Special chemistry (Endocrine) – Page 2

07 Jun

THIOPURINE METHYLTRANSFERASE ACTIVITY

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

DRUGS/ TDM/ TOXICOLOGY.

Synonyms/Aliases

TPMT PHENOTYPE; TPMT ACTIVITY; TPMT DEFICIENCY; 6-MERCAPTOPURINE (6-MP; PURINETHOL) TOXICITY; AZATHIOPRINE (IMURAN) TOXICITY.

Abbreviations

TPMT.

^Type

INDIVIDUAL TEST.

^{7 DAYS}

RESULTS READY/ REPORTED IN 7 WORKING DAYS.

^Method

LC-MS.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

N/A.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

COLLECT SAMPLES PRIOR TO INITIATION OF THERAPY WITH THIOPURINE DRUGS.

Sample type

EDTA PLASMA OR HEPARIN PLASMA.

Container/ preservative

EDTA OR HEPARIN WITH ALIQUOTING OF PLASMA INTO A SEPARATION VIAL.

Sample volume

AT LEAST 2 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE; FROZEN SAMPLE.

Other Instructions

THE PLASMA SEPARATION VIAL MUST BE LABELED WITH AT LEAST 2 PATIENT IDENTIFIERS AND THE SAMPLE TYPE (E.G. EDTA PLASMA; HEPARIN PLASMA). TESTING SHOULD NOT BE RETROSPECTIVE I.E. AFTER COMMENCEMENT OF THERAPY.

Reference intervals

INTERPRETIVE DATA IS PROVIDED ON THE REPORT.

Clinical Utility

TO DETECT THIOPURINE METHYLTRANSFERASE DEFICIENCY PRIOR TO INITIATION OF TREATMENT WITH THIOPURINE DRUGS E.G. AZATHIOPRINE, 6-MERCAPTOPURINE (6-MP), 6-THIOGUANINE (6-TG) ETC. TPMT DEFICIENCY PREDISPOSES TO MYELOTOXICITY (BONE MARROW TOXICITY) FROM STANDARD DOSES OF THIOPURINE DRUGS. INCREASED TPMT ACTIVITY MAY BE ASSOCIATED WITH RESISTANCE TO THIOPURINE DRUGS & INCREASED RISK OF HEPATOTOXICITY.

Test Limitations/ Confounders

N/A.

07 Jun

TESTOSTERONE, FREE

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

ENDOCRINE.

Synonyms/Aliases

N/A.

Abbreviations

N/A.

^Type

INDIVIDUAL TEST.

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

IMMUNOASSAY.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

N/A.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

COLLECT SAMPLES BETWEEN 8-10A.M.

Sample type

SERUM. HEPARIN PLASMA IS AN ACCEPTABLE ALTERNATE SPECIMEN.

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

2ML

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE.

Other Instructions

CENTRIFUGE SST (SERUM GEL TUBES) WITHIN 1-2 HOURS OF COLLECTION. CENTRIFUGE RED TOP VACUTAINERS AND ALIQUOT SERUM WITHIN 1-2 HOURS OF COLLECTION. THE SEPARATION VIAL MUST BE LABELED WITH AT LEAST 2 PATIENT IDENTIFIERS AND THE SAMPLE TYPE.

Reference intervals

DEPENDENT ON AGE, GENDER & TANNER STAGE.

Clinical Utility

CONFIRMATION OF TRUE TESTERONE STATUS IN PATIENTS WITH ACTUAL OR SUSPECTED ABNORMAL SHBG LEVELS (ABNORMAL SHBG LEVELS MAY OCCUR IN A VARIETY OF SITUATIONS E.G. OBESITY, THYROID DISEASE, LIVER DISEASE, WITH SOME DRUGS ETC.). EVALUATION OF SUSPECTED MALE HYPOGONADISM (LOW LIBIDO, ERECTILE DYSFUNCTION, ETC.). AS A FOLLOW UP TEST FOR ABNORMAL SEMENALYSIS RESULTS (E.G. AZOOSPERMIA, OLIGOSPERMIA). ASSESSMENT OF INFERTILITY, PRECOCIOUS MALE PUBERTY, AMENORRHEA, OLIGOMENORRHEA. EVALUATION OF VIRILIZATION IN FEMALES [E.G. FROM PCOS, ANDROGEN SECRETING OVARIAN OR PITUITARY TUMORS, CONGENITAL ADRENAL HYPERPLASIA ETC.). EVALUATION OF AMBIGUOUS GENITALIA AND DISORDERS OF SEX DEVELOPMENT (DSDs)].

