HAEMATOLOGY Screen 23 Haemochromatosis Gene Testing (H63D, C282Y) 23 Haptoglobin 24 Haemoglobin A2...

University Hospital Limerick Laboratory User Manual – Haematology File Name: MP-L-HAE-USERMAN-TEST_REPERTOIRE Edition No.: 06 Date of Issue: 9

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of 36 09/10/2015 Approved By: Dr. Maeve Leahy

Printed copies are only valid on the date printed. 09/10/2015

HAEMATOLOGY Contents

CONTACTING THE HAEMATOLOGY LABORATORY ----------------------------------------- 3

HAEMATOLOGY LABORATORY ON-CALL SERVICE ---------------------------------------- 3

QUALITY MANAGEMENT ------------------------------------------------------------------------------ 4

REQUEST FORM COMPLETION --------------------------------------------------------------------- 4 Change to Patient Demographics 4 Requesting GP / Consultant 5 Additional Copy of Report(s) 5 Specimen Labelling 5 Confidentiality 5

AVAILABILITY / ACCESS TO LABORATORY RESULTS ------------------------------------- 6 iLAB 6 Searching by Test / Profile 6 General Practitioners (GP’s) 7 Telephone Enquiries 7 Availability /Access to Laboratory Results – Patients/Relatives 7 Reports Received in Error 7 Policy on Telephoning Results 7 Policy of ‘Faxing’ Results 8 Referral Laboratory Reports 8

CLINICAL ADVICE & INTERPRETATION ---------------------------------------------------------- 8

REFERENCE RANGES ---------------------------------------------------------------------------------- 8

TURNAROUND TIMES ---------------------------------------------------------------------------------- 8

TEST REQUIREMENTS --------------------------------------------------------------------------------- 9 Coagulation specimen requirements 9 Blood Film Requests 9 FBC Analysis 9 Flow Cytometry 9

INDEX: TEST REPERTOIRE - HAEMATOLOGY ----------------------------------------------- 10 Activated Protein C Resistance (APC-R) 10 Anti-Factor Xa Level 10 Antithrombin III (ATIII) 11 APTT (Activated Partial Thromboplastin Time) 11 B12 12 Blood film 13 Bone Marrow Aspirate (BMA) Processing 13 C282Y Mutation (Haemochromatosis Gene) 13 CALR exon 9 mutations 14 CD 4/8 Count (Flow Cytometry) 14 Coagulation Factor Assays 14 Coagulation Screen 15 CSF Immunophenotyping (Flow Cytometry) 15 D-Dimer 16 Erythropoietin (EPO) Levels 16 ESR (Erythrocyte Sedimentation Rate) 16 Factor II (Prothrombin) 17


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Factor V 17 Factor V Leiden (FVL) 17 Factor VII 18 Factor VIII: C 18 Factor IX 18 Factor X 19 Factor XI 19 Factor XII 19 Factor XIII 20 FBC (Full Blood Count) 20 Ferritin 20 Fibrinogen 21 Folate (Folic Acid) 21 Free Protein S 22 Giemsa Stain for Malaria Parasites 22 Glucose 6 Phosphate Dehydrogenase (G6PD) 22 H63D Mutation (Haemochromatosis Gene) 23 Haematinics Screen 23 Haemochromatosis Gene Testing (H63D, C282Y) 23 Haptoglobin 24 Haemoglobin A2 (Hb A2) 24 Haemoglobin F (Hb F) 24 Haemoglobin S (Hb S) 24 Haemoglobinopathy Screen 25 Heinz Bodies 25 Hereditary Spherocytosis Screen (Flow cytometry) 25 Heparin Induced Thrombocytopaenia (HIT) Screen 26 INR (International Normalised Ratio) 26 Iron Stain (Perls Prussian Blue Stain) (Cytochemical Stain) 26 Janus Kinase 2 mutation (JAK2 V617F) 27 Leucocyte Esterase (Cytochemical Stain) 27 Lupus Like Anticoagulant (LLA) 28 Malaria Antigen Test 28 Malaria Screen 28 Monospot (Paul Bunnell Test) 29 Oxidative Burst Test 29 Plasma Viscosity 29 PNH (Paroxysmal Nocturnal Haemoglobinuria) By Flow Cytometry 30 Protein C 30 Protein S 30 Protein S Profile 31 Prothrombin (Factor II) 31 PT (Prothrombin Time) 31 Red Cell Folate 32 Red Cell Membrane Analysis for Hereditary Spherocytosis 32 Reptilase Time 32 Reticulocyte Count 33 Sickle Screen (Sickledex) 33 Sudan Black B (Cytochemical Stain) 33 T cell subsets, CD 4/8 Count (Flow Cytometry) 34 Thalassaemia 34 Thrombin Time (TT) 35 Thrombophilia Screen 35 Urinary Haemosiderin 35 vWF:Ag (von Willebrand Factor Antigen) 36 vWF Screen (von Willebrand Factor Screen) 36 Warfarin assay 36


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Contacting the Haematology Laboratory Results /General Enquiries: Ext 2249, Ext 2258 (061) 482249, 482258 Coagulation: Ext 2851 (061) 482851 Haematinics: Ext 2853 (061) 482853 Fax number: (061) 482559 Chief Medical Scientist Ms Carol Lenihan Ext 2847 (061) 482847 [email protected] Quality Officer Ms Claire Deering Ext 2258 (061) 482258 [email protected] Haematology Consultant Secretaries Dr D. O’Keeffe Ext 2642 (061) 482642 Dr M. Leahy Ext 2618 (061) 482618 Dr H. O’Leary Ext 2036 (061) 482036 Anti-Coagulation Clinic Ext 2270 (061) 48227 Anticoagulation co-ordinator Bleep #180 Haemovigilance Secretary Ext 2036 (061) 482036

Haematology laboratory on-call service Monday-Friday 20:00 to 08:00 (the following day) Saturday 13:00 to 09:00 (the following day) Sunday 09:00 to 08:00 (the following day) The on-call service is provided to process non-deferrable/urgent test requests, the results of which will impact on immediate patient management. Do not forward routine requests to the laboratory during on-call hours. Tests performed on-call include: • Full blood count and white cell differential • Reticulocyte count • Coagulation screen (PT, INR and APTT) • D-Dimer (All requests must include relevant clinical details) • Fibrinogen Requests for all other tests MUST be approved by a member of the haematology on-call team; the consultant requesting the test must contact the haematology consultant on call via the hospital switchboard (Ext 2119). After midnight, laboratory on-call personnel must be contacted via hospital switchboard (Ext 2119). Failure to do this may result in prolonged turnaround times for urgent requests.

mailto:[email protected]

mailto:[email protected]


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Delivery of Samples ‘Out of Hours’

Samples may be delivered to the laboratory via the Pneumatic Chute system or by ‘hand’. Samples delivered by hand should be left on the desk in the Haematology reception area. Samples left at other locations may not be noticed by personnel ‘On-Call’ resulting in a delay in processing of samples and provision of results.

