Professional Documents
Culture Documents
Version no.
21
Produced by
Dr Gill Rumsby
Approved by
Dr Gill Rumsby
Date active
September 2015
PD-CB-411 v21
September 2015
Page 1 of 33
GENERAL INFORMATION
GENERAL ENQUIRIES: 020344 79405 (x79405); email: biochemhelpdesk@uclh.nhs.uk
CLINICAL ENQUIRIES: Call the number above and ask for the duty biochemist. Alternatively email dutybiochemist@uclh.nhs.uk and someone will deal with your enquiry (MondayFriday 0900-1700). Out of hours ask for the on-call biochemistry consultant via the switchboard.
REQUEST FORMS: The request forms have an attached bag for insertion and sealing of the blood samples. Labels on urine bottles should be completed with the patient details and time of
start and end of collection. The accompanying request form should be securely attached to the 24-hour urine bottles. It is strongly advised that requests are restricted to one sample type
per form. Request forms must always be fully and legibly completed. The case number, surname, forename and date of birth must be recorded accurately for all patients. Using patient
identification labels is very desirable providing they are legible. The location of the patient with consultants name or approved code must be included for the return of results. Please
clearly state the tests required using their full names or widely accepted abbreviations only. If it is only possible to obtain a small sample, the order of priority for the tests requested
should be indicated. Where special conditions are required for a valid result, information on timing, fasting, protocol and drug doses should be written on the request form.
LABELLING OF SAMPLES: The Department will NOT analyse samples that have inadequate identification. All specimens MUST be labeled with the surname and two other items of
identification from:
Hospital number
Date of birth
Forename
SAMPLE CONTAINERS: The sample types for each of the tests are included in the tabulated information later.
TEST AVAILABILITY: Not all of the more esoteric tests listed are available within UCLH. Those for which UCLH has to pay to be analysed elsewhere are subject to particular scrutiny and
are likely to be refused unless a clear clinical justification is provided.
Test name beginning with (Ctrl click):
A
PD-CB-411 v21
September 2015
Page 2 of 33
Blood: The main vacutainer tube used is the gold top (SST, clotted blood with gel separator). Others needed for certain tests are: red top (plain clotted blood), , purple top (EDTA anticoagulant),
grey top (fluoride preservative) and green top (lithium heparin anticoagulant). Usually many tests can be done from one sample, eg one 5mL gold top tube is sufficient for U/E, LFT, bone profile
and more. However, the volume stated is that which must normally be sent even if requesting the individual test on its own.
Paediatric samples: the tube top colours given above do not apply to paediatric containers. Usually white tops are plain but other lids will vary with manufacturer. Staff should
familiarize themselves with the preservative content prior to bleeding the patient.
Urine: Random and early morning urine samples should be collected in 50 mL Sterilin containers. Plain containers for 24 hour urine collections are available by ordering from Supplies.
Acidified containers for 24hr urines, containing concentrated hydrochloric acid, are available from Clinical Biochemistry reception. Please check the following Test Information table if
you do not know which type of container is needed.
Faeces: Random samples should be collected in 50 mL Sterilin containers.
CSF: Plain sterile containers from CSSD (grey fluoride tube must be used for CSF glucose)
Sweat: A special collection system is used by the Childrens Outpatients Department at UCLH
Other fluids, Calculi etc: Sterilin or other suitable container.
SAFETY PRECAUTIONS: Please adhere to the instructions, so that the risk to all staff is minimised. There is a legal obligation to observe these precautions.
PD-CB-411 v21
September 2015
Page 3 of 33
Needle Stick Injuries: Current guidelines must be followed so as to avoid stick injuries to those taking, transporting and processing samples. Specimens for analysis must not be sent to
the laboratory in the original syringe. .
Infection Risk: General requirements and good practice:
Do not contaminate the request form with the sample.
Ensure that the container is correctly sealed so that it does not leak in transit.
Do not stick samples to the request form with tape, use the bag.
Dangerous Pathogens
Specimens containing certain viral pathogens (ACDP Category 4) cannot be handled by the laboratory. Do NOT send samples containing or suspected of containing these
pathogens to the laboratory. Phone the Help Desk in advance if in doubt.
Specimens must be regarded as potentially infected if they come from the patient categories below. Only request tests which are essential to the management of these disorders:
Known to be HbsAG positive.
With known or suspected viral hepatitis or with jaundice of unknown cause.
With known AIDS or HIV positive, or relevant risk groups.
Frequently transfused including haemophilia.
Known to be drug addicts.
With known or suspected brucellosis, typhoid or paratyphoid A infection.
With known or suspected tuberculous meningitis (CSF only) or tuberculosis of the urinary or gastrointestinal tract (urine or faecal specimens only).
With known or suspected amoebiasis (faecal specimens only).
With pyrexia of unknown origin (PUO).
