Body:

Assay	Androstenidione
Key Words	Androstenidione, ANDI
Specimen Collection	Serum (brown), Plasma (orange). Upon receipt in the laboratory the sample is centrifuged and the serum/plasma refrigerated prior to referral.
Turnaround time	This test is referred to another centre for analysis: Chemical Pathology Department Kings College Hospital Denmark Hill London SE5 9RS Tel: 020 7737 4000 Fax: 020 7346 3445 Expected turnaround time: 6 weeks
Test Indications	Used in the investigation of endocrinology disorders
Limitations/Interferences	Contact referal laboratory
Reference Range	Male: Pre-pubertal = <0.9 nmol/L, Post-pubertal = 1.5 - 8.3 nmol/L Female: Pre-pubertal = <0.9 nmol/L, Post-pubertal = 1.1 - 7.7 nmol/L
Analytical Error	N/A
Reference Change Value	N/A

ABL Kinase domain mutations

Last update: Sun, 09/19/2021 - 09:22

Body:

Assay	ABL Kinase domain mutations
Key Words	ABL, Kinase, Domain, Mutation
Specimen Collection	20ml peripheral blood EDTA.
Referral	This test is referred to another centre for analysis: Laboratory for Molecular Haemato-Oncology (LMH) King's College Hospital NHS Trust
Turnaround time	5 days from receipt at reference laboratory
Test indications	To test for resistance to therapy with first line Tyrosine kinase inhibitors (Eg Imatinib, Nilotinib, Dasatinib)
Interferences	Contact referral laboratory for information
Reference Range	Contact referral laboratory for information
Minimum retesting interval	N/A

Abnormal Haemoglobin Referral (Globin chain analysis)

Last update: Sun, 09/19/2021 - 11:57

Body:

Assay	Abnormal Haemoglobin Referral (Globin chain analysis)
Key Words	Haemoglobinopathy, haemoglobin variant globin chain analysis, DNA testing, thalassaemia
Specimen Collection	10ml EDTA. Patients should be aware that when giving us their family origin information and agreeing to antenatal family origin screening, we will where necessary provide this information to other healthcare professionals outside the Pathology department in order to provide appropriate antenatal care.
Referral	This test is referred to another centre for analysis: North West Genomic Laboratory Manchester Centre for Genomic Medicine St Mary's Hospital Oxford Road Manchester M13 9WL
Turnaround time	6 weeks from receipt at reference laboratory
Test indications	Determination globin chain specificity for thalassaemias
Interferences	Contact referral laboratory for information
Reference Range	Contact referral laboratory for information
Minimum retesting interval	N/A

Abnormal Haemoglobin Referral (Haemoglobin variant)

Last update: Sun, 09/19/2021 - 11:58

Body:

Assay	Abnormal Haemoglobin Referral (Haemoglobin variant)
Key Words	Haemoglobinopathy, haemoglobin variant, mass spectroscopy
Specimen Collection	7.5ml EDTA. Patients should be aware that when giving us their family origin information and agreeing to antenatal family origin screening, we will where necessary provide this information to other healthcare professionals outside the Pathology department in order to provide appropriate antenatal care.
Referral	This test is referred to another centre for analysis: North West Genomic Laboratory Manchester Centre for Genomic Medicine St Mary's Hospital Oxford Road Manchester M13 9WL
Turnaround time	6 weeks from receipt at reference laboratory
Test indications	Haemoglobinopathy of unknown specificity
Interferences	Contact referral laboratory for information
Reference Range	Contact referral laboratory for information
Minimum retesting interval	N/A

Adrenocorticotrophic hormone (ACTH)

Last update: Tue, 03/22/2022 - 13:54

Body:

Assay	Adrenocorticotrophic hormone (ACTH)
Key Words	ACTH
Specimen Collection	EDTA Plasma (red top). Specimen must be transported on ice and taken to the laboratory as soon as possible. Failure to comply with these instructions may result in the request being rejected, particularly if there are delays of over 4hrs. Upon arrival in the laboratory the sample is centrifuged and the plasma stored frozen prior to dispatch
Turnaround time	This test is referred to another centre: Department of Clinical Chemistry Level 4 Addenbrookes Hospital NHS Trust [TPP] Hills Road Cambridge CB2 2QQ Tel: 01223 217157 Fax: 01223 216520 Expected turnaround time: 6 weeks
Test Indications	Used in the investigation of pituitary-adrenal disorders relating to glucocorticoids
Limitations/Interferences	Contact referal laboratory
Reference Range	<50 ng/L at 9am
Analytical Error	N/A
Reference Change Value	N/A