Quality Management All correspondence relating to any issues with the service provided should be directed to either the Chief Medical Scientist or the Quality Officer. All user complaints or suggestions for service improvement and compliments will be acknowledged and addressed through the quality system. Feedback will be provided.

Request Form Completion Refer also to the Introduction of this User Manual - Pathology Policy on request form completion and specimen labelling. The request form must include a minimum of 3 patient identifiers (Name, DOB, Address and/or Chart No./PID) to positively select individual(s) from HSE-MWA patient databases and/or to establish a ‘new’ patient on the system. Incomplete or illegible demographics will result in avoidable contact between the laboratory and the requesting source and may incur increased turnaround times if samples are received ‘out of hours’ or if the GP surgery is closed. Do not use old patient addressograph labels to label request forms as the location of the patient may be specified incorrectly.

Change to Patient Demographics The laboratory would appreciate if recent changes to patient demographics (e.g. change of Address, marriage status/maiden name etc) could be highlighted on the request form so that a new medical record is not established inappropriately, resulting in a ‘loss of historical results’. Record Patient's Home address on all request forms to facilitate correct identification on the laboratory system and to avoid creation of a 'New' patient record which may result in prolonged turnaround times etc and loss of historic links to previous results on the laboratory system. We discourage use of Residential/Nursing Homes, Prison, Psychiatric hospitals etc. as address of patient. Request forms should at least reference previous addresses so that records can be updated. All test requests referred to the Haematology laboratory must include relevant clinical details and medications. This is particularly important for blood film examination.


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Requesting GP / Consultant Identify relevant Consultant/General Practitioner. Non Consultant Hospital Doctors (NCHDs) are not registered on the laboratory information system and should not be identified in this field. It is advisable to include clinician’s forename/address to ensure reports are issued to the correct location. It is preferable to include an abbreviated address if it is known that there are 2 doctors with the same surname. GP identifier barcodes are available from the laboratory on request. New users of the laboratory service should provide full address and contact details to facilitate ‘set up’ on the laboratory system/user database and timely reporting of results. Likewise, supply full contact details of any consultant/ward/hospital outside of the Mid West Area to which a report should be issued. N.B. Requests for analyses must only be made by clinicians responsible for care of individual patients The practice of staff / relatives of the patient requesting tests without informing the responsible clinician is not encouraged and may lead to a delay in the reporting and subsequent follow up of critical results.

Additional Copy of Report(s) Complete this section only if multiple copies of the results (to be sent to another location) are required. It is the responsibility of the requesting clinician to inform the 2nd location to expect receipt of laboratory reports which may otherwise be returned to the issuing laboratory. If additional copies of report(s) must be sent to clinicians practicing outside of the MWA, full identification, postal/contact details must be provided to ensure correct transmission of results in a timely fashion.

Specimen Labelling Printed addressograph labels with patient details will be accepted on specimens provided the labels are no larger than the manufacturers’ specimen tube label. Labels should be affixed so that the label is placed directly over/in-line with the ‘original’ label. The use of labels should not conceal the visibility of the sample. A sample received for coagulation where the sample volume is not visible will be rejected.

Confidentiality All laboratory records and information are strictly confidential and will not be divulged or discussed except in the performance of normal duty unless acting on the instructions of an authorised officer. Records are retained securely and cannot be accessed by unauthorised persons.


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Availability / Access to Laboratory Results

iLAB Laboratory Results are available on the laboratory information system (iLAB / Apex) to UL Hospitals who use the Pathology Service.

Status of results on iLAB (Apex) Haematology samples which require further authorisation, e.g. blood films, are brought to an authorisation level (technical validation) below full authorisation which is visible at ward level on iLAB. Not fully authorised is displayed beside the test result on screen for such results. Users must be aware that they are viewing results which are incomplete and therefore subject to change. Hardcopy reports are issued to requesting sources following complete authorisation.

Abbreviations in the tests sections H Hour D Day W Week N/A Not applicable

Searching by Test / Profile As described in iLAB (Laboratory Information System) section – ‘Looking up patient results using Ward Enquiry (WRNQ)’ – iLab facilitates searching by specific specimens / test enabling rapid access to a specific result. Identify the patient using the search functionality

Enter 2 select Spec from the ‘Action Bar’ options.

The Select Specimens option provides a snapshot list of all specimens and tests requested, by date and specimen type and result availability.

Specimen No. Collection Date/Time Specimen Type Tests Result availability

HHXXXXXXT 17/07/12 10:31 BCR-ABL In Progress HHXXXXXXR 24/04/12 10:49 BCR-ABL Avlbl PAXXXXXXG/10 08/06/10 12:11 Bone Marrow Aspirate Avlbl PHXXXXXXC/09 26/05/09 09:24 ILIAC CREST BIOPSY Avlbl


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Toggle up / down using the ↑ / ↓ or Page Up / Page Down keys to select the test / specimen of

interest.

Return to display The search criteria may be further limited by designating the discipline as appropriate e.g. H for Haematology Lab.

General Practitioners (GP’s) Electronic reporting of results through Healthlink is the preferred reporting option. Rapid turnaround tests FBC/Routine Coagulation/ESRs are reported electronically. Other tests are reported electronically and as a hardcopy. GP’s/external requestors may access results generated by the laboratory information system through ‘Healthlink’.

Telephone Enquiries Laboratory results are available at the contact details above. Results may be provided to the requesting source including. Consultants and their secretaries Non Consultant Hospital Doctors (NCHDs) Nursing staff General practitioners or their secretaries/nurses

Availability /Access to Laboratory Results – Patients/Relatives The laboratory is unable to provide results to patients/their relatives. Any requests for results by the patient/relative must be made via the requesting clinician. The laboratory may telephone results to an identified clinician as requested by the patient/relative as required.

Reports Received in Error Laboratory Reports are occasionally issued to the incorrect requesting location in error resulting in delayed provision of results. Although every effort is made to avoid such occurrences through the use of ‘bar-coded location identifiers’ etc., errors may occur from time to time. To alleviate the delays in reporting associated with such errors: Return hardcopy report/copy of electronic report directly to the testing laboratory

or Telephone the relevant laboratory advising them of the need to verify records and re-issue the

report(s). Please do not forward reports directly to the patient noted.

