Académique Documents
Professionnel Documents
Culture Documents
Version no.
17
Produced by
Dr Gill Rumsby
Approved by
Dr Gill Rumsby
Date active
May 2014
April 2015
This issue replaces all previous
versions.
Version 17
May 2014
Page 1 of 31
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)
REQUEST FORMS: The request forms have an attached bag for insertion and sealing of the blood samples. Request forms should be firmly attached to previously 24-hour urine. 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. 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
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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.
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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
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SAMPLE REQUIREMENTS
5 mL whole blood purple or
green top
Timed
urine
samples
Follow dynamic test protocol
on intranet
5ml blood gold top tube
ACTH
REFERENCE RANGE
See report
Alanine:glyoxylate
aminotransferase
Albumin, serum
20 mg liver (frozen)
Albumin, urine
(Microalbumin)
Alcohol (Medical cases only)
Version 17
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
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
immediatey 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
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
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TEST
Aldosterone, blood
SAMPLE REQUIREMENTS
4 mL purple or gold top tube
Aldosterone, urine
Aldosterone synthase gene
analysis
Alkaline Phosphatase, Total
Alkaline phosphatase
Isoenzymes
Alkaline phosphatase,
Placental
Alkaline phosphatase
CSF
<100 mU/L
24 hour availability.
REFERENCE RANGE
1000-3800 pmol/L (1-3 Months)
400-1500 pmol/L (3-12 Months)
300-1000 pmol/L (1-4 Years)
400-800 pmol/L (4-8 Years)
150-450 pmol/L (8-16 Years)
600-1200 pmol/L (Adult, ambulant)
100-500 pmol/L (Adult, recumbent)
10-50 nmol/24 hours
0-250 IU/L (0-5 Days)
0-449 IU/L (5 -180 Days)
0-462 IU/L (180-365 Days)
0-281 IU/L (1-3 Years)
0-269 IU/L (3-6 Years)
0-300 IU/L (6-12 Years)
0-390 IU/L (Male 12-17 Years)
0-187 IU/L (Female 12-17 Years)
40-129 IU/L (Male >17 Years)
35-104 IU/L (Female >17 Years)
Female
Male
liver <73U/L
<68U/L
Biliary <13U/L
<8U/L
Bone <71U/L
<77U/L
<0.5 U/L (Non-smokers)
<1.5 U/L (Smokers)
AVAILABILITY / NOTES
Batched for weekly analysis. Steroid Endocrinology test
1 mL CSF
24 hour availability.
<1 kIU/L (Adult)
may be slightly higher in newborn period but less
than 12 kIU/L
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TEST
Alpha-1 antitrypsin, total
SAMPLE REQUIREMENTS
5ml blood gold top tube
Alpha-1-antitrypsin, faecal
Alpha-1
phenotype
antitrypsin
REFERENCE RANGE
0.9-2.2 g/L (0-6 months)
0.8-1.8 g/L (6 months 1 year)
1.1-2.2 g/L (1-5 years)
1.4-2.3 g/L (5-10 years)
1.2-2.0 g/L (10-15 years)
1.1-2.1 g/L (15-18 years)
Interpretation on report
Interpretation on report
4.0-21.9 nmol/h/mL
Alpha galactosidase
Aminophylline
Amiodarone
Ammonia
28-100 IU/L
See report
Androstenedione
Angiotensin
converting
enzyme
Anion gap
Antenatal screen (Downs)
calculation
12-20 mmol/L
AVAILABILITY / NOTES
24h availability
Interpretation on report
<0.4 umol/L (Subjects without CRF)
<2.2 umol/L (Low risk CRF patients)
Interpretation on report
Interpretation on report
Anticonvulsants
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TEST
Anti-mullerian hormone
Antitrypsin - 1
Apolipoproteins, A1 and B
SAMPLE REQUIREMENTS
5 mL blood gold top
Apolipoprotein E phenotype
Apolipoprotein E genotype
Aquaporin 4 antibodies
Arsenic
Aspartate aminotransferase
Barbiturates
Base excess
Bence Jones protein
REFERENCE RANGE
AVAILABILITY / NOTES
Must be sent without delay. Test not available for fertility issues.
Requests are individually reviewed by senior staff.