Radiation Hazards: Urine (particularly) may be radioactive following imaging / nuclear medicine procedures. Urine collections known or suspected to be highly radioactive must not be sent to
the laboratory. The name of any administered isotope must be stated on all samples of urine on both the first and second day after an imaging procedure. The laboratory monitors samples and
will refer all radiation safety violations back to the requester. Serious violations will be referred to the Radiation Protection Advisor.
TRANSPORT OF SAMPLES: Samples from the main hospital site should be sent by pneumatic tube (PTS) system. Please note some tests require samples to be carried to the laboratory
immediately, with or without other precautions (eg on ice). Routine transport pick-ups cannot not be used for such samples. Other sites collect from designated pick up points.
REQUESTS FOR URGENT ATTENTION: During normal working hours all urgent requests must be arranged personally by the requesting doctor telephoning the Clinical Biochemistry
Help Desk (UCLH ext 79405, or direct dial 0203 44 79405), except where there is prior agreement.
REPORTING RESULTS: Within the laboratory computer system the patient is identified by the case number. As soon as a request is registered in the computer it is listed as PENDING
when viewing on any ward, clinic or departmental terminal. As soon as the result is approved for reporting it is also available on any enquiry computer. Printed reports are not usually issued.
DYNAMIC FUNCTION TESTS: Please see test information and specific test request forms on Insight
http://insight/departments/medicineboard/pathology/biochemicalmedicine/ClinicalBiochemistry/Pages/default.aspx
PD-CB-411 v21
September 2015
Page 4 of 33
SAMPLE REQUIREMENTS
5 mL whole blood purple or
green top
Timed
urine
samples
Follow dynamic test protocol
on intranet
Blood spot or whole blood
(heparin)
REFERENCE RANGE
See report
ACTH
Positive or negative
Adalimumab antibodies
Adaluminab drug levels
Addictive drug screen
Adrenaline
AFP
AGXT gene analysis (primary
hyperoxaluria type 1)
Alanine aminotransferase
Alanine:glyoxylate
aminotransferase
Albumin, serum
PD-CB-411 v21
AVAILABILITY / NOTES
All requests reviewed by senior staff. Analysed at Cardiff
Toxicology
Sample requires special or immediate action. Transport to lab
immediately, routine transport not suitable. Urine pH after oral
ammonium chloride
For diagnosis of Pompes disease.
Sample must be sent to reference lab promptly therefore do not
take blood on a Friday.
Analysed at GOS
All requests reviewed by Chem Path senior medical or scientific
staff. Not for routine use in prostate cancer see PSA instead.
Analysed at Royal Free Hospital, phone 0207 830 2991
Sample requires special or immediate action. Transfer to lab
immediately and on ice. Routine transport not suitable. Batched
for analysis on selected days.
N.B. Cannot be requested retrospectively
Analysed at Neurometabolic Unit, 0207829 8716. Results available
within 7 working days
For monitoring patients on Adalimumab (antiTNF)
Analysed at Royal Devon and Exeter 01392 402948
For monitoring patients on Adalimumab (antiTNF)
Analysed at Royal Devon and Exeter 01392 402948
See Drug Screen
See Catecholamines
See Alphafetoprotein
Molecular Urology test. For diagnosis of primary hyperoxaluria
type 1
24 hour availability
Molecular Urology test. For diagnosis of primary hyperoxaluria
type 1
24 hour availability
September 2015
Page 5 of 33
TEST
Albumin, urine
(Microalbumin)
SAMPLE REQUIREMENTS
10ml random urine
Aldosterone, blood
Alkaline phosphatase
Isoenzymes
Alkaline phosphatase,
Placental CSF
1 mL CSF
Alkaline phosphatase,
Placental serum
Alphafetoprotein as tumour
marker
REFERENCE RANGE
0-2.8 mg/mmol creatinine
Clinically significant results:
Diabetics:>3mg/mmol
Non-diabetics:>30 mgl/mmol
Values up to 46 mg/L may arise endogenously
AVAILABILITY / NOTES
Usually 24 hour availability
PD-CB-411 v21
24 hour availability.
September 2015
Page 6 of 33
TEST
Alphafetoprotein, CSF
Alpha
SAMPLE REQUIREMENTS
1 mL CSF
Random urine
Alpha-1-antitrypsin, faecal
Alpha-1
phenotype
antitrypsin
REFERENCE RANGE
AVAILABILITY / NOTES
24 hour availability.