Policy on Telephoning Results It is our policy to telephone apparently unexpected results which may immediately affect patient management. General Practitioners are encouraged to provide a mobile telephone number to facilitate reporting of ‘urgent critical results’ out of hours. We are required to log all telephoned results. Therefore, you will be asked to confirm the patient’s name, date of birth and hospital number, and to give your name and grade. You will also be asked to


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read back the results transmitted to you to ensure they have been transcribed correctly. All telephoned results should be written in the ward results diary or in the patient's notes.

Policy of ‘Faxing’ Results To comply with the HSE Electronic Communications Policy… Reports will only be faxed by the department if a) No Alternative: There are no other means available b) Harm: In a medical emergency where a delay would cause harm to a patient/client/employee or the potential risk to a patient/client/employee is greater harm than the risk of disclosure of their personal information. Requests to fax results should identify

Clinical indication for need

Telephone & Fax numbers of intended recipient

Referral Laboratory Reports Results of tests referred for analysis to other laboratories are not available on the laboratory information system (iLab). All reports are forwarded to the requesting source and must be filed appropriately. The Haematology Laboratory will follow up on tests sent to other laboratories which have not been reported by the referral test site within the defined turnaround times. All queries relating to a referred test should be directed to the referral laboratory. Contact details for each referral laboratory are included in the relevant test sections.

Clinical Advice & Interpretation Clinical advice and interpretation of results is available from the consultant haematologists. The laboratory may provide information on specific test methodology and ‘assay performance characteristics’ to service users on request.

Reference ranges Reference ranges quoted in this manual refer to adult ranges. Age and sex related ranges where applicable are quoted on the haematology test report form.

Turnaround Times The Turnaround Times specified is defined as the ‘time of registration of sample on the Laboratory Information System (ILAB / APEX) to the time of authorisation of results’. Turnaround times are expressed as hours (H), working days (D) or weeks (W). Turnaround Times are monitored on a continuous basis and serve as a quality indicator reflecting the department’s contribution to patient care.


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Test requirements

Coagulation specimen requirements Relevant anticoagulant therapy (medications) should be included with all Coagulation requests. Relevant clinical details are required to facilitate D Dimer analysis. Requests may be rejected if no indication for testing is provided. Samples will be rejected for the following reasons: Under-filled samples i.e. any sample that is more than 4mm below the blue fill line indicated on

the sample bottle. Overfilled samples i.e. any sample that is more than 4mm above the blue fill level indicated on the

bottle. Any sample that is considered grossly haemolysed. Partially activated or clotted samples Lipaemic specimens for D-Dimers, Free Protein S, ATIII, Protein C, vWF:Ag and Anti-Xa requests Indications for testing not provided against D Dimer requests. Special precautions should be adhered to ensure coagulation samples are not contaminated with heparin or taken from a drip site.

Blood Film Requests Blood films will be made, examined and reported on patients’ FBC results which satisfy the criteria laid down by this laboratory in the guideline ‘ Indications for blood film examination’. If a clinician specifically requests a blood film which falls outside of these guidelines, this will also be examined.

FBC Analysis Clotted Samples Please note it is not technically possible to process a clotted FBC sample. The results on such a sample will be incorrect. Pleural Fluid/Aspirate/CSF Samples It is not technically possible to process pleural, ascites, CSF fluid etc. on a haematology analyser. Therefore, automated white cell/red cell counts cannot be provided on such fluids.

Flow Cytometry Tests carried out using flow cytometry include: T cell subsets (CD4/CD8 counts) – Wednesdays only. Immunophenotyping – Testing performed by referral laboratory. Flow cytometry is not carried out routinely. Under no circumstances should such a request be made out of hours. Requests for flow cytometry MUST be pre-booked with the Haematology laboratory reception staff (061 482258). Flow cytometry requests will only be processed if the clinical details are consistent with appropriate requesting guidelines, e.g. known HIV patient on HAART therapy, ICORG CLL Trial. All other requests for T cell subsets are to be approved following a review of clinical details and authorisation by a consultant haematologist/registrar. Flow cytometry is a specialised and time consuming test. Fresh EDTA samples (refer to test index for specifics) must be in the laboratory before 10.00am at the latest on the morning of testing


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Index: Test Repertoire - Haematology The user guide includes tests available to general users. A further range of specialised haematology tests are described in the departmental referral SOP. These tests can be ordered by the haematology or oncology service but are only available to general users after review of clinical details and authorisation by a consultant haematologist/registrar. Some tests described in the lab user guide also require review of clinical details and authorisation by a consultant haematologist/registrar.

Activated Protein C Resistance (APC-R) Generally requested as part of a thrombophilia screen. Thrombophilia screening requests must be sanctioned by the haematology team must include relevant clinical details. Thrombophilia screening is not performed on patients receiving warfarin and/or unfractionated heparin or novel anticoagulants. Specimen type: 2 x Citrated plasma (blue top) and 1 x EDTA (lilac top) or if ordered as part of a thrombophilia screen 4 x Citrated plasma (blue top) and 1 x EDTA (lilac top). Special requirements: Sample must be sent to laboratory ASAP; time of collection must be noted on request form and/or samples. Samples received in laboratory >4hrs post collection will be rejected. Turnaround times: 4W Reference range: 120-300 seconds Test / Profile code (iLab): APC-R / TPHIL

Anti-Factor Xa Level (Low molecular weight (LMWH) Heparin only) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 1 hour of phlebotomy. Routine weekly anti Xa levels should be sent on Monday mornings. Specimen should be taken 2-4 hours post dose. The time of the last heparin dose must be stated on the request form. Turnaround times: 1W Reference range: Ranges vary according to condition being treated and whether treatment is therapeutic or prophylactic. Test / Profile code (iLab): ANTI-X


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Antithrombin III (ATIII) Generally requested as part of a thrombophilia screen. Thrombophilia screening requests must be sanctioned by the haematology team and as such must include relevant clinical details. Thrombophilia screening is not performed on patients receiving warfarin and/or unfractionated heparin or novel anticoagulants. Specimen type: 2 x Citrated plasma (blue top) Or, if ordered as part of a thrombophilia screen, 4 x Citrated plasma (blue top) and 1 x EDTA (lilac top). Special requirements: Sample must be sent to laboratory ASAP; time of collection must be noted on request form and/or samples. Samples received in laboratory >4hrs post collection will be rejected. Turnaround times: 4 W Reference range: 80-120 U/dl Test / Profile code (iLab): ATIII / TPHIL

