Staff

Diagnostic Immunopathology Service

The Central Sydney Immunology Laboratory provides a comprehensive range of immunological tests for all hospitals in the  Sydney South West Area Health Service Eastern Zone as well as for other hospitals and laboratories in the private sector. These tests can be broadly classified into six categories:

(a) Immunochemistry, including:

• Protein electrophoresis and immunoelectrophoresis
• Immunoglobulin quantitation (IgG, IgA, IgM, IgE, IgD and IgG subclasses). This test must not be mistaken for immunoelectrophoresis (IEPG) or immunofixation electrophoresis (IFE) which are not quantitative assays.
• Complement quantitation (C3, C4)
• Total Haemolytic Complement (THC), Properdin B (PFB)
• C Reactive Protein (CRP)
• Cryoglobulins. (The Immunology Registrar must be contacted for arrangement for the correct collection and transport procedures - see below)
• Protein immunoelectrophoresis (for paraprotein typing)
• Urinary protein electrophoresis and immunoelectrophoresis
• Allergen Specific IgE (RAST)
• CSF electrophoresis for oligoclonal bands

(b) Autoimmune Serology

A comprehensive range of autoantibody tests is available including Antinuclear Antibodies, anti-ds DNA, anti-neutrophil cytoplasmic antibodies, Rheumatoid Factor, anti gastric parietal cell antibodies, anti smooth muscle antibody and numerous organ specific autoantibody tests.

Autoantibodies should be requested individually.

(c) Lymphocyte typing including T cell subsets, HLA - 27 status.

For these tests the blood must arrive in the laboratory the day it is taken.

(d) In vitro Cell Mediated Immune Function

Owing to the complexity of the functional tests and the difficulties in interpretation of results, these tests are only performed after arrangement with the department.

In vitro lymphocyte function +
Phagocytic function *

+ Contact the Department, after consulting the laboratory registrar, who will facilitate the collection of blood samples.
* Tests of phagocytic function are performed by arrangement. Contact the Immunology registrar or Immunology Department.

(e) Skin Tests - allergy tests, DTH tests

Arrangements for these tests should be made by contacting the Immunology registrar. Skin tests to be arranged through the Registrar, or Immunology Sister on X 57469.

(f) HIV serology and viral load quantitation

It is essential to obtain informed consent for HIV testing. Pre-test counselling is required to obtain informed consent. Post-test counselling is also important regardless of the result. Referral to the HIV/AIDS Social Worker is recommended.

HIV serology is performed daily; results are not given by telephone, nor are they available trough the PathNet Laboratory Information System. Results will be sent to the doctor requesting the test (and the local doctor if requested) or may be collected from the laboratory (Building 93) on production of appropriate hospital identification.

For urgent HIV serology please contact the Immunology Registrar.

Testing for Viral load requires EDTA blood which should arrive in the laboratory within 6 hours of collection.

Specimens

Specific requirements for individual tests are listed in the Handbook of the Central Sydney Laboratory Service.

The majority of immunology tests require serum. In general, the serum from 10 ml of clotted blood is sufficient for a number of immunological tests. The blood should be collected in a white top, plain tube or a yellow top gel tube which should be available in all wards. Requests for lymphocyte typing and tests of in vitro lymphocyte function need EDTA blood.

Some tests may also be performed on joint fluid, aspirates, ascites, and effusions. Contact laboratory for details.

Spot urine (approximately 50 ml) is sufficient for the detection and typing of Bence Jones protein and for the electrophoretic determination of protein loss patterns. 24 hour urine specimens should be sent if quantitation of daily protein loss including paraproteins is required.

Special arrangements are necessary for the collection of blood for the detection of cryoglobulins. If tests for cryoglobulins are required, the Immunology Registrar should be notified and the patient fasted on the morning of the collection. The blood specimen will then be taken by the Immunology Resident and transported to laboratory at 37oC.

Results

Results of tests performed in the laboratory are available in CCIS and in Millennium Powerchart on terminals located in all the patient care areas. Detailed instructions about access to results and the features of the results enquiry program is available in the LABORATORY INFORMATION SERVICE section of the handbook.

Urgent results may be obtained by phoning the laboratory on extension 58731.

HIV serology results are not accessible on ward or laboratory computer terminals but are sent to the requesting doctor (and local doctor on request). Urgent HIV serology results may be obtained by medical staff by coming to the Immunology Laboratory or pre-arranging for a nominated person to collect a hard copy of the report.

Laboratory Hours

The Diagnostic Laboratory is open from 0830 -1700 hours Monday to Friday, but laboratory staff are usually available between 0800 and 1800 hours. The Laboratory is located on level 2 of the Centenary Institute of Cancer Medicine and Cell Biology (Building 93).