Test Limitations/ Confounders

IMMUNOASSAY INTERFERENCE CAN GIVE RISE TO SPURIOUS RESULTS. SUCH INTERFERENCE CAN ARISE FROM PRESENCE OF HETEROPHILE ANTIBODIES, ANTI-ANIMAL ANTIBODIES, AUTOANTIBODIES, PARAPROTEINS, BIOTIN ETC. RESULTS SHOULD ALWAYS BE CORRELATED WITH CLINICAL FINDINGS.

07 Jun

TACROLIMUS

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

DRUGS/ TDM/ TOXICOLOGY.

Synonyms/Aliases

ASTAGRAF XL, ENVARSUS XR, PROGRAF, HECORIA.

Abbreviations

N/A.

^Type

INDIVIDUAL TEST.

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

IMMUNOASSAY.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

N/A.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY. DETAILED SPECIFIC HISTORY IS REQUIRED E.G. EXACT INDICATION FOR DRUG MONITORING, DRUG HISTORY (I.E. DOSE, ROUTE OF ADMINISTRATION, DURATION SINCE TREATMENT WAS STARTED OR DOSE ADJUSTED, CONCURRENT MEDICATION), HEIGHT, WEIGHT.

Patient preparation

SPECIFIC TIMING APPLIES I.E. COLLECT TROUGH (PRE-DOSE) SAMPLE.

Sample type

EDTA WHOLE BLOOD (MOST OF THE DRUG IS BOUND TO ERYTHROCYTES).

Container/ preservative

EDTA (PURPLE TOP) VACUTAINER.

Sample volume

AT LEAST 3ML EDTA WHOLE BLOOD.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE; MISSING HISTORY AS EXPOUNDED UNDER TEST ORDERING INSTRUCTIONS.

Other Instructions

NOT APPLICABLE.

Reference intervals

INTERPRETIVE DATA IS PROVIDED ON THE REPORT.

Clinical Utility

OPTIMIZE DRUG DOSAGE (TO AVOID SUBTHERAPEUTIC & TOXIC DOSES I.E. ENSURE TARGET THERAPEUTIC RANGE IS ACHIEVED); TO VERIFY COMPLIANCE. TACROLIMUS IS AN IMMUNOSUPPRESSANT DRUG USED IN SOLID ORGAN TRANSPLANT RECIPIENTS.

Test Limitations/ Confounders

LEVELS ARE INFLUENCED BY DOSAGE REGIMEN, DRUG INTERACTIONS, INDIVIDUAL'S METABOLIZING CAPACITY, LIVER DYSFUNCTION.

07 Jun

STOOL pH

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

MALABSORPTION.

Synonyms/Aliases

FAECES pH; FECES pH.

Abbreviations

N/A.

^Type

INDIVIDUAL TEST.

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

BIOCHEMICAL.

^Temp

AMBIENT (25℃):2HOURS R (2℃-8℃):1DAY.

^Setup

BATCHED.

Components Parameters

N/A.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

NOT APPLICABLE.

Sample type

STOOL.

Container/ preservative

STERILE CONTAINER PROVIDED BY THE LAB.

Sample volume

20 GMS OF STOOL.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE. SPECIMEN CONTAMINATED WITH URINE.

Other Instructions

NOT APPLICABLE.

Reference intervals

INTERPRETIVE DATA IS PROVIDED ON THE REPORT.

Clinical Utility

DETECT CARBOHYDRATE AND FAT MALABSORPTION.

Test Limitations/ Confounders

BARIUM PROCEDURES.

07 Jun

SEX HORMONE BINDING GLOBULIN

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

ENDOCRINE.

Synonyms/Aliases

SEX STEROID BINDING PROTEIN; TESTOSTERONE-OESTRADIOL BINDING GLOBULIN; TESTOSTERONE-ESTRADIOL BINDING GLOBULIN.

Abbreviations

SHBG; SBP; ToBG; TeBG.

^Type

INDIVIDUAL TEST.

^{7 DAYS}

RESULTS READY/ REPORTED IN 7 WORKING DAYS.

^Method

IMMUNOASSAY.

^Temp

AMBIENT, REFRIGERATED OR FROZEN.

^Setup

BATCHED.

Components Parameters

N/A.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

NOT APPLICABLE.

