Waikato District Health Board >> Laboratory Test Reference Guide

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FULL ALPHABETICAL TEST LISTING BY HANDBOOK NAME      Test Name and Handbook details Minimum volume Reference interval Uncert m'ment Reported as Specimen Transport/TAT Price $ 1,25 VITAMIN D (Referred test to Australia) Diagnostic use of this test is very limited. It is not a valid measure of Vitamin D stores. It is the active metabolite of Vitamin D, which may be elevated in patients with granulomatus disease and hypercalcaemia. Apart from the rare indication in patients with hypercalcaemia of unknown cause and a suppressed PTH value, there is little or no clinical reason to order this test. If you would still like this sample analysed, please contact Mr Joe Bouwhuis on ext.8266 or 07 8398841. (Provider: ROYAL BRISBANE HOSPITAL ) Dept: BIOCHEM 3mL serum or EDTA plasma protected from light Consult Laboratory Report N/A   Blood - 5mL Plain tube protected from light. EDTA tube acceptable but not preferred. Transport: Frozen TAT: 2 month 150 Price exclusive of GST 11-DEOXYCORTISOL (11-D) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO 500uL EDTA or heparin plasma or serum Consult Laboratory Report N/A   Blood - EDTA, Heparin or Plain tube. Transport: Chilled TAT: Monthly   17 ALPHA HYDROXY PROGESTERONE This assay is not suitable for neonates. Please refer these samples to Auckland in the first instance.   Dept: BIOCHEM 0.3 mL serum Adult Male < 10 nmol/L Female: Post menopausal < 5 nmol/L Follicular phase < 6 nmol/L Luteal phase < 14 nmol/L Female on OC pill < 8 nmol/L 20%   100 uL Serum/plasma (EDTA or Heparin) 2 mL blood. Plain tube.   TAT: 14 days   17 b OESTRADIOL (Serum-non Pregnancy)     Dept: BIOCHEM 0.3 mL serum Early follicular 100 - 400 pmol/L Late follicular 200 - 1500 pmol/L Luteal 100 - 400 pmol/L Post menopause <100 pmol/L Males <200 pmol/L 20%   200 uL Serum/plasma (Heparin) 2 mL blood. Plain tube.   TAT: 1 week 13.46 Price exclusive of GST 5 HYDROXYINDOLE ACETIC ACID (5HIAA) (Urine) (Referred test) The following drugs and foods interfere with the estimation and should be avoided for at least 72 hours prior to and during the collection. Phenothiazides, Methyldopa, Naproxen, Cough Mixture, Fruits and fruit juices, Eggplant, Nuts, Tomatoes. This list is not complete. A list of drugs being taken must be included on the request form. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 20 mL acidified urine Consult Laboratory Report N/A   Urine - 24 hr collected with acid preservative Transport: Chilled TAT: 10 Days 76.32 Price exclusive of GST 6-MMP (RBC 6-MMP) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL EDTA whole blood Consult Laboratory Report N/A   Blood - 5mL EDTA tube. Transport: Chilled TAT: 2 Weeks 111.72 Price exclusive of GST ACETONE (Referred Test)     Dept: BIOCHEM 1 mL Consult Laboratory Report N/A   20 mL urine collected at end of workers shift.   TAT: 3 days   ACETONE (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 20mL urine Consult Laboratory Report N/A   Urine - 20mL collected at end of shift Transport: Chilled TAT: 3 Days 31.5 Price exclusive of GST ACETYLCHOLINE RECEPTOR ANTIBODIES (Referred test) Acetylcholine receptor binding antibodies are present in approximately 90% of patients with adult onset generalised myasthenia gravis, 60% of ocular myasthenia and 60% of patients in remission. This antibody is highly specific for myasthenia gravis. Approximately 1 % of patients with rheumatoid arthritis being treated with D-penicillamine develop AChR antibodies and these antibodies are seen occasionally in patients after bone marrow grafts. Assays for antibody levels may be useful in monitoring the course of individual patients. (Provider: AUCKLAND LAB PLUS ) Dept: IMMVIRO 0.5 mL serum Normal = 0 - 0.25 nmol/L Borderline = 0.25 - 0.4 nmol/L Positive = >0.4 nmol/L Not known nmol/L 5 mL blood. Plain tube or 0.5 mL separated serum.   