Interpretation on report
4.0-21.9 nmol/h/mL
Alpha galactosidase
Amikacin
Interpretation on report
Interpretation on report
Aminophylline
Amiodarone
Ammonia
Interpretation on report
PD-CB-411 v21
September 2015
Page 7 of 33
TEST
Ammonium chloride Test
Amylase
Amylase (isoenzymes)
28-100 IU/L
See report
Androstenedione
Angiotensin
converting
enzyme
Anion gap
Antenatal screen (Downs)
calculation
12-20 mmol/L
Referenceranges(10th90thpercentiles):
2029years:13.153.8pmol/L
3034years:6.847.8pmol/L
3539years:5.537.4pmol/L
4044years:0.721.2pmol/L
4550years:0.314.7pmol/L
Apolipoprotein B
Apolipoprotein E genotype
Apolipoprotein E phenotype
Aquaporin 4 antibodies
Negative or positive
Arsenic
Anticonvulsants
Anti-mullerian hormone
Antitrypsin - 1
Apolipoprotein A1
SAMPLE REQUIREMENTS
REFERENCE RANGE
AVAILABILITY / NOTES
See Acid load test in dynamic function test folder
24 hour availability
Requests individually reviewed by senior staff. Results available
within 4 weeks. Analysed at Gt Ormond St 0207 829 8662
Daily
PD-CB-411 v21
September 2015
Page 8 of 33
TEST
Aspartate aminotransferase
B12, see vitamin B12
Barbiturates
Base excess
Bence Jones protein
SAMPLE REQUIREMENTS
5ml blood gold top tube
REFERENCE RANGE
0-37 IU/L (Male)
0-31 IU/L (Female)
AVAILABILITY / NOTES
Approved research studies only
0-2.3 mg/L
22-29 mmol/L
<14 umol/L
24 hour availability
24 hour availability
See Gases
Run weekly. This test is for total bile acids.
random urine
Refer to report
Analysed at ICH
24 hour availability
3.9-18.9 nmol/mL/min
2g stool sample
24 hour availability
Daily service if received by noon Mon to Fri
24 hour availability
Random urine
Refer to report
Busulfan
CA 15-3
PD-CB-411 v21
September 2015
Page 9 of 33
CA19-9
TEST
SAMPLE REQUIREMENTS
5ml blood gold top tube
0-27 KIU/L
CA125
0-35 KIU/L
Cadmium, blood
Cadmium, urine
25 mL random urine
Caeruloplasmin
Calcitonin
2.20-2.60 mmol/L
Calcium, urine
Carbamazepine
Carbamazepine (free)
Carbamazepine epoxide
REFERENCE RANGE
<2.6%
antigen
0-3.4 ug/L
Carbon monoxide
Carcinoembryonic
(CEA)
AVAILABILITY / NOTES
24 hour availability. For monitoring pancreatic carcinoma
Not suitable as a screening test
24 hour availability. For monitoring carcinoma of the ovary
Not suitable as a screening test
Requests individually reviewed by senior staff. Results available
within 2 weeks. Analysed by Trace Metal lab, Guildford 01483
259978
Requests individually reviewed by senior staff. Results available
within 2 weeks. Analysed by Trace Metal lab, Guildford 01483
259978
24 hour availability
Change in reference range 08/03/2013
PD-CB-411 v21
September 2015
Page 10 of 33
TEST
Cardiac enzymes
Carnitines, see acyl carnitine
Carotene, beta
Catecholamines, urine
Please note: no longer
recommended.
See
metanephrines, urine
Catecholamines, plasma
Please note: no longer
recommended. See
metanephrines, plasma
C1 esterase inhibitor (mass
assay)
SAMPLE REQUIREMENTS
REFERENCE RANGE
0.19-1.58 umol/L
40-150%
Ceramide trihexosides
urine
<0.03 mg/mmol
Chitotriosidase
<150 nmol/h/mL
Chloride, blood
Chloride, sweat
98-107 mmol/L
<40 mmol/L (Normal)
40-60 mmol/L (Equivocal)
>60 mmol/L (Positive)
<5.0 mmol/L
0.9-1.5 mmol/L (Male)
1.2-1.7 mmol/L (Female)
< 3.5 mmol/L
See report
C1
esterase
(functional)
inhibitor
Cholesterol Total
Cholesterol (HDL), High
density lipoprotein
Cholesterol (LDL),
Low
density lipoprotein
Cholinesterase (activity and
phenotyping)
Chorionic Gonadotrophin
Chromium
AVAILABILITY / NOTES
see Creatine Kinase
PD-CB-411 v21
September 2015
Page 11 of 33
TEST
Chromogranin
SAMPLE REQUIREMENTS
4 mL blood purple top tube
Fasting and rapid separation
required
4ml blood purple top tube
REFERENCE RANGE
Chromogranin A <60 pmol/L
Chromogranin B <150 pmol/L
Citrate
Clobazam + metabolite
Clonazepam
Clozapine (Clozaril)
See report
Cobalt
Ciclosporin
AVAILABILITY / NOTES
Fasting sample. See gut hormones
Sample requires special or immediate attention. Transfer to lab
immediately, routine transport not suitable.
Same day service if received by 11.00 Monday to Friday and by
08.00 Saturday. No Sunday service. Ideal sampling time: pre dose
Samples analysed at Royal Free Hospital
Molecular urology test. Batched for analysis on selected days
C3 0.90-1.80 g/L
C4 0.10-0.40 g/L
PD-CB-411 v21
September 2015
Page 12 of 33
Copper
TEST
SAMPLE REQUIREMENTS
5ml blood white top tube
or
<1.0 umol/24h
Cortisol
0-250 nmol/24h
C-peptide
C-Reactive Protein
Creatine
guanidinoacetate
and
0-4m:
4-6m:
6-12m:
>12m:
REFERENCE RANGE
1.4-7.2 umol/L
3.9-17.3 umol/L
7.9-20.5 umol/L
11.0-22.0 umol/L
AVAILABILITY / NOTES
Requests individually reviewed, results are available in 2 to 4
weeks. White top tubes are available from lab.
