Immunology

Our Immunology department helps to diagnose patients with allergies, defective immune systems and autoimmune diseases. This includes testing for thyroid disease, coeliac disease and systemic lupus erythematosus (SLE). Immunology also performs tests which detect hidden tuberculosis (TB) infection, and there are numerous research programmes underway, looking at allergy, HIV infection, immune deficiency, vaccine responses and immune function.

Our Immunology department provides a molecular service and is working with suppliers to develop an extensive sequencing service to assist in disease monitoring and response to therapies.

Our Histocompatibility and Immunogenetics laboratory performs tissue typing and crossmatching for kidney and bone marrow transplant patients and donors. We test the blood of potential transplant recipients for antibodies and compare them with those of potential donors to avoid rejection of the organ. We also perform the HLA-B27 test to confirm a suspected diagnosis of ankylosing spondylitis or reactive arthritis.

This is a regional service, including out-of-hours donor typing, and we work closely with laboratories in other trusts to ensure the on-going support for transplant patients across the region. This extensive programme includes pre-and post-transplant testing, and monitoring of patients.

Please see Specialist Laboratories – Histocompatibility and Immunogenetics

The clinical staff responsible for clinical advice, diagnostic and interpretative services are:

Immunology Lead: Dr Peter Kelleher B.A. M.B. B.Ch. B.A.O: University of Dublin. M.R.C.P. (Ireland) Ph.D. Pathology: Imperial College University of London FRCPath

Histocompatibility & Immunogenetics Director: Arthi Anand

Urgent Tests

Samples to be performed urgently must be discussed with the Infection and Immunity laboratory within working hours (9.00am – 5.30pm, Monday to Friday) on 020331 10130 (in the case of Virological investigations, with a Medical Virologist on 020331 10138 or 020331 10139).

If eligibility for same day testing is agreed, these must be in the laboratory at Charing Cross by the time specified by the lab team (according to details of the test).

Test Add Ons

Add on tests can be requested by contacting the Infection and Immunity laboratory directly by phone within working hours (9.00am – 5.30pm, Monday to Friday) on 020 331 10130 or via email to [email protected]

Abnormal test results

In the Virology and Infection and Immunity department there is no specific list for abnormal test results that gets called out to general practitioners (GP). The existing procedure is that some tests have been built to appear on the call back queue or Clinvue for review.

Comments are added where necessary and the GP may be called where it is clinically relevant to call the GP such as positive Hep B IgM and a GBM positive result and first time positive patients for Anti-neutrophil cytoplasmic antibodies. In Microbiology there are certain investigations that meet these criteria. The following will be telephoned out or emailed to the GP practice at the discretion of Microbiology Medical staff:

1. Highly significant culture results such as Corynebacterium diphtheriae
2. Multi-drug resistant organisms with limited treatment options
3. Positive acid and alcohol fast microscopy and Mycobacterium tuberculosis complex culture

If clinical advice on any Microbiology result is required, please contact the Microbiology Medical Staff on 07827904038.

Information for collection of samples

Please ensure the collection date is correct for all electronic orders placed.

If a ‘future order’ has been placed for a patient in advance, the collection date must be updated for the correct date of collection in the clinic ordering system. This cannot be done on receipt in the NWLP laboratories. Where this cannot be updated, a new order must be placed. Please do not re-print labels from fulfilled orders with incorrect collection dates.

Please ensure that every sample container requested by the ordering system is collected. Every sample container for which a label is printed must be sent to ensure all tests are performed. Tests associated with a label will not be processed if the associated sample container is not sent.

N.B. In rare cases where is not possible to take an additional sample (e.g. Cerebro Spinal Fluid samples) the Infection & Immunity Laboratory must be contacted directly to enquire if the test can be added on to an existing container (placing an additional label in the sample bag with the sample or attaching more than one label on the same tube will not guarantee testing).