Anderson-Fabry Disease

Last update: Wed, 01/25/2023 - 08:46

Body:

Assay	Anderson-Fabry Disease Disease
Key Words	Plasma α-galactosidase A activity, Anderson-Fabry Disease, Fabry disease
Specimen Collection	6ml-10ml EDTA (large EDTA) and 6-10ml Li-Heparin (large Li-Heparin)
Referral	This test is referred to another centre for analysis: Willink Biochemical Genetics Laboratory 6th Floor, Pod 1 Saintt Mary's Hospital Oxford Road Manchester M13 9WL
Turnaround time	14 days from receipt at reference laboratory for enzyme investigations 28 days from receipt at reference laboratory for genetic investigations
Test indications	To exclude Anderson-Fabry Disease
Interferences	Contact referral laboratory for information
Reference Range	Contact referral laboratory for information
Minimum retesting interval	N/A

Alanine Aminotransferase

Last update: Tue, 02/28/2023 - 13:33

Body:

110test

Assay	Alanine Aminotransferase
Key Words	ALT
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround time	8hrs
Test indications	Elevated serum ALT is found in hepatitis, cirrhosis, obstructive jaundice, carcinoma of the liver, and chronic alcohol abuse. ALT is only slightly elevated in patients who have an uncomplicated myocardial infarction.
Interferences	Sulfasalazine and sulfapyradine at therapeutic concentrations may cause falsely low or high results. Please contact laboratory for further information on assay interferences
Reference Range	Male <41 U/L Female <33 U/L
Analytical error	2.3%
Reference change value	26.6%
Minimum retesting interval	Liver function test requests made within 2 days of a previous result on a patient are intervened

Anti-Cytosolic 5'-nucleotidase 1A

Last update: Thu, 08/03/2023 - 07:56

Body:

Assay	Anti-Cytosolic 5’-nucleotidase 1A
Key Words	NT5C1A, CN1A, Cytosolic 5’- Nucleotidase 1A
Specimen Collection	Serum (Brown)
Turnaround time	This test is referred to another centre: Turnaround time is 10 working days Referral centre Address Immunology Herschel Building Level B38 Blood Sciences Royal United Hospital Bath NHS Foundation Trust Combe Park Bath BA1 3NG
Test indications	Anti-Cytosolic 5’-nucleotidase 1A antibodies are associated with inclusion body myositis. Inclusion body myositis is a progressive muscle disorder characterised by muscle inflammation, weakness, and atrophy. It is a type of inflammatory myopathy. IBM develops in adulthood usually after age of 50. The symptoms and rate of progression vary.
Methodology	Immunoblotting
Interferences	Contact referral centre
Reference Range	Contact referral centre
Analytical error	Contact referral centre
Reference change value	Contact referral centre

Acylcarnitines

Last update: Thu, 09/21/2023 - 07:44

Body:

Assay	Acylcarnitines
Key Words	Acylcarnitines, total carnitines
Specimen Collection	Blood spot (Guthrie Card) or Lithium-heparin sample (unspun)
Turnaround time	This test is referred to another centre: Department of Clinical Chemistry Level 4 Addenbrookes Hospital NHS Trust [TPP] Hills Road Cambridge CB2 2QQ Tel: 01223 217157 Fax: 01223 216520 Expected turnaround time: 6 weeks
Test indications	Used in the investigation of disorders of fatty acid chain oxidation
Interferences	Contact referral laboratory
Reference Range	C0 Free Carnitine Up to 1 month: 9-57 umol/L 1 month-99 years: 9-49 umol/L C2 Acetyl Carnitine Up to 1 month: 5-50 umol/L 1 month-99 years: 6-32 umol/L C3 Propionyl Carnitine Up to 1 month: 0.2-4.2 umol/L 1 month-99 years: 0.4-3.2 umol/L C4 Butyryl Carnitine Up to 1 month: <=0.5 umol/L 1 month-99 years: 0.1-0.4 umol/L C5 Isovaleryl Carnitine Up to 1 month: <=0.3 umol/L 1 month-99 years: <=0.2 umol/L C6 Hexanoyl Carnitine Up to 1 month: <=0.2 umol/L 1 month-99 years: <=0.1 umol/L C8 Octanoyl Carnitine Up to 1 month: <=0.3 umol/L 1 month-99 years: <=0.1 umol/L C10 Decanoyl Carnitine Up to 1 month: <=0.3 umol/L 1 month-99 years: <=0.2 umol/L C14 Myristoyl Carnitine Up to 1 month: 0.1-0.4 umol/L 1 month-99 years: <=0.2 umol/L C16 Palmitoyl Carnitine Up to 1 month: 0.4-6.5 umol/L 1 month-99 years: 0.3-1.8 umol/L
Analytical error	N/A
Reference change value	N/A

Apixaban

Last update: Thu, 01/18/2024 - 14:12

Body:

Assay	Apixaban
Key Words	Direct Xa inhibitor, Apixaban
Specimen Collection	3.0ml Citrate (Green lid). 1.4ml Citrate for paediatric (Green lid). Fill to mark. Samples shoule ideally be received by the laboratory within 3 hours of collection.
Turnaround time	Next working day
Test indications	Apixaban dose monitoring
Interferences	Apixaban levels change markedly over time owing to the pharmacokinetics of the drug (e.g. levels of apixaban will differ greatly 2–4 hours versus 12 hours after dosing). Interpret results with caution. Discuss with Consultant Haematologist if necessary.
Reference Range	See table below. Discuss with Consultant Haematologist if necessary.
Minimum retesting interval	N/A

Dose (mg)

Trough (ng/mL)

Peak (ng/mL)

2.5,g twice daily

20-94

36-100

10mg twice daily

31-412

122-412

Gosselin RC, Adcock DM. The laboratory’s 2015 perspective on direct oral anticoagulant testing. J Thromb Haemost 2016; 14: 886-93.

Albumin (Serum/Plasma)

Last update: Fri, 01/19/2024 - 09:17

Body:

Assay	Albumin (Serum/Plasma)
Key Words	Albumin
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround time	8hrs
Test indications	Albumin is a key plasma protein. Low levels are seen in liver disease, burns, malabsorption, and is losses through the kidneys (proteinuria) and stool. Raised levels usually indicate dehydration.
Interferences	No known methodological interferences
Reference Range	• <1 year: 30-45 g/L • <17 years: 30-50 g/L • ≥17 years: 35-50 g/L
Analytical error	2.2%
Reference change value	8.9%
Minimum retesting interval	Liver function test requests made within 2 days of a previous result on a patient are intervened

Angiotensin Converting Enzyme

Last update: Fri, 01/19/2024 - 09:35

Body:

Assay	Angiotensin Converting Enzyme
Key Words	ACE
Specimen Collection	Serum (brown)
Turnaround time	24hrs
Test indications	Elevated levels of serum ACE associated with the ACE-I/D-gene polymorphism have been measured in patients suffering from various disorders and often indicate a poor prognosis or rapid progression of the disease. Examples include, granulomatous inflammatory diseases such as sarcoidosis and mixed connective tissue
Interferences	Treatment with angiotensin converting enzyme inhibitors will give falsely low ACE results
Reference Range	• <18 years: 33-112 U/L • <70 years: 20-70 /L
Analytical error	4.2%
Reference change value	N/A

Anti Thyroid Peroxidase

Last update: Fri, 01/19/2024 - 11:13

Body:

Assay	Anti Thyroid Peroxidase
Key Words	aTPO, TPO
Specimen Collection	Serum (brown), Plasma (orange)
Turnaround Time	24hrs
Test Indications	Anti-TPO is used to investigate the presence of autoimmune thyroiditis (e.g. Hashimotos' thyroiditis and Grave's Disease). The measurement of thyroid antibodies in subjects with subclinical hypothyroidism helps to define the risk of developing overt hypothyroidism
Limitations/Interferences	No known common methodological interferences.
Reference Range	<35 IU/mL
Analytical Error	7.1%
Reference Change Value	25.7%
Minimum retesting interval	Repeat testing of Anti-TPO within 12 months is not usually indicated, and repeat tests within this timeframe are intervened. If you require a repeat test please contact the laboratory prior to requesting.