Analysed at Royal Free Hospital
PD-CB-411 v21
24 hour availability
24 hour availability
September 2015
Page 13 of 33
TEST
Creatinine
Creatinine clearance
CRF test
CRP
Cryoglobulins
SAMPLE REQUIREMENTS
5ml blood gold top tube
or
REFERENCE RANGE
21-75 umol/L (0-60 Days)
15-37 umol/L (60-365 Days)
21-36 umol/L (1-3 Years)
27-42 umol/L (3-5 Years)
28-52 umol/L (5-7 Years)
35-53 umol/L (7-9 Years)
34-65 umol/L (9-11 Years)
46-70 umol/L (11-13 Years)
50-77 umol/L (13-15 Years)
66-112 umol/L (Male >15 Years,)
49-92 umol/L (Female >15 Years,)
AVAILABILITY / NOTES
7.0-21.0 mmol/24h
Reference range for adults only
70-152 ml/min
Not detected
41-415 umol/24h
24 hour availability
24 hour availability
Blood Cortisol after injecting CRF
Random urine
PD-CB-411 v21
September 2015
Page 14 of 33
TEST
Deoxy-cortisol, 11
SAMPLE REQUIREMENTS
5mL gold /red top tube
Dexamethasone suppression
test
Diazepam
Digoxin
Dihydrotestosterone (DHT)
Diuretic screen
Dopamine
Drug Screen:
Addiction
REFERENCE RANGE
7-13 nmol/L (9am)
AVAILABILITY / NOTES
For diagnosis and monitoring of 11-hydroxylase deficiency only.
Requests are individually reviewed by Clin Biochem senior
medical or scientific staff
Analysed at Royal London 02032460383
Blood Cortisol after oral dexamethasone. See DFT information
Blood and urine Cortisol after prolonged (4-6 days) stepped-dose
dexamethasone
Requests individually reviewed by senior staff.
Analysed at Cardiff Toxicology
24 hour availability. Ideal sampling time: at least 6 hours (may be
up to 24 hours) after last dose, oral or iv. Time to steady state:
7days
<0.27 prepubertal
<0.6 nmol/L (Adult Female)
0.32-1.64 nmol/L (Adult Male)
of
Negative
Negative
Negative
Drug Overdose
Samples
Drug
Overdose:
toxicology screen
eGFR
Save
Urgent
Calculation
See Catecholamines
Usually 24 hour availability
Screens for:
Opiates
Cocaine
Methadone
Benzodiazepines
Amphetamines
Barbiturates
Cannabis
Requests are individually reviewed.
Samples referred to Birmingham City Hospital
Requests are individually reviewed, results are available in 2 to 4
weeks
Analysed at Birmingham City Hospital
The laboratory will store these samples to be available for the
Coroner
PD-CB-411 v21
September 2015
Page 15 of 33
TEST
Elastase (faecal)
Electrophoresis
Proteins
Electrophoresis
Proteins
ELF test
SAMPLE REQUIREMENTS
1g (almond-size lump) faeces
in plain pot
Serum
Urine
REFERENCE RANGE
>200 ug/g normal
<5-100 ug/g indicates severe pancreatic insufficiency
100-200 ug/g indicates moderate insufficiency
Erythrocyte
acetylcholinesterase
Ethanol
7524-13323 U/L
Ethosuxemide
Everolimus
Fatty
acids,
(includes C15-22)
Felbamate
essential
Flecainide
Fractional Phosphate
Reabsorption
Free T3
Folate
Ferritin
AVAILABILITY / NOTES
Requests are individually reviewed, results are available in 2 to 4
weeks
Analysed at Gt Ormond St 02078297806
24 hour availability
Normal 0.8-1.44
PD-CB-411 v21
September 2015
Page 16 of 33
TEST
Free T4
Fructosamine
SAMPLE REQUIREMENTS
REFERENCE RANGE
12.0-22.0 pmol/L
215-264 umol/L (Non-diabetic)
264-320 umol/L (Well-controlled)
320-476 umol/L (Poorly controlled)
Gabapentin
Galactose-1-phosphate
0.1-0.57 umol/g Hb
Galactose-1-uridyl phosphate
Gamma-glutamyl transferase
(GGT)
Gases
2ml blood
(heparin syringe on ice)
NOT AVAILABLE IN
BIOCHEMISTRY
<40 pmol/L
Gentamicin
AVAILABILITY / NOTES
Requests are individually reviewed, results are available in 2 to 4
weeks
Only for monitoring diabetic control in patients with an abnormal
haemoglobin (invalidating HbA1c)
Analysed at East Surrey Hospital 01737768511 x1691
Analysed at the Pharmacology and Therapeutic unit, Chalfont
01494 601 423
Requests individually reviewed. Results available in 5 weeks.