See Alpha-1 Antitrypsin
Requests are individually reviewed by senior staff. For specialist
lipid clinic use only. Analysed at Royal Free Hospital, phone
02077940500 bleep 1595 (Duty Biochemist)
Requests individually reviewed by senior staff. Results available in
8 weeks. For specialist lipid clinic use only.
Analysed at University of Wales, Cardiff 02920747747 x8350
Lipid Clinic only.
Analysed at University of Wales, Cardiff 02920747747 x8350
Analysed at the Immunology Dept., Churchill Hospital, Oxford
Requests individually reviewed by senior staff. Results available
within 2 weeks. Analysed at Trace metal lab, Guildford 01483
259978. Exclude high seafood diet for 5 days prior to sampling
Approved research studies only
Negative
Plasma: <133.5 nmol/L
Urine: <534 nmol/L
0-37 IU/L (Male)
0-31 IU/L (Female)
3-beta hydroxysteroid
dehydrogenase type 2
genetics
Beta-2 microglobulin
Bicarbonate (TotalCO2)
Standard bicarbonate
Bile acids (Total)
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.
Refer to report
Analysed at ICH
24 hour availability
Version 17
24 hour availability
Daily service if received by noon Mon to Fri
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TEST
Blood in faeces
SAMPLE REQUIREMENTS
2g stool sample
REFERENCE RANGE
Negative in normal individuals
AVAILABILITY / NOTES
Batched for analysis on selected days
CA 15-3
CA19-9
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)
24 hour availability
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TEST
Carbamazepine epoxide
Carbon dioxide Total
Carbon dioxide pCO2
Carbohydrate
deficient
transferrin
SAMPLE REQUIREMENTS
5 mL blood red top tube
REFERENCE RANGE
<2.6%
0-3.4 ug/L
Carbon monoxide
Carcinoembryonic
(CEA)
antigen
Cardiac enzymes
Carnitines, see acyl carnitine
Carotene, beta
Catecholamines, urine
Catecholamines, plasma
Please note: no longer
recommended. See plasma
metanephrines
C1 esterase inhibitor
(immunological assay)
C1
esterase
(functional)
40-150%
urine
<0.03 mg/mmol
inhibitor
Ceramide trihexosides
AVAILABILITY / NOTES
Batch assay, includes total carbamazepine. Analysed at the
Pharmacology and Therapeutic unit, Chalfont 01494 601 423
See Bicarbonate
See Gases
Requests are individually reviewed by senior staff. Results
available within 2 weeks. Available for patients of Dr Bradley T15
and PPW patients only.
Analysed at Kings 0203299 3856
See Gases. No service in Biochemistry, refer to ITU for analysis on
blood gas machine
24 hour availability. For monitoring carcinoma of the colon /
rectum
Not suitable as a screening test
see Creatine Kinase
For patients with documented low vit A concentrations.
Requests are individually reviewed. Analysed at St Helier 0208
2962804
Batched for analysis on selected days (includes adrenaline,
noradrenaline and dopamine)
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TEST
Chitotriosidase
SAMPLE REQUIREMENTS
5 mL light green top or purple
top
REFERENCE RANGE
<150 nmol/h/mL
Chloride, blood
Chloride, sweat
High
Low
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)
< 3.0 mmol/L
2.3-9.0 KU/L
Citrate
Clobazam + metabolite
Clonazepam
Clozapine (Cliozail)
See report
Cobalt
Cholesterol Total
Cholesterol (HDL),
density lipoprotein
Cholesterol (LDL),
density lipoprotein
Cholinesterase
Chorionic Gonadotrophin
Chromium
Chromogranin
Ciclosporin
24 hour availability
24 hour availability
Calculated from other results (Friedewald formula)
AVAILABILITY / NOTES
Requests are individually reviewed. For monitoring of Gauchers
disease
Analysed at Gt Ormond St Hospital 02072429789 x2114
24 hour availability
Sample requires special or immediate attention. Transfer to lab
immediately, routine transport not suitable.