APTT (Activated Partial Thromboplastin Time) Specimen type: Citrated plasma (blue top). Special requirements: APTT requests for heparin dosage assessment should be received by the laboratory within 1 hour of phlebotomy. Samples for patients who are not on heparin must be received by the laboratory within 8 hours of phlebotomy. Turnaround times: Non GP: 4H GP: 8H Reference range: 28.0-40.0 seconds Test / Profile code (iLab): APTT / COAG


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B12 Specimen type: Serum (brown top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy, add on tests within 24 hours of phlebotomy. Relevant Clinical Details required. Indications for Vitamin B12 and Folate testing

1. Haematological a. Unexplained anaemia (or other cytopenia) b. Unexplained macrocytosis (raised MCV)

2. Neurological a. Peripheral neuropathy b. Dementia c. Other unexplained neurology

3. Pregnancy / Fertility Investigations 4. Glossitis 5. Diabetic patients on metformin. 6. Malabsorption.

B12 is recommended (if not already tested) in those who test positive for parietal cell and/or intrinsic factor antibodies.

7. Patients on dialysis

Fatigue and tiredness are not indications for Vitamin B12 or Folate testing unless accompanied by one of the above indications.

Vitamin B12 and Folate testing should not be done as part of a general health screen unless initial screening reveals one of the above indications.

Patients on oral contraceptive pills/pregnancy may have falsely low Vitamin B12 levels. Repeat testing of Vitamin B12 and Folate

Vitamin B12 stores last over three years. Therefore if a normal Vitamin B12 result has been obtained in the previous six months a further Vitamin B12 test will not be processed unless discussed with a haematology consultant.

Folate stores last for a shorter period of time. Therefore repeat Folate testing may be necessary if above indications are met.

Patients on B12 and/or Folate replacement

Patients on replacement do not need repeat Vitamin B12 or Folate testing unless haematological or neurological parameters have not improved.

Turnaround times: 3 D Reference range: Age and sex related. Refer to report form. Test / Profile code (iLab): B12 / BFF


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Blood film Specimen type: EDTA (lilac top). Special requirements: Sample must be received within 2 hours of phlebotomy to avoid EDTA changes on the blood film. Please include relevant clinical details. Turnaround times: 3 D Reference range: N/A Test / Profile code (iLab): FILM

Bone Marrow Aspirate (BMA) Processing Specimen type: Bone marrow spread on glass slides. Special requirements: All BMA requests should be accompanied by an EDTA (FBC) sample. FBC/film should be requested on a separate form. Bone marrow slides should be delivered to the laboratory fresh or should be fixed in methanol. Slides must be labelled on frosted side using a lead pencil. Identification details should include: Patients full name. PID / Chart number and/or DOB. Specimen date. Accompanied by UHL haematology request form. Turnaround times: 14 D Reference range: N/A Test / Profile code (iLab): N/A. Search by discipline – Histology.

C282Y Mutation (Haemochromatosis Gene) Specimen type: 2 x EDTA (lilac top). Special requirements: See Haemochromatosis Gene Testing. Turnaround times: 45 D Reference range: N/A Test / Profile code (iLab): C282Y / HLAHP


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CALR exon 9 mutations Specimen type: Peripheral blood (or bone marrow) sample taken into EDTA or, if already extracted, a DNA sample Special requirements: Prior arrangement with UHL laboratory (061 482258). Review of clinical details and authorisation by a consultant haematologist/registrar. Consultant signature/approval required on request form. Referred to Cambridge Molecular Malignancy Laboratory / Haemato-Oncology Diagnostics Service (HODS) Turnaround times: 60 D Haematology team may contact referral laboratory re urgent samples. Reference range: N/A Test / Profile code (iLab): CALR

CD 4/8 Count (Flow Cytometry) Specimen type: 2 x EDTA (lilac top). Special requirements: Prior arrangement with laboratory; contact 061 482258. Flow cytometry requests will only be processed if the clinical details are consistent with appropriate requesting guidelines, e.g. known HIV patient on HAART therapy, ? lymphoproliferative disorder (requesting restricted to haematology consultants only). CD4/CD8s counts are only processed on Wednesdays. Samples must arrive in the laboratory before 10.00am on day of processing. Urgent requests must be discussed with Senior Medical Scientist in flow cytometry prior to referral of samples. Turnaround times: 3-5 D Reference range: See report form. Test / Profile code (iLab): CD4/8

Coagulation Factor Assays Specimen type: 3 x Citrated plasma (blue top). 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples Special requirements: Prior arrangement with the coagulation department, contact 061 482851. Refer to specific factor assays for special requirement details. Turnaround times: 3 W Reference range: See individual assay. Test / Profile code (iLab): Refer to specific Factor Assay.


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Coagulation Screen Specimen type: 1 x Citrated plasma (blue top). Special requirements: Profile includes PT, INR (for patients on warfarin) and APTT. Details of anticoagulant therapy required. Do not refrigerate INR samples. Turnaround times: Non-GP: 4H GP 8H Reference range: See individual assay. Test / Profile code (iLab): COAG

CSF Immunophenotyping (Flow Cytometry) Specimen type: Cerebrospinal Fluid (in RPMI) Clinical Details required and referral authorised following consultation with Consultant

Haematologist. Separate specimen required to avoid unnecessary delay in transport to referral lab.

Take further samples for Microbiology, Biochemistry, Histology tests as required. Special requirements: Prior arrangement with UHL laboratory; contact 061 482258. Consultant signature/approval required on request form. Monday to Friday only. Requests should be received by the laboratory before 11:00 hours to facilitate same day transport to referral laboratory. Referred to Haematology Laboratory, (Immunophenotyping), St James’ Hospital, James Street, Dublin 8. Tel: 01 4162909. Turnaround times: 14 days (Routine) Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): CSFIMR / CSFIMP


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D-Dimer Specimen type: 1 x Citrated plasma (blue top). Special requirements: All requests must include relevant clinical details. D dimer testing should only be carried out in the community when assessing patients with low risk based upon a clinical score of a thrombosis (Well’s criteria for DVT assessment). If the patients risk assessment indicates a high risk of thrombosis, the D dimer should not be done and the patient should be referred into the Medical Assessment Unit for further investigation. Requests should be received by the laboratory within 8 hours of phlebotomy. Lipaemic or haemolysed plasmas not suitable for analysis. Turnaround times: 1 D Reference range: 0.00-0.50 ug/ml Test / Profile code (iLab): DD / COAGD

Erythropoietin (EPO) Levels Specimen type: 2 x Serum (brown top). Special requirements: Consultant signature / approval required on request form. Review of clinical details and authorisation by a consultant haematologist/registrar. Referred to Haematology Lab, St James Hospital

Tel: 01 416 2943 / 416 2944 (09.00 to 17.00)

Turnaround times: 14 D Reference range: Refer to report issued by referral laboratory Test / Profile code (iLab): EPOR / EPOP

ESR (Erythrocyte Sedimentation Rate) Specimen type: Sedivette/Sodium Citrate. Blood track labels may be used if placed over the manufacturer’s label. The use of addressograph labels larger than the manufacturer’s specimen label is not encouraged and may yield ‘false low’ results and resulting rejection of the sample. Special requirements: Requests should be received by the laboratory within 6 hours of phlebotomy. Turnaround times: 3 H Reference range: Age and sex related. Refer to report form.