Analysed at GOS 02072429789 x2509
For investigation of prolonged conjugated jaundice.
Please do not request on Friday or over weekend.
Requests individually reviewed. Results available in 5 weeks.
Analysed at GSTS 020 7188 2591
Results unreliable unless at least 120 days post transfusion
24 hour availability
PD-CB-411 v21
September 2015
Page 17 of 33
TEST
Glucose
haemoglobin
Glycerate
See Primary
metabolites
See Primary
metabolites
Glycolate
Glycosaminoglycans
mucopolysaccharides)
Glyoxylate reductase
SAMPLE REQUIREMENTS
3ml blood light grey top tube
or
0.5ml CSF light grey top tube
or
5ml fresh random urine
3ml blood Light grey top tube
Follow dynamic function test
protocol
4ml blood purple top tube
REFERENCE RANGE
3.9-5.8 mmo/L
2.2-3.9 mmol/L
Not detected
For interpretation see dynamic function test protocol
4.0-6.0 % total Hb
20-42 mmol/mol (IFCC)
hyperoxaluria
hyperoxaluria
(see
Gonadotrophins
GRHPR
gene
(Primary
hyperoxaluria type 2)
Growth Hormone (GH)
See Mucopolysaccharides
20mg liver biopsy, frozen
Gut hormones
Haptoglobin
HbA1c
HCG
0-3 IU/L
HCG, CSF
HCG, pregnancy test
1 mL CSF
5ml random urine
HDL cholesterol
AVAILABILITY / NOTES
24 hour availability.
PD-CB-411 v21
September 2015
Page 18 of 33
TEST
Hexosaminidase (Tay Sachs)
SAMPLE REQUIREMENTS
8 mL blood green top tube
5-HIAA
HMMA
HOGA1
gene
(primary
hyperoxaluria type 3)
3-hydroxybutyrate
(blood
ketones)
11-hydroxylase genetics
Hydroxycholecalciferol
4-hydroxy-2-oxoglutarate
Hydroxyprogesterone (17)
17-hydroxysteroid
dehydrogenase type 3
genetics
Homocysteine
IA2 antibodies
REFERENCE RANGE
Refer to report
0 42 umol/24h
AVAILABILITY / NOTES
Requests are individually reviewed by senior staff, results available
within 2-4 weeks. Analysed at Gt Ormond St 02074059200 x5076
Avoid the following for 3 days prior to collection:
Bananas, plantain, plums, pineapple, tomatoes, kiwi fruit,
avocados, dates, pecan/hickory nuts, walnuts
Nicotine and smoking
Cough and antihistamine preparations, along with nasal
sprays/drops
5-12 umol/L
Refer to report
PD-CB-411 v21
September 2015
Page 19 of 33
IGF1BP3
TEST
SAMPLE REQUIREMENTS
5 mL blood gold or red tube
REFERENCE RANGE
0-2y 0.5-2.9 mg/L
3-4 y 0.8-3.4 mg/L
5-6y 1.0-3.8 mg/L
7-8y 1.1-4.3 mg/L
9-10y 1.3-4.6 mg/L
11-12y 1.6-5.0 mg/L
13-14y 2.1-5.3 mg/L
15-16y 2.5-5.4 mg/L
17-18y 2.4-5.4 mg/L
19-20y 2.3-5.3 mg/L
21-40y 1.7-5.2 mg/L
41-60y 1.3-4.8 mg/L
61-80y 0.7-4.4 mg/L
>80y 0.5-4.3 mg/L
Immunofixation
Immunoglobulins G, A, M
Immunoglobulin D
Immunoglobulin E (total)
Immunoglobulin
(IgG subclasses)
Positive or negative
subclasses
Infliximab antibodies
AVAILABILITY / NOTES
Requests individually reviewed by senior staff. Analysed at
Guildford 01483406715
Rarely required.
Analysed at Northern General
24 hour availability
PD-CB-411 v21
September 2015
Page 20 of 33
TEST
Infliximab drug levels
SAMPLE REQUIREMENTS
5 mL blood gold top tube
Trough sample
5 mL blood gold top tube
Inhibin B
Insulin
Insulin antibodies
Iodine
Ions difference
Iron and Iron
Capacity (IBC)
Binding
Iron, Urine
Ketones (qualitative)
Ketones (blood), see
hydroxybutyrate
REFERENCE RANGE
Reference range not established
AVAILABILITY / NOTES
For monitoring patients on infliximab
Refer to report
2m-5y
6-8y
9-11y
12-15y
16-20y
21-24y
25-40y
41-50y
51-60y
61-75y
Female
4.4-22.3
10.4-31.7
11.4-51.9
24.5-66.3
34.8-61.2
19.4-43.2
16.1-39.8
12.6-35.5
12.9-33.0
11.8-28.6
Units nmol/L
Male
3.6-14.8
7.1-26.8
11.1-32.3
15.0-64.8
32.1-62.6
24.4-52.0
16.3-39.3
11.6-31.3
12.2-30.0
12.7-29.3
PD-CB-411 v21
September 2015
Page 21 of 33
TEST
SAMPLE REQUIREMENTS
REFERENCE RANGE
Labstix
AVAILABILITY / NOTES
These sticks are widely available for local clinical use includes
pH, Protein, Blood, Glucose, Ketones, etc
24 hour availability. Sample must be transported to the lab
immediately.