Ammonia

Last update: Fri, 01/19/2024 - 15:37

Body:

Assay	Ammonia
Key Words	NH3, Amm
Specimen Collection	Plasma (red EDTA-K paediatric tubes). The sample MUST be received on ice within 30 minutes of venepuncture.
Turnaround time	8hrs
Test indications	Hyperammonemia in infants can be caused by inherited deficiencies of the urea cycle enzymes or acquired through acute (as in Reyes syndrome) or chronic liver disease (as in cirrhosis). In adults, elevated ammonia levels can aid in diagnosis of liver failure or hepatic encephalopathy from advanced liver diseases such as viral hepatitis or cirrhosis.
Interferences	The anticoagulants fluoride, citrate and heparin must not be used. Sodium cefoxitin causes artificially high ammonia values when used at therapeutic doses. Sulfasalazine and sulfapyradine at therapeutic concentrations may cause falsely low or high results. Elevated gamma-globulin concentrations significantly increase the apparent ammonia concentration.
Reference Range	• <28 days: <100 umol/L • ≥28 days: <50 umol/L (Reported reference range for ammonia is for full-term neonates. Reference range for sick or premature neonates: <150 umol/L
Analytical error	2.8%
Reference change value	N/A

Amylase (urine)

Last update: Wed, 02/14/2024 - 15:49

Body:

Assay	Amylase (urine)
Key Words	AMYU
Specimen Collection	Random urine sample in 20ml universal
Turnaround time	72hrs
Test indications	Used in the investigation of raised serum amylase activity, to exclude macroamylasaemia
Interferences	No known interferences
Reference Range	Random urine amylase: A reference interval for this test result has not been provided because individual factors, such as medications, diet, and other health conditions, may significantly affect the interpretation of the results. For further discussion, please contact the Consultant Chemical Pathologist. 24hr urine excretion: Females: <447 U/24hr Males: <491 U/24hr
Analytical error	1.6%
Reference change value	192.7%

Acetylcholine Receptor Antibodies (ACRA)

Last update: Wed, 10/22/2025 - 10:09

Body:

Assay	Acetylcholine receptor antibodies (ACRA)
Key Words	Acetylcholine receptor antibodies ACRA, Myasthenia gravis Panel
Specimen Collection	Serum (brown)
Turnaround time	Contact referral centre for Turnaround time This test is referred to another centre: Department of Immunology The Churchill Hospital Headington Oxford OX3 7LJ Tel: 01865 225995 Fax: 01865 225990
Test indications	IgG Anti-AChR antibodies are found in 80-90% of subjects with myasthenia gravis, and 60% of those with ocular myasthenia. They are virtually never found in the normal population, but are seen in 3-10% of unaffected first degree relatives of myasthenic patients. 50% of patients with non-myasthenic thymoma are positive, and in 4% of patients on penicillamine with no clinical evidence of myasthenia. The majority of neonates born to seropositive myasthenic mothers are transiently anti-AChR positive due to passive transfer of maternal immunoglobulin, however only a small percentage develop clinical neonatal myasthenia. Please Note: MuSK antibodies may be useful in patients with a convincing history of myasthenia who are negative for AChR antibodies.
Methodology	Indirect immunofluoresence
Interferences	Contact referral laboratory
Reference Range	Contact referral laboratory
Analytical error	Contact referral laboratory
Reference change value	N/A

AMPA receptor antibodies

Last update: Wed, 10/22/2025 - 10:17

Body:

Assay	Alpha-Amino-3-Hydroxyl-5-Methyl-4-Isoxazolepropionic acid antibodies (AMPA/GABB)
Key Words	AMPA receptor antibodies, Glutamate receptor antibodies profile (GABB)
Specimen Collection	Serum (Brown)
Turnaround time	14 Days This test is referred to another centre: Churchill Hospital Old Road Headington Oxford OX3 7LE 0300 304 7777
Test indications	AMPA receptors are glutamate receptors that mediate fast excitatory neurotransmission in the brain. Antibodies targeting the extracellular domains of either or both GluR1 or GluR2 subunits have been associated with limbic encephalitis.
Methodology	Cell based assay
Interferences	Contact referral laboratory
Reference Range	N/A
Analytical error	Contact referral laboratory
Reference change value	N/A