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Factor II (Prothrombin) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 3 W Reference range: 70-120 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FII / FIIP

Factor V Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 1 hour of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 3 W Reference range: 70-120 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FV / FVP

Factor V Leiden (FVL) Specimen type: 2 x EDTA Special requirements: Positive APCR / relevant family history required. Referred for analysis to: Haemostasis Molecular Genetics, St Thomas’ Hospital, London. Tel: +44-207-188 2779 Turnaround times: 4W Reference range: N/A Test / Profile code (iLab): FVLR / FVLP


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Factor VII Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Do not refrigerate samples. Turnaround times: 3 W Reference range: 70-130 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FVII / F7P

Factor VIII: C Specimen type: Citrated plasma (blue top). Special requirements: Fresh Specimen required. Requests should be received by the laboratory within 1 hour of phlebotomy. Turnaround times: 3 W Reference range: 60-150 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FVIIIC / F8P

Factor IX Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 3 W Reference range: 60-150 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FIX / FIXP


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Factor X Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Turnaround times: 3 W Reference range: 70-120 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FX / FXP

Factor XI Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Turnaround times: 3 W Reference range: 60-140 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FXI / FXIP

Factor XII Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Turnaround times: 3 W Reference range: 60-140 u/dl Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FXII / F12P


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Factor XIII Specimen type: 2 x Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Monday to Friday only. Requests should be received by laboratory before 10:00 hours to facilitate same day transport to testing laboratory. Referred to the National Centre for Hereditary Coagulation Disorders, St James. Tel.: 01-4162956 Turnaround times: 4 W Reference range: Refer to report issued by referral laboratory. Volume: 1-2 factor assays requires 2 samples; 3-4 factor assays requires 3 samples; more than 4 factor assays require 4 samples. Test / Profile code (iLab): FXIII / FXIIIP

FBC (Full Blood Count) includes White Cell Differential – Neutrophil, Lymphocyte, Monocyte, Eosinophil and Basophil counts. Specimen type: EDTA (lilac top). Special requirements: After 24 hours, WBC differential and red cell indices are affected by EDTA changes. Ensure samples are not taken from a drip site as this results in haemodilution of the sample. Turnaround times: Non GP: 4 H GP: 24 hours Reference range: See report form. Test / Profile code (iLab): FBCD / FBCDR

Ferritin Specimen type: Serum (brown top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy, add on tests within 24 hours of phlebotomy. Turnaround times: 3 D Reference range: Age and sex related. Refer to report form. Test / Profile code (iLab): FERR / BFF


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Fibrinogen Specimen type: 1 x Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy. Turnaround times: 1 D Reference range: 2.0-4.0 g/l Test / Profile code (iLab): FIB

Folate (Folic Acid) Specimen type: Serum (brown top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy, add on tests within 24 hours of phlebotomy. Relevant Clinical Details required. Indications for Vitamin B12 and Folate testing

1. Haematological a. Unexplained anaemia (or other cytopenia) b. Unexplained macrocytosis (raised MCV)

2. Neurological a. Peripheral neuropathy b. Dementia c. Other unexplained neurology

3. Pregnancy / Fertility Investigations 4. Glossitis 5. Diabetic patients on metformin. 6. Malabsorbtion.

B12 is recommended (if not already tested) in those who test positive for parietal cell and/or intrinsic factor antibodies.

7. Patients on dialysis

Fatigue and tiredness are not indications for Vitamin B12 or Folate testing unless accompanied by one of the above indications.

Vitamin B12 and Folate testing should not be done as part of a general health screen unless initial screening reveals one of the above indications.

Patients on oral contraceptive pills/pregnancy may have falsely low Vitamin B12 levels. Repeat testing of Vitamin B12 and Folate

Vitamin B12 stores last over three years. Therefore if a normal Vitamin B12 result has been obtained in the previous six months a further Vitamin B12 test will not be processed unless discussed with a haematology consultant.

Folate stores last for a shorter period of time. Therefore repeat Folate testing may be necessary if above indications are met.

Patients on B12 and/or Folate replacement

Patients on replacement do not need repeat Vitamin B12 or Folate testing unless haematological or neurological parameters have not improved.

Turnaround times: 3 D Reference range: Age and sex related. Refer to report form. Test / Profile code (iLab): FOL / BFF


th October 2015



Free Protein S Generally requested as part of a thrombophilia screen. Thrombophilia screening requests must be sanctioned by the haematology team and as such must include relevant clinical details. Thrombophilia screening is not performed on patients receiving warfarin and/or unfractionated heparin. Specimen type: 2 x Citrated plasma (blue top). Or, if ordered as part of a thrombophilia screen, 4 x Citrated plasma (blue top) and 1 x EDTA (lilac top). Special requirements: Requests should be received by the laboratory within 4 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 4 W Reference range: 65-140 U/dl Test / Profile code (iLab): FREEPS / TPHIL

Giemsa Stain for Malaria Parasites Specimen type: Thick and thin blood films. Special requirements: A fresh sample is required for malaria screens and preferably should be obtained when the patient is at the peak of a febrile attack. Travel history and clinical details including medication details, are essential. 3 negative results are needed to confirm absence of malaria. Turnaround times: 3 D Reference range: N/A Test / Profile code (iLab): MAL / MALA

Glucose 6 Phosphate Dehydrogenase (G6PD) Specimen type: 2 x EDTA (lilac top) Special requirements: Authorisation by Consultant Haematologist/Registrar Referred for analysis to: Haemolytic Anaemia Laboratory, St James. Tel.: 01 416 2394 Turnaround times: 30 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): G6PD / G6PDP


th October 2015



H63D Mutation (Haemochromatosis Gene) Specimen type: 2 x EDTA (lilac top). Special requirements: See Haemochromatosis Gene Testing. Turnaround times: 45 D Reference range: N/A Test / Profile code (iLab): H63D / HLAHP