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TEST
Collagen type 1 cross-linked
C telopeptide (CTX)
SAMPLE REQUIREMENTS
4 mL blood purple top
Fasting, rapid separation
REFERENCE RANGE
(Children males and females)
<1 month
0.44-2.27 ug/L
1month -1year
0.20-2.31
1-9 years
0.15-0.82
Males
9-14y
0.23-1.24
14-17y
0.24-1.73
17-19y
0.10-0.79
Females
9-11y
0.30-1.0
11-13y
0.33-1.7
13-15y
0.14-1.20
15-19y
0.05-0.58
AVAILABILITY / NOTES
Sample must be sent to lab without delay for separation.
Requests individually reviewed. Analysed at Norfolk and Norwich
Cortisol
C-peptide
C-Reactive Protein
C3 0.90-1.80 g/L
C4 0.10-0.40 g/L
11 20 umol/L
<0.9 umol/24h
Paediatric reference ranges differ
Midnight <140 nmol/L
0900 140-700
0-250 nmol/24h
24 hour availability.
Urines are batched for analysis on selected days
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TEST
Creatine
guanidinoacetate
and
Creatinine clearance
CRF test
CRP
Cryoglobulins
SAMPLE REQUIREMENTS
5 mL blood green top tube or
urine
Must be sent on ice
REFERENCE RANGE
Plasma creatine: 10-100 umol/L
Plasma guanidinoacetate: 0.8-3.1 umol/L
Urine creatine
0-4y 6-1200 umol/mmol
4-12 17-720 umol/mmol
>12y 11-240 umol/mmol
urine guanidinoacetate
0-15y 4-220 umol/mmol
>15y 3-78 umol/mmol
38-204 IU/L (Male)
26-140 IU/L (Female)
0-4.9 ug/L (Male)
0-2.9 ug/L (Female)
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,)
7.0-21.0 mmol/24h
Reference range for adults only
70-152 ml/min
AVAILABILITY / NOTES
For inherited disorders of creatine deficiency only
All requests reviewed by senior staff.
Analysed at Cambridge Biochemical Genetics
24 hour availability
24 hour availability
24 hour availability
24 hour availability
Blood Cortisol after injecting CRF
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TEST
Cyclosporin, see ciclosporin
Cystic fibrosis genotyping
SAMPLE REQUIREMENTS
REFERENCE RANGE
AVAILABILITY / NOTES
Cystine/homocystine, Urine,
Screen
Cystine/homocystine, Urine,
Quantitative
Cystine/homocystine, Blood
Dehydroepiandrosterone
sulphate (DHEAS)
7-Dehydrosterols
Deoxy-cortisol, 11
Not detected
41-415 umol/24h
Dexamethasone suppression
test
Diazepam
Digoxin
Random urine
5mL gold /red top tube
Dihydrotestosterone (DHT)
Diuretic screen
Dopamine
Drug Screen:
Addiction
of
<0.27 prepubertal
<0.6 nmol/L (Adult Female)
0.32-1.64 nmol/L (Adult Male)
See Catecholamines
Usually 24 hour availability
Screens for:
Opiates
Cocaine
Methadone
Benzodiazepines
Amphetamines
Barbiturates
Cannabis
Requests are individually reviewed.
Negative
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TEST
Drug Overdose
Samples
Drug
Overdose:
toxicology screen
Save
Urgent
SAMPLE REQUIREMENTS
25ml random urine with
5ml blood red top tube and
2ml blood light grey top tube
25ml random urine with
5ml blood Red top tube and
2ml blood Light grey top tube
eGFR
Calculation
Elastase (faecal)
Electrophoresis
Proteins
Electrophoresis
Proteins
ELF test
Serum
Urine
REFERENCE RANGE
Ethanol
See Alcohol
Ethosuxemide
Everolimus
Fatty
acids,
(includes C15-22)
AVAILABILITY / NOTES
The laboratory will store these samples to be available for the
Coroner
essential
Felbamate
Ferritin
Flecainide
See report
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TEST
Follicle stimulating hormone
(FSH)
SAMPLE REQUIREMENTS
5ml blood gold top tube
REFERENCE RANGE
Male: 1.5-12.4 IU/L
Female:
3.5-12.5 IU/L (Follicular)
4.7-21.5 IU/L (Mid cycle)
1.7-7.7 IU/L (Luteal)
25.8-134.8 IU/L (Post menopausal)
Normal 0.8-1.44
Fractional Phosphate
Reabsorption
Free T3
Free T4
Fructosamine
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
AVAILABILITY / NOTES
24 hour availability
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TEST
Gastrin (Fasting essential)
SAMPLE REQUIREMENTS
2 X 4ml blood purple top tube
ON ICE (see notes)
<50 pmol/L
Glucose
3.9-5.8 mmo/L
haemoglobin
Glycolate
Glycosaminoglycans
mucopolysaccharides)
Glyoxylate reductase
REFERENCE RANGE
<40 pmol/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)
140-620 umol/24hr
Glycolate/creatinine (umol/mmol)
Under 1 y: 1-49
1-4y: 2-54
5-11 y: 1-68
>12y: 14-57
(see
Gonadotrophins
GRHPR
gene
(Primary
hyperoxaluria type 2)
Growth Hormone (GH)
AVAILABILITY / NOTES
Sample requires special or immediate action (see Guidance note
#19). Transport to lab immediately, on ice. Requests are
individually reviewed, results are available in 2 to 4 weeks Off
Omeprazole for 2 weeks; H2 blockers for 3 days and antacids for 1
day.