Sample type

SERUM. HEPARIN PLASMA IS AN ACCEPTABLE ALTERNATE SPECIMEN.

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

AT LEAST 2 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE.

Other Instructions

Reference intervals

DEPENDENT ON AGE, GENDER & TANNER STAGE.

Clinical Utility

SHBG IS THE MAJOR SEX STEROID BINDING PROTEIN & INFLUENCES BIOAVAILABLE LEVELS OF TESTOSTERONE. FURTHER TESTING WHEN TOTAL TESTOSTERONE LEVELS ARE DISCORDANT WITH SIGNS & SYMPTOMS E.G. CALCULATION OF FREE ANDROGEN INDEX FROM TOTAL TESTOSTERONE & SHBG LEVELS. ALSO USED IN EVALUATION OF PATIENTS WITH FEATURES OF ANDROGEN EXCESS (HIRSUTISM, PCOS ETC.).

Test Limitations/ Confounders

LEVELS ARE INCREASED BY THYROID HORMONES, ESTROGENS AND DECREASED BY ANDROGENS. IMMUNOASSAY INTERFERENCE CAN GIVE RISE TO SPURIOUS RESULTS. SUCH INTERFERENCE CAN ARISE FROM PRESENCE OF HETEROPHILE ANTIBODIES, ANTI-ANIMAL ANTIBODIES, AUTOANTIBODIES, PARAPROTEINS, BIOTIN ETC. RESULTS SHOULD ALWAYS BE CORRELATED WITH CLINICAL FINDINGS.

07 Jun

SERUM IMMUNOGLOBULINS

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

IMMUNE.

Synonyms/Aliases

SERUM IMMUNOGLOBULIN PANEL (IgG, IgA AND IgM).

Abbreviations

N/A.

^Type

PROFILE/ PANEL (BUNDLED TESTS).

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

NEPHELOMETRY.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

SERUM IgG, IgA, IgM.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

NOT APPLICABLE.

Sample type

SERUM.

Container/ preservative

PLAIN TUBE (RED TOP) OR SERUM SEPARATOR (YELLOW TOP).

Sample volume

AT LEAST 2 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE., NONFASTING SAMPLES.

Other Instructions

Reference intervals

AGE & GENDER APPROPRIATE VALUES ARE PROVIDED ON THE REPORT.

Clinical Utility

EVALUATION OF HYPOGAMMAGLOBULINEMIA, SUSPECTED IgG/ IgA/ IgM DEFICIENCY, IgG/ IgA/ IgM GAMMOPATHY.

Test Limitations/ Confounders

CHRONIC INFLAMMATORY STATES CAN CAUSE HYPERGAMMAGLOBULINEMIA.

07 Jun

SERUM IMMUNOFIXATION ELECTROPHORESIS

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

TUMOR MARKER.

Synonyms/Aliases

IMMUNOFIXATION, SERUM.

Abbreviations

SIFE; IFE.

^Type

PROFILE/ PANEL (BUNDLED TESTS).

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

IMMUNOTYPING.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

IgG, IgA, IgM HEAVY CHAINS; KAPPA & LAMBDA LIGHT CHAINS.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

NOT APPLICABLE.

Sample type

SERUM (CENTRIFUGED & SEPARATED WITHIN 1 HOUR AFTER COLLECTION).

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

AT LEAST 2 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE.

Other Instructions

Reference intervals

NEGATIVE FOR M BAND/ M SPIKE.

Clinical Utility

DIAGNOSE & MONITOR PATIENTS WITH MONOCLONAL GAMMOPATHIES E.G. MULTIPLE MYELOMA.

Test Limitations/ Confounders

N/A.

07 Jun

SERUM FREE LIGHT CHAINS

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

TUMOR MARKER.

Synonyms/Aliases

FREE LIGHT CHAINS, SERUM; SERUM FLC.

Abbreviations

SFLC.

^Type

PROFILE/ PANEL (BUNDLED TESTS).

^{5 DAYS}

RESULTS READY/ REPORTED IN 5 WORKING DAYS.

^Method

IMMUNOASSAY.

^Temp

REFRIGERATED.

^Setup

BATCHED.

Components Parameters

KAPPA LIGHT CHAINS, LAMBDA LIGHT CHAINS AND RATIO OF THE TWO.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

NOT APPLICABLE.

Sample type

SERUM (CENTRIFUGED & SEPARATED WITHIN 1 HOUR AFTER COLLECTION).