Haematinics Screen Specimen type: Serum (brown top). Special requirements: Profile includes B12, Folate and Ferritin. Requests should be received by the laboratory within 8 hours of phlebotomy. Relevant Clinical Details required for B12 & Folate requests. Guidelines on Vitamin B12 and Folate Testing are available. The laboratory may not process specimens where the indications for B12 & Folate testing are not provided. Turnaround times: 3 D Reference range: See individual assays. Test / Profile code (iLab): BFF

Haemochromatosis Gene Testing (H63D, C282Y) Specimen type: 2 x EDTA (lilac top). Note: Screening requirements pre genetic analysis. Special requirements: Accompanied by completed Patient information request form issued by National Centre for Medical Genetics (NCMG), OLHSC, Crumlin. Referred to Biomnis Ireland, Three Rock Rd, Sandyford Business Estate, Sandyford, D18 Tel: 01 295 8545 Referrals for genetic testing will only be accepted with a clear indication of the reason for testing. The patient must either have a fasting transferrin saturation > 50% for pre-menopausal women, or 55% for post menopausal women and men, or a first degree relative who is currently being venesected for haemochromatosis. Turnaround times: 45 D Reference range: N/A Test / Profile code (iLab): HLAHP


th October 2015



Haptoglobin Specimen type: Serum (brown top). Special requirements: Monday to Friday only. Requests should be received by the laboratory before 13:00 hours within 24 hours of phlebotomy. Haemolysis of the sample will affect the reliability of the result. Referred to Biomnis Ireland, Sandyford, Dublin 18. Tel: 01 2958545 Turnaround times: 14 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): HAPTR / HAPTP

Haemoglobin A2 (Hb A2) Specimen type: EDTA (lilac top). Special requirements: Accompanied by UHL haemoglobinopathy request form. See haemoglobinopathy screen. Turnaround times: 42 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): HBEL-A (Adults) / HBEL-P (Minors <16 years)

Haemoglobin F (Hb F) Specimen type: EDTA (lilac top). Special requirements: Accompanied by UHL haemoglobinopathy request form. See haemoglobinopathy Screen. Turnaround times: 42 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): HBEL-A (Adults) / HBEL-P (Minors <16 years)

Haemoglobin S (Hb S) Specimen type: EDTA (lilac top). Special requirements: Accompanied by UHL haemoglobinopathy request form. See haemoglobinopathy Screen. Turnaround times: 42 D Reference range: 0 g/dl Test / Profile code (iLab): HBEL-A (Adults) / HBEL-P (Minors <16 years)


th October 2015



Haemoglobinopathy Screen Specimen type: 1 x Serum (brown top), 2 x EDTA (lilac top). Special requirements: Accompanied by UHL haemoglobinopathy request form Includes Haemoglobin A, A2, F & S etc. Adult samples (>16 years) are referred to Haematology Lab, St James. Tel.: 01 416 2909. Paediatric samples (<16 years) are referred to Haematology Lab, OLHSC, Crumlin. Tel.: 01 409 6432 Full Blood Count and serum ferritin reports are provided to the relevant referral lab with all requests to facilitate interpretation of results. Samples may not be referred for analysis if red cell indices are suggestive of iron deficiency in the absence of a serum ferritin result. Alpha thalassaemia trait cannot be excluded where iron deficiency exists. Turnaround times: 42 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): HBEL-A (Adults) / HBEL-P (Minors <16 years)

Heinz Bodies Specimen type: EDTA (lilac top) Special requirements: Sample must be in receipt of laboratory within 2 hours of phlebotomy. Turnaround times: 1 W Reference range: N/A Test / Profile code (iLab): HEINZ

Hereditary Spherocytosis Screen (Flow cytometry) Specimen type: 2 x EDTA (lilac top). Special requirements: Prior arrangement with Consultant Haematologist and Laboratory, contact 061 482258. Consultant signature / approval required on request form. All requests must be accompanied by FBC, Reticulocyte Count, Blood Film and Bilirubin reports as specified by the Referral Laboratory. Referred to National Centre for Medical Genetics, Cytogenetics Laboratory, Our Lady’s Hospital for Sick Children, Crumlin Tel: 01-409 6432 Samples must be received by 10.00 a.m. to ensure same day delivery to Dublin. Turnaround times: 30 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): RCM1R / RCM1P


th October 2015



Heparin Induced Thrombocytopaenia (HIT) Screen Specimen type: 2 x Citrated plasma (blue top). 1 x EDTA (lilac top) 2 x Serum (brown top) Special requirements: Prior arrangement with the UHL Coagulation Department. Contact 061 482851. St James NCHCD request form must be completed by requesting source Fresh specimens must be received before 10.00 a.m. Referred to Coagulation Laboratory, National Centre for Hereditary Coagulation Disorders, St James’ Hospital. Tel: 01-4162956 / 4103569. Turnaround times: 30 D Reference range: N/A Test / Profile code (iLab): HITR / HITP

INR (International Normalised Ratio) Specimen type: Citrated plasma (blue top). Special requirements: Only performed on patients receiving Warfarin therapy and as such this must be specified on the request form. PT / INR requests for Warfarin dosage assessment must be received by the laboratory within 24 hours of phlebotomy. Details of anticoagulant therapy required. **Do not refrigerate INR samples** Turnaround times: Non GP: 4 H GP: 24H Reference range: 0.9-1.2 Ratio Test / Profile code (iLab): PTINR / COAG

Iron Stain (Perls Prussian Blue Stain) (Cytochemical Stain) Specimen type: Bone marrow spread on glass slides. Special requirements: All BMA requests should be accompanied by a FBC sample. FBC/Film should be requested on a separate form. Bone marrow slides, must be delivered fresh to the laboratory, or be fixed in methanol. Slides must be labelled on frosted side using a lead pencil, include: Patients full name. PID / Chart number and/or DOB. Specimen date. Accompanied by UHL haematology request form. Turnaround times: 1 W Reference range: N/A Test / Profile code (iLab): N/A. Search by discipline – Histology.