Analysed at Charing Cross 0203383 5914
Sample requires special or immediate action. Transport to lab
immediately, on ice. Requests are individually reviewed, results are
available in 2 to 4 weeks.
Analysed at Charing Cross
24 hour availability.
See Mucopolysaccharides
20mg liver biopsy, frozen
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TEST
Gut hormones
SAMPLE REQUIREMENTS
2x5mL purple top tubes on
ice.
Patient must be fasting and off
treatment (see notes)
Haptoglobin
HbA1c
HCG
REFERENCE RANGE
VIP <30 pmol/L
Pancreatic polypeptide <300 pmol/L
Gastrin <60 pmol/L
Glucagon <50 pmol/L
Somatostatin <150 pmol/L
Chromogranin A <60 pmol/L
Chromogranin B <150 pmol/L
0.3-2.0 g/L
0-3 IU/L
HCG, CSF
HCG, pregnancy test
1 mL CSF
5ml random urine
HDL cholesterol
AVAILABILITY / NOTES
Samples require special or immediate action (see Guidance note
#19). Transport to lab immediately, on ice. Requests are
individually reviewed, results are available in 2 to 4 weeks For
gastrin must be off Omeprazole for 2 weeks; and H2 blockers for 3
days. Includes gastrin, glucagon, somatostatin, pancreatic
polypeptide, VIP, chromogranin A and B.
Analysed at Charing Cross 0203383 5914
Usually 24 hour availability
See Glycated haemoglobin
24 hour availability
24 hour availability
Not out of hours. For ?ectopic out of hours, send blood in gold top
tube for HCG
(A&E and some wards carry supply of Clearview Easy pregnancy
testing strips)
24h availability
5-HIAA
11-hydroxylase genetics
Hydroxycholecalciferol
Hydroxyprogesterone (17)
17-hydroxysteroid
dehydrogenase type 3
genetics
IGF1, see insulin like growth
factor
HMMA
HOGA1
gene
(primary
hyperoxaluria type 3)
3-hydroxybutyrate
(blood
ketones)
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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)
subclasses
AVAILABILITY / NOTES
Requests individually reviewed by senior staff. Analysed at
Guildford 01483406715
Version 17
Rarely required.
Analysed at Northern General
24 hour availability
May 2014
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TEST
SAMPLE REQUIREMENTS
5 mL blood gold top tube
Inhibin B
Insulin
Insulin antibodies
Insulin-like Growth Factor 1
(IGF1)
Iodine
Ions difference
Iron and Iron
Capacity (IBC)
Binding
Iron, Urine
Ketones (qualitative)
Ketones (blood), see
hydroxybutyrate
Labstix
Lactate
REFERENCE RANGE
Males: 25-325 ng/L
Females:
day 3 <273 ng/L
Otherwise <341 ng/L
2.6-24.9 mIU/L
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
AVAILABILITY / NOTES
Requests are individually reviewed by senior staff. Results
available within 3 weeks.
Analysed at Charing Cross 0208 846 1415
24 hour availability. For investigation of spontaneous
hypoglycaemia. Glucose level must always be measured at same
time.