24 hour availability
N.B. Assay change from 4/4/2011 with significant change in ref
range
Lactate
0.5-2.2 mmol/L
Lactate dehydrogenase
Lamotrigene
Laxative Screen
Random urine, 20 mL
Negative
LDL Cholesterol
Lead (inorganic)
20 mL random urine or 5 mL
paediatric urine
Levetiracetam
LHRH test
13-60 IU/L
24 hour availability
0-0.3 g/L
0.6-1.0 mmol/L (at lower end for maintenance
therapy and the elderly)
24 hour availability
Lipase
(Trial use only)
Lipid profile (fasting)
Inc:Cholesterol ,
Triglycerides, HDLchol,
LDLchol, & Chol/HDL ratio
Lipoprotein (a)
Lithium
Liver profile
Inc:
Albumin, Bilirubin,
Alkaline
Phosphatase, ALT
Luteinising hormone (LH)
PD-CB-411 v21
September 2015
Page 22 of 33
TEST
Macroprolactin
SAMPLE REQUIREMENTS
5ml blood gold top tube
Magnesium
Magnesium, Urine
Mercury (inorganic)
25 ml random urine
Mercury (organic)
Metanephrines, plasma
Metanephrines, urine
Methotrexate
umol/L
Dependent on patient type and dose route.
Methylmalonic acid
2 mL gold/purple/green top
tube
Methylmalonic acid
Methylhistamine
Microalbumin
Microglobulin (2)
Mucopolysaccharides
5 mL urine
10 mL random urine
Manganese
Muscle enzymes
Mycophenalate
Myoglobin
REFERENCE RANGE
0.6-1.0 mmol/L
2.5-8.5 mmol/24h
Refer to report
0-5y: 0.6-4.0 mg/L
>5y: 1.0-4.0 mg/L
<50 nmol/L
<30 nmol/L
Normetanephrine 120-1180 pmol/L
Metanephrine 80-510 pmol/L
3-methoxytyramine <180 pmol/L
Refer to report
PD-CB-411 v21
AVAILABILITY / NOTES
Assayed weekly. Routinely assessed if prolactin >700. See
Guidance note 23 on intranet
24 hour availability
Usually 24 hour availability
Requests are individually reviewed by senior staff. Results
available within 2 weeks. Analysed at Trace Element lab,
Guildford 01483 259978
Requests are individually reviewed by senior staff
Analysed at Northern General
Requests are individually reviewed, results are available in 2 to 4
weeks.
For cases of suspected exposure to mercury vapour or inorganic
mercury salts
Analysed at Guildford, 01483259978
Analysed at Guildford, 01483259978
Sample must be sent to lab immediately. Routine porter is not
suitable.
Requests are individually reviewed by senior staff, results available
within 2-4 weeks. Some drugs affect measurement: please list drug
history. Plasma metanephrines sample preferred.
Analysed at Epsom & St Helier Hospital.
Daily service, including Saturday and Sunday. Sample must be
received before 2pm.
Analysed in Neurometabolic Unit 020344 84716
Analysed at GOS
Test no longer available. SeeTryptase
See Albumin, urine
See Beta-2 Microglobulin
Requests are individually reviewed, results are available in 2 to 4
weeks
Analysed at Gt Ormond St, 0207829 8662
See Creatine Kinase
For suspicion of toxicity. Analysed at St Georges 02087679686
Qualitative stix test. Usually daily service. CK is a more sensitive
marker of muscle damage
September 2015
Page 23 of 33
TEST
NAG
(N-acetylglucosaminidase),
urine
SAMPLE REQUIREMENTS
10 mL random urine
1 mL heparinised blood
(green top tube); orange
paediatric tube
5 ml blood gold top
Noradrenaline
NT-proBNP
NTX
(collagen
telopeptide)
Occult blood
Oestradiol
Olanzapine
N-
REFERENCE RANGE
<1y : 2-27 U/mmol
1-5y 2-22 U/mmol
5-10y 2-10 U/mmol
10-16y 2-12 U/mmol
AVAILABILITY / NOTES
Requests individually reviewed by senior staff. Analysed at Gt
Ormond St 02078298662. Usually requested with retinal binding
protein.
