Immunology
Introduction
The immunology laboratory diagnostic service aims to provide its users with a comprehensive repertoire of tests for autoimmunity, rheumatic diseases and allergy in- house. The laboratory liaises closely with all other pathology services at Gateshead to offer interpretation of all tests relating to immune function if required. Requests for tests outside our repertoire will be sent for testing to external laboratories. We are committed to a service of the highest quality in line with user requirements, to good professional practice and continued compliance with ISO 15189:2012 accreditation standards. We welcome dialogue with our users regarding tests and future service provision.
Staffing
The immunology laboratory diagnostic service is consultant led with medical and technical laboratory staff always available to answer queries and provide advice.
Advice
Day to day advice can be obtained by contacting the Laboratory. Where clinical advice is required the Consultant Immunologist may be contacted.
Laboratory hours
Core laboratory hours are from 8.30 a.m to 5 p.m. Laboratory staff are always available during those times to answer queries and will contact the Immunology Consultant if required.
Key Telephone numbers
| Dr Helen Bourne, Immunology Consultant | 0191 2820958 or email helen.bourne2@nhs.net |
| BMS Lead, Mr S Nixon / Immunology Laboratory | 0191 4456546 |
Test Repertoire
A searchable list is available in the Tests section of the website. This section will give details of tests available, collection details, reference ranges and units, telephone criteria, turnaround times and any appropriate comments.
Some tests require special sample tubes and/or conditions, e.g. AP100 and CH100. In these cases please contact the Laboratory BEFORE taking the sample. This is to try and ensure that correct procedures are followed and time is not wasted.
Where tests are not performed on-site these will be indicated as ‘Referred’ and the turnaround times will be listed as those given by the referral laboratory whenever available. In the absence of this information it may be based on experience and hence may be an approximation.
The referral centres employed by SoTW Clinical Laboratory Services are selected based upon their UKAS accreditation status and their ability to meet the needs of our users. The laboratory periodically reviews the quality of these referral centres.
If you cannot locate any test or there is insufficient detail in this section then please contact the laboratory.
The Immunology laboratory will provide urgent testing for ANCA (MPO/ PR3), GBM autoantibodies and serum Free Light Chains when required but please inform us by telephone if they are required prior to sending samples.
Tests for cellular function or phenotype and complement function are also available but please consult with laboratory staff for type of sample, volumes and other requirements before requesting these tests.
Requesting
Where available, ALL the requests should be made using the appropriate electronic ordering system:
Meditech Order Management – CHS Hospital requests
Sunquest ICE – GH and ST Hospital requests, Gateshead, South Tyneside and Sunderland CCGs,
To find out how to request on Sunquest ICE, please follow this link: ICE Training Manual.pdf
To find out how to request on Meditech Order Management, please follow this link: TO FOLLOW
Where or when paper requests need to be used the following information is mandatory:
- Surname
- Forename (given and not a diminutive)
- Date of Birth
- Unit/NHS Number where possible
- Consultant or GP
- Ward or Surgery
- Request(s)
If the request is from inside the Hospital a contact bleep number is extremely useful. When from a GP it should include contact information for the patient (e.g. telephone number and home address) so that the service is able to deal effectively with abnormal results when necessary.
It is extremely important for relevant Clinical Details to be included on the request. This helps us to help you by giving advice and interpretation where necessary and to add other useful tests when indicated. The date and time the sample is taken should also be included. This is essential when interpreting certain tests.
On occasions where samples need to be written by hand they must be labelled with the patient’s full Surname and Forename, Date of Birth and date and time of collection.
All samples must be labelled with the sample label. Samples should also be taken into the correct type of tube, if in doubt refer to the Tests page or contact the Laboratory for advice. Ideally a separate sample for each department is required but there are exceptions to the rule, e.g. patients very difficult to bleed, neonates.
To safeguard patients against wrong treatment, samples with details that are grossly at odds with those on the ICE form will NOT be processed and the requesting source will be notified.