Request are individually reviewed by senior staff. Analysed at
Royal Surrey County Hospital, 01483 259978
Batched for analysis on selected days
Change of method to Diasorin on 18/12/2012
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.
0.5-2.2 mmol/L
Version 17
May 2014
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TEST
Lactate dehydrogenase
SAMPLE REQUIREMENTS
5ml blood gold top tube
REFERENCE RANGE
Females 135-214 IU/L
Males 135 -225 IU/L
Children ( up to 15) 120 300 IU/L
Lamotrigene
Laxative Screen
Random urine, 20 mL
Negative
LDL Cholesterol
Lead (inorganic)
Up to 3.5 mmol/L
< 0.5 umol/L (Normal)
>3.0 umol/L (Toxic)
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)
Macroprolactin
Magnesium
Magnesium, Urine
AVAILABILITY / NOTES
24 hour availability
N.B. Assay change from 4/4/2011 with significant change in ref
range
0.6-1.0 mmol/L
2.5-8.5 mmol/24h
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TEST
SAMPLE REQUIREMENTS
4 mL blood purple top (plastic
canula or if using needle,
discard first 10 mL)
5 mL gold top tube
Mercury (inorganic)
25 ml random urine
Mercury (organic)
Metanephrines, plasma
Metanephrines, urine
Manganese
Methotrexate
Methylmalonic acid
2 mL gold/purple/green top
tube
Methylhistamine
10 mL random urine
REFERENCE RANGE
Refer to report
0-5y: 0.6-4.0 mg/L
>5y: 1.0-4.0 mg/L
<50 nmol/L
<30 nmol/L
Normatanephrine 120-1180 pmol/L
Metanephrine 80-510 pmol/L
3-methoxytyramine <180 pmol/L
Refer to report
umol/L
Dependent on patient type and dose route.
Normal: up to 0.29 umol/L
0.30-0.74 umol/L suggests B12 deficiency
>0.74 umol/L consistent with overt B12 deficiency
Microalbumin
Microglobulin (2)
Mucopolysaccharides
Muscle enzymes
Mycophenalate
Myoglobin
10 mL random urine
NAG
(N-acetylglucosaminidase),
urine
AVAILABILITY / NOTES
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.
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TEST
Non-esterified fatty acids
(NEFA)
Neurone specific enolase
SAMPLE REQUIREMENTS
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
0.1-0.6 mmol/L
<12.5 ug/L
Urine (random)
Osmolality
285-295 mosmo/kg
300-900 mosmo/kg
Oxalate, Plasma
http://guidance.nice.org.uk/CG108/QuickRefGuide/pdf/English
AVAILABILITY / NOTES
Neuroimmunology test
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TEST
Oxalate, Urine
SAMPLE REQUIREMENTS
24hr urine collected in bottle
with acid
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
REFERENCE RANGE
100-460 mmol/24 hour
(adults, for children correct for BSA)
Ox/cre ratio:
Infants < 1 year 4 98 umol/mmol
1 4 years 4 72
5 11 years 3 71
> 12 years 1 38
Light
green
top
tubes
Follow dynamic function test
protocol
Phenobarbitone
Phenytoin
Phenytoin (free)
AVAILABILITY / NOTES
Molcular Urology test. Batched for analysis on selected days
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)
Phosphatase
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TEST
Phosphate
Phosphate
Phytanate
SAMPLE REQUIREMENTS
5ml blood gold top tube
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
24 hour availability
24 hour availability
0-10 umol/L
Refer to report
3.5-5.1 mmol/L
25-125 mmol/24h
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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
AVAILABILITY / NOTES
Batched for analysis on selected days
24 hour availability
Progesterone
Progesterone 17OH
Prolactin
Protein, Total
24 hour availability
See Hydroxyprogesterone, 17
24 hour availability
24 hour availability
24 hour availability
Protein selectivity
See Phenobarbitone
For monitoring bone resorption.