th October 2015



Janus Kinase 2 mutation (JAK2 V617F) Specimen type: 9 mL EDTA Special requirements: Prior arrangement with UHL laboratory (061 482258). Review of clinical details and authorisation by a consultant haematologist/registrar. Consultant signature/approval required on request form. Referred to Cancer Molecular Diagnostics (CMD), St James Hospital. Tel.: 01 410 3575 Requests must be completed on CMD request forms including adequate clinical details e.g. ? PPP, ET, CML, etc. Bone Marrow samples must be received by 10.00am to ensure same day delivery to Dublin. Note: CMD routinely reject JAK2 requests on patients who have been previously tested and may not issue a report to that effect. Turnaround times: 45 D Haematology team may contact referral laboratory re urgent samples. Reference range: N/A Test / Profile code (iLab): JAK2R / JAK2P

Leucocyte Esterase (Cytochemical Stain) Specimen type: Bone Marrow Aspirate on slides. Special requirements: Prior arrangement with Consultant Haematologist and Laboratory (061 482258). This test will only be processed with authorisation by a consultant haematologist / registrar. Referred to St James Hospital for pre-analytical staining. Turnaround times: 45 D Haematology team may contact referral laboratory re urgent samples. Reference range: Refer to Report. Test / Profile code (iLab): NCAE


th October 2015



Lupus Like Anticoagulant (LLA) Unless requested by

A Neurologist

A Rheumatologist

Miscarriage clinic

Gynaecologist for investigation of recurrent miscarriage/fertility treatment Lupus screening requests must be sanctioned by the haematology team. Lupus screening is not performed on patients receiving warfarin and/or unfractionated heparin or novel anticoagulants. Specimen type: 3 x Citrated plasma (blue top). Special requirements: Fresh specimens required. Details of anticoagulant therapy required. Turnaround times: 4 W Reference range: N/A Test / Profile code (iLab): LLA / TPHIL

Malaria Antigen Test Specimen type: EDTA (lilac top). Special requirements: A fresh sample is required for malaria screens and preferably should be obtained when the patient is at the peak of a febrile attack. Travel history and clinical details including medication details are essential. Turnaround times: 1 D Reference range: Negative or Positive. Test / Profile code (iLab): MALAB / MALA

Malaria Screen Specimen type: EDTA, Fresh Blood Films. Special requirements: Travel history and clinical details, including medication details are essential. Screen includes Malaria antigen Test for the qualitative detection of Plasmodium Falciparum, Plasmodium Vivax, Plasmodium Malariae and Plasmodium Ovale and a blood film stained for malaria parasites. A fresh sample is required for malaria screens and preferably should be obtained when the patient is at the peak of a febrile attack. 3 negative blood film results are needed to confirm absence of malaria. Turnaround times: 3 D Reference range: N/A Test / Profile code (iLab): MALA


th October 2015



Monospot (Paul Bunnell Test) Specimen type: EDTA (lilac top) or Serum (brown top). Special requirements: N/A Turnaround times: 2 D Reference range: Negative or positive. Test / Profile code (iLab): MONOSP

Oxidative Burst Test Specimen type: 2 x EDTA (lilac top). Special requirements: This test will only be processed with authorisation by a consultant haematologist. Consultant signature/approval required on request form. Prior arrangement with laboratory also required (061 482258). Referred to Haematology Lab, OLHSC, Crumlin. Tel.: 01 409 6432. Samples must be in receipt of referral laboratory within 4 hours of phlebotomy. Referrals accepted Monday – Wednesday. Turnaround times: 30 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): NBT1 / NBTP

Plasma Viscosity Specimen type: EDTA (lilac top). Special requirements: This test is only available if one of the following applies:

1. Patients with a significant paraprotein (IgG >30g/l; IgA>20g/l; IgM>15g/l). 2. Patients having plasmapheresis for a lymphoproliferative disorder 3. Patients where the test has been discussed with, and authorised by a haematology

registrar/consultant haematologist Requests should be received by the laboratory within 6 hours of phlebotomy. Samples MUST NOT be refrigerated. Turnaround times: 3 D Reference range: 1.13-1.30 mPa@37 ºC Test / Profile code (iLab): PVISC


th October 2015



PNH (Paroxysmal Nocturnal Haemoglobinuria) By Flow Cytometry Specimen type: EDTA x 3 (lilac top). Special requirements: Prior arrangement with Consultant Haematologist and laboratory, contact 061 482258. Consultant signature / approval required on request form. Samples must be within receipt of laboratory by 10:00 hours. Referred for analysis to: Haematology Lab, St James. Tel.: 01 416 2909 Turnaround times: 30 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): PNHR / PNHP

Protein C Generally requested as part of a thrombophilia screen. Thrombophilia screening requests must be sanctioned by the haematology team and as such must include relevant clinical details. Thrombophilia screening is not performed on patients receiving warfarin and/or unfractionated heparin or novel anticoagulants Specimen type: 2x Citrated plasma (blue top). Or, if ordered as part of a thrombophilia screen, 4 x Citrated plasma (blue top) and 1 x EDTA (lilac top). Special requirements: Requests should be received by the laboratory within 4 hours of phlebotomy. Urgent requests must be approved by a Consultant Haematologist. Details of anticoagulant therapy required. Turnaround times: 4 W Reference range: 70-130 u/dl Test / Profile code (iLab): PROTC / TPHIL

Protein S Generally requested as part of a thrombophilia screen. Thrombophilia screening requests must be sanctioned by the haematology team and as such must include relevant clinical details. Thrombophilia screening is not performed on patients receiving warfarin and/or unfractionated heparin or novel anticoagulants Specimen type: 2x Citrated plasma (blue top). Or, if ordered as part of a thrombophilia screen, 4 x Citrated plasma (blue top) and 1 x EDTA (lilac top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 4 W Reference range: 65-140 u/dl Test / Profile code (iLab): PROTS / TPHIL


th October 2015



Protein S Profile Specimen type: 2 x Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Test includes Protein S & Free Protein S. Turnaround times: 30 D Reference range: Protein S: 65-140 u/dl, Free Protein S: 60-140 u/dl. Test / Profile code (iLab): PROTS / FREEPS

Prothrombin (Factor II) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 3 W Reference range: 70 -120u/dl Test / Profile code (iLab): FII / FIIP

PT (Prothrombin Time) Specimen type: Citrated plasma (blue top). Special requirements: PT / INR requests for Warfarin dosage assessment must be received by the laboratory within 24 hours of phlebotomy. Details of anticoagulant therapy required. Do not refrigerate PT samples. Turnaround times: Non GP 4H GP: 24H Reference range: 11.0-15.0 seconds Test / Profile code (iLab): PTINR / COAG


th October 2015



Red Cell Folate Specimen type: 2 x EDTA (lilac top) + Serum sample (brown top). Special requirements: Monday to Friday only. Requests should be received by the laboratory before 13:00 hours and within 3 hours of phlebotomy. Referred to Biomnis Ireland, Sandyford, Dublin 18 Tel: 01 2958545 Turnaround times: 14 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): RCFR / RCFP