In cases where there are no details on the sample:
- a repeat will be requested where it is easily obtained or
- in cases where it is difficult to obtain a further sample, the sample may be analysed after discussion and the requesting clinician affirming, preferably in writing, that the sample is from the correct patient. A caveat will be added to any report.
Justification may be required for some tests. In these cases the sample will be held for a reasonable length of time to allow contact with the BMS Lead.
Requesting additional tests
Immunology samples are kept for a maximum of 1 month from receipt. Any additional test requests must be made to the lab before this time expires.
For instructions for preparation of patient (see Tests)
There are no current requirements for patient consent
Any factors known to significantly affect the performance of the examination or the interpretation of results are contained within the Tests.
All High Risk or Hazardous samples MUST be double bagged and marked as such with Danger of Infection labels.
They should never be sent to the laboratory in the pneumatic air tube system
Please hand deliver them to the Laboratory wherever possible
Reference Ranges
All reported numerical results are accompanied by an appropriate Reference Range where this is applicable. This is sometimes related to age and sex but is always a population range and not an individual range.
Adult reference ranges are given in the Tests section where appropriate
Abnormal Results
Results of Anti-MPO, Anti-PR3, Anti-GBMA and serum Free Light Chains that are significantly abnormal & not previously reported or that have changed significantly will be communicated to the requesting team at the earliest opportunity. This will be done whether or not the request has been deemed “urgent”
Where it is deemed appropriate comments and suggestions will be appended to the report, and further tests added.
Samples
High Risk/Hazardous samples MUST be double bagged.
The request form and sample(s) MUST be marked with ‘Danger of Infection’ labels.
NEVER send High Risk/ Hazardous samples, glass containers or CSF samples in the pneumatic tube system, these must be delivered by hand to the laboratory.
Blood
In most cases a single 5ml SST II (13×100 Yellow Tube) or Vacuette (13×75 Gold Tube) is sufficient unless a large number of investigations are required (the ICE requesting system will indicate when more than one is required).
Please DO NOT use Lithium Heparin (light green or orange top (Paediatric)) samples for any Immunology tests.
Turnaround Times
Many Immunology tests are analysed on receipt which gives a turnaround time in the laboratory as given in the Tests section.
Only ANCA (MPO/ PR3), GBMA and serum Free Light Chain requests are processed as URGENT samples and can be turned around in less than 120 minutes (may be longer to include check, repeat and cascade analysis).
Some Immunology investigations done in-house will be batched and analysed at varying times depending on numbers, cost and ease of analysis. Where tests are referred to a reference Laboratory, turnaround times are dependent on the Referral Laboratory. This means that turnaround can vary between 2 days to several weeks depending on the test (contact the Laboratory for any specific enquiry).
The referral centres employed by SoTW Clinical Laboratory Services are selected based upon their UKAS accreditation status and their ability to meet the needs of our users. The laboratory periodically reviews the quality of these referral centres. Referred tests are indicated within the turnaround section of each individual test listing.
Where repeat analyses or further tests are cascaded, the turnaround may be delayed.
There is flexibility in the analysis schedule and the Laboratory is always willing to try and accommodate specific requests for faster turnaround times. When assays are not done in-house we will also try and intercede with the Referral Laboratory where there is an urgent requirement for the result. Please contact the Laboratory.
Quality Assurance
The Laboratory endeavors to make quality a fundamental component of all its work, and to continually monitor its performance and improve deficiencies.
All analyses are subject to internal quality control procedures, involving analysis of “QC” samples with known values to check that the analysis remains accurate and precise.
In addition all analyses are subject to External Quality Assurance procedures involving the blind analysis of samples distributed from nationally recognized Reference Centres. These allow the accuracy and precision of this Laboratory’s results to be compared with other laboratories in the country and with reference values.
The Laboratory performance in External Quality Assurance is available on line.
Results of all Immunology investigations are screened by the Laboratory computer system and those with significant abnormalities or which have changed from previous results are selected for checking and authorization by the Consultant Immunologist.
The Department is accredited to ISO15189:2012 and ISO22870:2016; our full scope of accreditation is published on the UKAS website.
South of Tyne & Wear Pathology Centre