0.1-0.6 mmol/L
<12.5 ug/L
Orotate
Urine (random)
Osmolality
285-295 mosmo/kg
300-900 mosmo/kg
Oxalate, Plasma
http://guidance.nice.org.uk/CG108/QuickRefGuide/pdf/English
Neuroimmunology test
PD-CB-411 v21
September 2015
Page 24 of 33
TEST
Oxalate, Urine
SAMPLE REQUIREMENTS
24hr urine collected in bottle
with acid
REFERENCE RANGE
100-460 mmol/24 hour
(adults, for children correct for BSA)
Ox/cre ratio:
06months
<291umol/mmol
723months<220umol/mmol
24years
<143umol/mmol
511years<76umol/mmol
1217years
<44umol/mmol
18+female<45umol/mmol
18+male<33umol/mmol
AVAILABILITY / NOTES
Molcular Urology test. Batched for analysis on selected days
Ref range change for ox/cre ratio from 1/10/14
Oxcarbazepine
Oxygen
Pancreolauryl Test
Paracetamol
10-30 mg/L
and
No paraprotein present.
and
1.6-6.9 pmol/L
Paraprotein
typing
quantitation, Serum
Paraprotein
typing
quantitation, Urine
Parathyroid hormone
Pentolinium Test
pH Blood
pH Urine
Light
green
top
tubes
Follow dynamic function test
protocol
Phenobarbitone
Phenytoin
Phenytoin (free)
See Gases
See Acid load test or Labstix
Therapeutic range 10-40 mg/L
(please note, units changed to mg/L occurred on
13/8/12)
PD-CB-411 v21
September 2015
Page 25 of 33
TEST
Phosphatase
SAMPLE REQUIREMENTS
Phosphate
Phosphate
Phytanate
Phytosterols
Piracetam
Porphyrins, Urine
(for screening & quantitation)
Porphyrins, Blood
Porphyrins, Faeces
Potassium
Potassium, Urine
Pregabalin
REFERENCE RANGE
1.45-2.91 mmol/L (0-10 Days)
1.45-2.16 mmol/L (10 Days-2 Years)
1.45-1.78 mmol/L (2-13 Years)
0.87-1.45 mmol/L (>13 Years)
13-42 mmol/24h
AVAILABILITY / NOTES
See Acid Phosphatase
See Alkaline Phosphatase
24 hour availability
24 hour availability
<10 umol/L
Refer to report
3.5-5.1 mmol/L
25-125 mmol/24h
PD-CB-411 v21
September 2015
Page 26 of 33
Pregnancy
Urine
TEST
test Routine,
SAMPLE REQUIREMENTS
5 mL random urine
REFERENCE RANGE
Urine samples from non-pregnant females generally
contain <10 mIU/mL hCG. On the first day of the
missed period the levels of maternal hCG are
normally 50-250 mIU/mL. The minimum detection
limit of the strip is 25 mIU/mL.
Reported as: not detected or Positive
Primidone
Procollagen type I
aminoterminal peptide
(P1NP)
Progesterone
AVAILABILITY / NOTES
Batched for analysis on selected days
24 hour availability
See Phenobarbitone
For monitoring bone resorption.
Restricted availability
Analysed at Norfolk and Norwich
24 hour availability
Progesterone 17OH
See Hydroxyprogesterone, 17
PD-CB-411 v21
September 2015
Page 27 of 33
Prolactin
TEST
SAMPLE REQUIREMENTS
5ml blood gold top tube
Protein, Total
Protein selectivity
PTH
PTHrP (PTH related peptide)
REFERENCE RANGE
86-324 mIU/L (Male)
102-496 mIU/L (Female)
NO RANGE (Female)
0-1.4 ug/L (Male 0-40 Years)
0-2.0 ug/L (Male 40-50 Years)
0-3.1 ug/L (Male 50-60 Year)
0-4.1 ug/L (Male 60-70 Years)
0-4.4 ug/L (Male >70 Years)
63-83 g/L
0.13-0.4 g/L
0-13 mg/mmol creatinine
AVAILABILITY / NOTES
24 hour availability
24 hour availability
24 hour availability
Refer to report
Purines, plasma
Refer to report
Purines, urine
Pyruvate, blood
45-150 umol/L
Quetiapine
Quinine
Refer to report
Rast
Reducing substances
50-200 ug/L
PD-CB-411 v21
September 2015
Page 28 of 33
TEST
SAMPLE REQUIREMENTS
4 mL blood purple top tube.
Renin
REFERENCE RANGE
4-12 nmol/l/hr (1-3 months)
2-6 nmol/l/hr (3-12 months)
2.2-7.70 nmol/l/hr (ambulant adult)
0.5-3.9 nmol/l/hr (recumbent adult)
AVAILABILITY / NOTES
Steroid Endocrinology test
Change of assay and ref range from 1/11/2014
24 hour availability
Requests individually reviewed by senior staff. Analysed at
Sheffield 0142715552
Molecular urology test
Molecular urology test
Requests individually reviewed, results are available in 2 to 4
weeks. White top tubes are available from lab.
Analysed at Royal Free Hospital.