Adalimumab

Last update: Wed, 10/22/2025 - 10:19

Body:

Assay	Adalimumab (ADALIM)
Key Words	Adalimumab , Adalimumab antibodies
Specimen Collection	Serum (Brown)
Turnaround time	14 days This test is referred to another centre: Department of Clinical Biochemistry City Hospital Dudley road Birmingham B18 7QH 0121 507 3441
Test indications	Adalimumab is a humanised monoclonal antibody directed against tumour necrosis factor alpha (TNF). Anti-TNF therapy has become an important alternative treatment in the management of patients with chronic inflammatory diseases such as rheumatoid arthritis (RA), Crohn’s disease (CD), and ankylosing spondylitis (AS). The relationship between serum trough levels of anti-TNF drug and clinical improvement has been identified indicating that it can be used as a therapeutic monitoring tool. Within a given population of patients a significant number have been noted to develop resistance to the drug and show undetectable trough levels of Adalimumab. The main indication for undertaking the test is lack of clinical response to the Adalimumab. A trough serum concentration of <5 µg /mL, in a patient on Adalimumab, indicates subtherapeutic levels. If anti-drug antibodies are present, a change in drug therapy should be considered. In patients with low levels of Adalimumab but absent antibodies, a review of the treatment regimen may be required once non-compliance has been excluded. Antibodies will only be tested if indicated by a trough serum concentration of <5.0 µg/mL
Methodology	ELISA
Interferences	Contact referral lab
Reference Range	Trough therapeutic cut-off : >5.0 µg/mL
Analytical error	Contact referral lab
Reference change value	Contact referral lab

Adrenal Cortical Antibodies

Last update: Wed, 10/22/2025 - 10:20

Body:

Assay	Adrenal cortical antibodies
Key Words	Adrenal cortical antibodies, adrenal antibodies (ADRA)
Specimen Collection	Serum (brown)
Turnaround time	10 days This test is referred to another centre: Department of Clinical Chemistry and Immunology Level 4 Addenbrookes Hospital NHS Trust Hills Road Cambridge CB2 2QQ Tel: 01223 217215 Fax: 01223 217794
Test indications	Anti-adrenal antibodies are found in 60% of patients with idiopathic hypoadrenalism where they are directed against the enzyme 21-hydroxylase, and in 90% of those with hypoadrenalism in association with ovarian failure (Autoimmune Polyglandular Syndrome-1, APS-1) where they react with 17-hydroxylase and the side chain cleaving enzyme complex involved in steroid bio-synthesis. They are found in <0.1% of the normal population. The titre of antibody is of no significance, and so is not measured. As the adrenal gland atrophies the antibodies may disappear so sequential follow-up is not useful.
Methodology	Indirect immunofluorescence
Interferences	Contact referral laboratory
Reference Range	N/A
Analytical error	N/A
Reference change value	N/A

Aquaporin-4 Antibodies (NMO Antibodies)

Last update: Wed, 10/22/2025 - 10:22

Body:

Assay	Aquaporin-4 antibodies (anti-NMO antibodies)
Key Words	Aquaporin abs (AQUS)
Specimen Collection	Serum (brown)
Turnaround time	14 days This test is referred to another centre: Department of Immunology The Churchill Hospital Headington Oxford OX3 7LJ Tel: 01865 225995 Fax: 01865 225990
Test indications	This test is indicated for patients suspected to have neuromyelitis optica (also called Devic's disease) which causes pain in the eye and vision loss. Transverse myelitis is also associated which causes weakness, numbness, and sometimes paralysis of the arms and legs, along with sensory disturbances and loss of bladder and bowel control.
Methodology	Contact referral centre
Interferences	Contact referral centre
Reference Range	N/A
Analytical error	Contact referral centre
Reference change value	N/A

Phlebotomy

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