Red Cell Membrane Analysis for Hereditary Spherocytosis Specimen type: 2 x EDTA (lilac top). Special requirements: Prior arrangement with Consultant Haematologist and Laboratory, contact 061 482258. Consultant signature / approval required on request form. All requests must be accompanied by FBC, Reticulocyte Count, Blood Film and Bilirubin reports as specified by the Referral Laboratory. Referred to Haematology Laboratory, Our Lady’s Hospital for Sick Children, Crumlin Tel: 01-409 6432 Samples must be received by 10.00 a.m. to ensure same day delivery to Dublin. Turnaround times: 30 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): RCM1R / RCM1P

Reptilase Time Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy. Turnaround times: 30 D Reference range: 12-20 Seconds Test / Profile code (iLab): REPT


th October 2015



Reticulocyte Count Specimen type: EDTA (lilac top). Special requirements: Requests should be received by the laboratory within 12 hours of phlebotomy. Turnaround times: 4 H Reference range: 22-139 x 109/l Test / Profile code (iLab): RET / FBCDR

Sickle Screen (Sickledex) Specimen type: 1 x Serum (brown top), 2 x EDTA (lilac top). Special requirements: Urgent pre-operative specimens only. Accompanied by UHL haemoglobinopathy request form. All Sickledex requests are referred for haemoglobinopathy screen for confirmatory analysis. Turnaround times: 3 D Reference range: Positive or negative. Test / Profile code (iLab): SICKLE / SICKLP

Sudan Black B (Cytochemical Stain) Specimen type: Bone Marrow Aspirate Slides, FBC sample. Special requirements: Prior arrangement with Consultant Haematologist and Laboratory, contact 061 482258. This test will only be processed with authorisation by a consultant haematologist. Referred to St James Hospital for pre-analytical staining. Turnaround times: 45 D Haematology team may contact referral laboratory re urgent samples. Reference range: N/A Test / Profile code (iLab): SBB


th October 2015



T cell subsets, CD 4/8 Count (Flow Cytometry) Specimen type: 2 x EDTA (lilac top). Special requirements: Prior arrangement with laboratory, contact 061 482258. Flow cytometry requests will only be processed if the clinical details are consistent with appropriate requesting guidelines, e.g. known HIV patient on HAART therapy, ? lymphoproliferative disorder (requesting restricted to haematology consultants only). T cell subsets are only processed on Wednesdays only. Samples must arrive in the laboratory before 10.00 a.m. on day of processing. Turnaround times: 2 D Reference range: CD4: 500-1000 cells/ul CD8: 300-900 cell/ul Test / Profile code (iLab): CD4/CD8

Thalassaemia Specimen type: 1 x Serum (brown top), 2 x EDTA (lilac top). Special requirements: Accompanied by UHL haemoglobinopathy request form Includes Haemoglobin A, A2, F & S etc. Adult samples (>16 years) are referred to the Haematology Lab, St James. Tel.: 01 416 2909. Paediatric samples (<16 years) are referred to the Haematology Lab, OLHSC, Crumlin. Tel.: 01 409 6432 Full Blood Count and serum ferritin reports are provided to the relevant referral lab with all requests to facilitate interpretation of results. Samples may not be referred for analysis if red cell indices are suggestive of iron deficiency in the absence of a serum ferritin result. Alpha thalassaemia trait cannot be excluded where iron deficiency exists. Turnaround times: 42 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): HBEL-A (Adults) / HBEL-P (Minors <16 years)


th October 2015



Thrombin Time (TT) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy. Details of anticoagulant therapy required. Turnaround times: 30 D Reference range: 14-21seconds Volume: 1 citrated (blue top) sample. Test / Profile code (iLab): TT

Thrombophilia Screen Screen Includes: PT/INR, APTT, Fibrinogen, ATIII, Protein C, Protein S, Free Protein S, APC-R, Lupus Like Anticoagulant Specimen type: 4 x Citrated plasma (blue top), 1 x EDTA (lilac top). Special requirements: Requests should be received by the laboratory within 4 hours of phlebotomy. Clinical details required. Please provide patient and family history. Appropriate for: Confirmed thrombotic event in persons <50 years if no clear precipitating factor; 1st degree relatives of patients with proven thrombophilia about to commence oral contraception or scheduled for surgery. Testing should not be done during acute thrombotic period or while the patient is on anticoagulant therapy. Turnaround times: 4 W Reference range: N/A Volume: 4 samples (blue top). Test / Profile code (iLab): TPHIL

Urinary Haemosiderin Specimen type: Urine without any preservative. Special requirements: A fresh early morning specimen is preferable. Review of clinical details and authorisation by a consultant haematologist/registrar. Consultant signature / approval required on request form. Turnaround times: 3-5 D Reference range: N/A Test / Profile code (iLab): HAEMO


th October 2015



vWF:Ag (von Willebrand Factor Antigen) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 8 hours of phlebotomy. Turnaround times: 28 D Reference range: 60-150 u/dl Volume: 1 sample Test / Profile code (iLab): VWF / VWFP

vWF Screen (von Willebrand Factor Screen) Specimen type: Citrated plasma (blue top). Special requirements: Requests should be received by the laboratory within 2 hours of phlebotomy. Turnaround times: 28 D Reference range: See specific tests included in screen for ranges – FVIII:C, RICOF, VWF:ag Volume: 1 sample Test / Profile code (iLab): VWFP

Warfarin assay (PIVKA – Protein induced by Vitamin K absence antagonist) Specimen type: Serum (brown top) Special requirements: Prior arrangement with the UHL coagulation department. Contact: 061-482851. Consultant signature / approval required on request form. Details of anticoagulant therapy required. Referred for analysis to Centre for Haemostasis & Thrombosis, Guy’s & St Thomas’ Hospital, London. Tel.: +44-207-401 3125 Turnaround times: 28 D Reference range: Refer to report issued by referral laboratory. Test / Profile code (iLab): WARFR

HAEMATOLOGY Screen 23 Haemochromatosis Gene Testing (H63D, C282Y) 23 Haptoglobin 24 Haemoglobin A2...

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Transcript of HAEMATOLOGY Screen 23 Haemochromatosis Gene Testing (H63D, C282Y) 23 Haptoglobin 24 Haemoglobin A2...