Sertraline
Serum amyloid A
Sex
Hormone
Globulin (SHBG)
Binding
For compliance
Requests individually reviewed by senior staff. Analysed at Cardiff
Toxicology 029 2071 6893
If ?AA amyloidosis, contact National Amyloidosis centre at Royal
Free Hospital.
24 hour availability
Ref range change 5/8/13
Sirolimus (rapamycin)
Sodium
135-145 mmol/L
Sodium, Urine
40-220 mmol/24h
PD-CB-411 v21
September 2015
Page 29 of 33
TEST
Steroid profile
SAMPLE REQUIREMENTS
24h urine collected in plain
bottle or random sample from
child (minimum 10 mL)
Newborns, take sample after 5
days.
5 mL blood green top tube or
urine, protect from light
Sterols
Stone
Sugars, Urine
Sugars, Faecal
Sulphite,
urine
sulphocystine)
Sulphonylureas
(or
Refer to report
Tacrolimus
Tay Sachs
Testosterone
See hexosaminidase
5ml blood gold top tube
Thallium
AVAILABILITY / NOTES
Steroid Endocrinology test
Theophylline
REFERENCE RANGE
Full report given
Negative
Full report given
24 hour availability
PD-CB-411 v21
September 2015
Page 30 of 33
TEST
Thiopentone
Thiopurine
transferase (TPMT)
SAMPLE REQUIREMENTS
4 mL purple top tube
methyl
Thymidine
Thyroglobulin
Thyroglobulin antibodies
REFERENCE RANGE
Refer to report
0-34 IU/mL
Thyroid
Stimulating
Hormone
Thyroxine (Free-T4)
Tiagibine
0.27-4.20 mIU/L
12.0-22.0 pmol/L
Topimirate
Total CO2
Toxicology screen
5 mL random urine
Transferrin, Blood
Transferrin, CSF
Transferrin)
Transaminase
TRH test
AVAILABILITY / NOTES
For assessment of non responsive to azathioprine
Request individually reviewed by senior staff. Analysed at GSTS
020 7188 8689
Request individually reviewed by senior staff. Results available
within 1 week. Analysed at Birmingham City Hospital.
0121 5075353
Results unreliable unless at least 120 days post transfusion
(Asialo-
Triglyceride (fasting)
<2.3 mmol/L
Tri-iodothyronine (Free-T3)
Trimethylamine (TMA)
Troponin T
4.0-6.8 pmol/L
Urine TMA 2.5-10.9 umol/mmol creatinine
Urine TMA-n-oxide: 17.0-147.0 umol/mmol
Ratio TMA/oxide: 0.05-0.21
<14 ng/L
PD-CB-411 v21
24 hour availability
Request individually reviewed by senior staff. Analysed at Sheffield
Childrens Hospital 0114 271 7445
24 hour availability.
Note: change of units to ng/L December 1st 2014
September 2015
Page 31 of 33
TEST
Trypsin, immunoreactive
SAMPLE REQUIREMENTS
Guthrie card (blood spot)
REFERENCE RANGE
<60 ug/L whole blood
Tryptase
5 mL blood
top tube
2-14 ug/L
TSH receptor
(TRAb)
antibodies
gold or purple
Urea, Blood
Urea, Urine
Urobilinogen
Valproate
Vancomycin
Vigabatrin
Vitamin A
1.05-2.27 umol/L
Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
Vitamin
B6
phosphate)
15-73 nmol/L
(pyridoxal
24 hour availability
24 hour availability
24 hour availability
Urea may be used to determine if a wound drain fluid is urine
Daily service if received by noon on Mon to Fri
Usually 24 hour availability. Ideal sampling time: pre dose. Time
to steady state: 3 days
Analysed in Clinical Biochemistry for Microbiology
66-200 nmol/L
174-471 nmol/L
AVAILABILITY / NOTES
Request individually reviewed by senior staff. Analysed at
Addenbrookes Hospital, 01223257130.
For the diagnosis of cystic fibrosis up to 6 weeks of age
Samples must be taken <1h, 3 and 24h after the anaphylactic
event.
Give time post event on the form.
Requests are individually reviewed, results are available in 2 to 4
weeks.
Analysed at Sheffield Northern 01142715552
To predict neonatal thyrotoxicosis in pregnancy.
Requests individually reviewed by senior staff. Analysed at RVI,
Newcastle 0191 282 4559
24 hour availability
PD-CB-411 v21
September 2015
Page 32 of 33
TEST
Vitamin B12
SAMPLE REQUIREMENTS
5 mL gold top or green top
tube
REFERENCE RANGE
191-663 pg/mL
Vitamin D, 25-OH
Vitamin E
Vitamin K
VMA (HMMA)
Water deprivation test
White cell enzymes
11.5-46.4 umol/L
Zinc
11-18 umol/L
Zinc (urine)
1.5-11.0 umol/24h
Zonisamide
AVAILABILITY / NOTES
PD-CB-411 v21
September 2015
Page 33 of 33