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

AT LEAST 2 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE.

Other Instructions

Reference intervals

AGE & GENDER APPROPRIATE VALUES ARE PROVIDED ON THE REPORT.

Clinical Utility

DIAGNOSE AND MONITOR PLASMA CELL DISORDERS SUCH AS MULTIPLE MYELOMA.

Test Limitations/ Confounders

N/A.

07 Jun

SEROTONIN, SERUM

June 7, 2023June 7, 2023vincentochiengde

Category

SPECIAL CHEMISTRY.

Sub Category

TUMOR MARKER.

Synonyms/Aliases

5-HYDROXYTRYPTAMINE, SERUM.

Abbreviations

5-HT.

^Type

INDIVIDUAL TEST.

^{10 DAYS}

RESULTS READY/ REPORTED IN 10 WORKING DAYS.

^Method

CHROMATOGRAPHY.

^Temp

FROZEN (PREFERRED) OR REFRIGERATED.

^Setup

BATCHED.

Components Parameters

NOT APPLICABLE.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY. PROVIDE CLINICAL HISTORY & PATIENT'S CURRENT DRUG HISTORY (MULTIPLE DRUGS CAN INCREASE OR DECREASE 5-SEROTONIN LEVELS; CONSULT PATHOLOGIST IF IN DOUBT). DISCONTINUE SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs).

Patient preparation

DO NOT CONSUME FOODS RICH IN SEROTONIN (E.G. AVOCADOS, BANANAS, PINEAPPLE, MELONS, TOMATOES, EGGPLANTS, NUTS ETC.) FOR 48-72 HOURS PRIOR TO SAMPLE COLLECTION. AVOID STRENUOUS EXERCISE.

Sample type

SERUM.

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

AT LEAST 2ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE.

Other Instructions

Reference intervals

AGE & GENDER APPROPRIATE VALUES ARE PROVIDED ON THE REPORT.

Clinical Utility

DIAGNOSIS & MONITORING OF NEUROENDOCRINE TUMORS/ CARCINOID TUMORS.

Test Limitations/ Confounders

DIETARY & DRUG RESTRICTIONS APPLY. RESULTS SHOULD ALWAYS BE CORRELATED WITH CLINICAL FINDINGS & RESULTS OF OTHER DIAGNOSTIC WORK-UP E.G. IMAGING, TISSUE BIOPSY FINDINGS.

07 Jun

PROCALCITONIN

June 7, 2023June 7, 2023vincentochiengde

Category

ROUTINE CHEMISTRY.

Sub Category

INFECTIOUS.

Synonyms/Aliases

N/A.

Abbreviations

PCT.

^Type

INDIVIDUAL TEST.

^{2 Days}

RESULTS READY/ REPORTED IN 2 WORKING DAYS.

^Method

IMMUNOASSAY.

^Temp

REFRIGERATED, 2-8ºC, 2-7 DAYS; FROZEN >30 DAYS.

^Setup

DAILY.

Components Parameters

NOT APPLICABLE.

PRE-ANALYTIC CONSIDERATIONS

Test Ordering Instructions

FILL OUT TEST REQUEST FORM FULLY & LEGIBLY.

Patient preparation

N/A.

Sample type

SERUM.

Container/ preservative

SERUM SEPARATOR TUBE (SST/ GEL) OR PLAIN (RED TOP) VACUTAINER.

Sample volume

3 ML.

Rejection criteria

LABELING ISSUE (UNLABELED/ MISLABELED); MISSING REQUEST FORM; MISMATCH BETWEEN REQUEST FORM & SAMPLE DETAILS; MISSING AGE/ GENDER; WRONG SAMPLE TYPE; INSUFFICIENT SAMPLE; GROSS HEMOLYSIS.

Other Instructions

Reference intervals

AGE AND GENDER APPROPRIATE VALUES PROVIDED WITH REPORT

Clinical Utility

TO DIAGNOSE, RISK STRATIFY & MONITOR TREATMENT RESPONSE IN PATIENTS WITH SEPSIS. TO DISTINGUISH BETWEEN BACTERIAL VS. NON-BACTERIAL SEPSIS.

Test Limitations/ Confounders

BIOTIN INTERFERENCE MAY OCCUR AND PATIENTS SHOULD STOP BIOTIN SUPPLEMENTS AT LEAST 72 HOURS PRIOR TO TESTING.

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