Restricted availability
Analysed at Norfolk and Norwich
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TEST
PTH
PTHrP (PTH related peptide)
SAMPLE REQUIREMENTS
See parathyroid hormone
5 mL blood collected in prearranged special tube
Purines, plasma
Purines, urine
Pyruvate, blood
45-150 umol/L
Quetiapine
Quinine
Refer to report
Rast
Reducing substances
Renin
24 hour availability
REFERENCE RANGE
Refer to report
Refer to report
50-200 ug/L
AVAILABILITY / NOTES
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TEST
SCC antigen (squamous cell
ca antigen)
Sco1 gene analysis
Sco2 gene analysis
Selenium
SAMPLE REQUIREMENTS
5mL blood gold top tube
Sertraline
Serum amyloid A
Sex
Hormone
Globulin (SHBG)
Binding
REFERENCE RANGE
0-1.8 ug/L
Full report given
Full report given
At birth: 0.48-1.19 umol/L
0-6m :0.36-0.46 umol/L
6m-2y :0.32-0.63 umol/L
2-15y :0.57-0.9 umol/L
>15y: 0.89-1.65 umol/L
AVAILABILITY / NOTES
Requests individually reviewed by senior staff. Analysed at
Sheffield 0142715552
Molecular urology test
Molecular urology test
Requests individually reviewed by senior staff. Analysed at Trace
Element Lab, Guildford 01483 259978
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
Stone
Sugars, Urine
Sugars, Faecal
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TEST
Sulphite,
urine
sulphocystine)
Sulphonylureas
(or
SAMPLE REQUIREMENTS
Urine, send to lab on ice
immediately after collection
5mL gold top (preferred) or
random urine
4ml blood purple top tube
REFERENCE RANGE
Refer to report
Negative
Full report given
Tacrolimus
Tay Sachs
Testosterone
See hexosaminidase
5ml blood gold top tube
Thallium
Theophylline
Thiopentone
Thiopurine
transferase (TPMT)
methyl
24 hour availability
Thyroglobulin
0.27-4.20 mIU/L
12.0-22.0 pmol/L
Thyroid
Stimulating
Hormone
Thyroxine (Free-T4)
Tiagibine
AVAILABILITY / NOTES
For sulphite oxidase/molybdenum cofactor deficiency
Analysed at Gt Ormond St., 02074059200 x5225
Requests individually reviewed by senior staff. Analysed at
Guildford 01483406715
Molecular urology test
See Chloride
Blood cortisol after injecting ACTH (Synacthen)
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Topimirate
TEST
SAMPLE REQUIREMENTS
5 mL blood red top tube
Total CO2
Toxicology screen
5 mL random urine
Transferrin, Blood
Transferrin, CSF
Transferrin)
Transaminase
TRH test
REFERENCE RANGE
(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
0-0.014 ug/L
Trypsin, immunoreactive
Tryptase
5 mL blood
top tube
2-14 ug/L
TSH receptor
(TRAb)
antibodies
gold or purple
Urea, Blood
Urea, Urine
Urobilinogen
24 hour availability
Request individually reviewed by senior staff. Analysed at Sheffield
Childrens Hospital 0114 271 7445
24 hour availability. Sample should not be taken before 12 hr after
onset of chest pain
0-0.04 ACS unlikely
0.04-0.09 possible ACS. Suggest cardiology opinion
0.1 Probably ACS
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
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
AVAILABILITY / NOTES
Analysed at the Pharmacology and Therapeutic unit, Chalfont
01494 601 423
See Bicarbonate
Rarely sent for analysis. Users requiring addictive drug screen,
please request specifically
Not available. Request Iron + IBC instead.
See Asialo-transferrin, nasal fluid, See Neuroimmunology tests.
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Valproate
TEST
SAMPLE REQUIREMENTS
5ml blood gold top tube
Vitamin A
REFERENCE RANGE
<100 mg/L
(please note, units changed to mg/L occurred on
13/8/12)
1.05-2.27 umol/L
Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
Vitamin
B6
phosphate)
15-73 nmol/L
Vitamin D, 25-OH
(pyridoxal
Vitamin E
Vitamin K
VMA (HMMA)
Water deprivation test
White cell enzymes
66-200 nmol/L
174-471 nmol/L
11.5-46.4 umol/L
Zinc
11-18 umol/L
Zinc (urine)
4.5-9.0 umol/24h
Zonisamide
AVAILABILITY / NOTES
Usually 24 hour availability. Ideal sampling time: pre dose. Time
to steady state: 3 days
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