TAT: 3 weeks 121.2 Price exclusive of GST ACHONDROPLASIA (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4 mL EDTA whole blood   TAT: 6 weeks 684.93 Price exclusive of GST ACID PHOSPHATASE (Referred test) Do not collect within 72 hours after rectal examination, urethral instrumentation, prostatic massage or FNA. Falsely high levels may result from these procedures. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL serum in special tube obtainable from Waikato Laboratory. Consult Laboratory Report N/A   Blood - 5ml Plain tube on ice. Transport: Frozen TAT: 1 week 23.47 Price exclusive of GST ACTH (Adrenocorticotropic Hormone)     Dept: BIOCHEM 0.3 mL EDTA plasma. Must be frozen on receipt. 2 - 11 pmol/L for samples taken 0700 – 1100 15%   4 mL EDTA blood. Preferably collected into cold EDTA tube and transported immediately to the laboratory in ice water. Must be separated within 4 hours.   TAT: 3 days   ACTINOMYCES CULTURE     Dept: BACTO         Tissue, aspirate, IUCD Aseptic collection as for deep wound cultures.   TAT: Gram stain – same day / Culture - 21 days 82.8 Price exclusive of GST ACTIVATED PROTEIN C RESISTANCE (APC) Test no longer performed. Molecular testing for Factor V leiden is performed.   Dept: HAEM                 ACUTE LEUKAEMIA PANEL (FLOW CYTOMETRY)     Dept: HAEM 10 mL blood. Heparin tube.       10 mL blood Heparin tube. For bone marrow, FNA or tuissue from biopsy, use RPMI media available from flow cytometry section (Ext. 8462). Please provide an appropriate bone marrow or blood film. Transport: Room Temperature TAT: 3 days 414 Price exclusive of GST Acute Lymphocytic Leukemia FISH   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO   Bone marrow Aspirate Peripheral Blood > 10% Blasts         TAT: 7 days 414 Price exclusive of GST Acute Myeloid Leukaemia FISH     Dept: CYTO         Bone Marrow Aspirate     414 Price exclusive of GST ACUTE PHASE PROTEINS Acute phase proteins covers the following tests: -Alpha 1 Antitrypsin, Haptoglobin, C- Reactive Protein Acute phase proteins are useful as indicators of infection, trauma, neoplasia and other inflammatory conditions associated with tissue injury and repair. Several plasma proteins are measured to determine the degree and type of “acute phase” response.   Dept: IMMVIRO 0.3 mL serum alpha 1-antitrypsin 0.8 – 2.0g/L Haptoglobin 0.3 – 2.0g/L C-Reactive Protein - See C-Reactive Protein for normal ranges     5 mL blood. Plain tube or 0.3 mL separated serum   TAT: 1 day   Acute Promyelocytic Leukemia (FISH) t(15;17)   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO         Bone marrow aspirate 4 ml whole blood (Heparin-green top)   TAT: 7 Days 414 Price exclusive of GST ACYLCARNITINE PROFILE (Referred Test)   (Provider: NSW BIOCHEMICAL GENETICS LABORATORY, AUSTRALIA ) Dept: BIOCHEM Guthrie card Consult Laboratory Report N/A   Blood - Guthrie Card Transport: By mail   165.86 Price exclusive of GST ADENOSINE DEAMINASE (Fluid) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 200uL minimum, centrifuge fluid to remove cells or clots Consult Laboratory Report N/A   Pleural aspirate Transport: Room Temperature     Adenovirus Adenovirus causes infection of the respiratory tract, eye, intestine and occasionally the bladder. Samples should be collected as early as possible in the disease. Any isolate is forwarded to ESR for typing.   Dept: IMMVIRO       Negative or positive. Viral throat swab, nasopharyngeal aspirate, nasal swab for respiratory infections. Viral eye swab for conjunctivitis Urine for haemorrhagic cystitis Faeces for type 40/41 gastroenteritis   TAT: Same day for type 40/41 antigen detection 5 days minimum, 14 days maximum for culture 41.2 Price exclusive of GST ADH (Anti Diuretic Hormone, or AVP, or Vasopressin) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: IMMVIRO 0.6mL EDTA plasma minimum Consult Laboratory Report N/A   Blood - 2mL EDTA tube. Transport: Chilled TAT: 1 week 60.84 Price exclusive of GST ADRENAL ANTIBODIES 1. For investigation of adrenal insufficiency. 2. For investigation of autoimmune conditions. Adrenal antibodies are found in the majority of patients with idiopathic Addison’s disease. They can also be detected in almost all patients suffering from autoimmune primary oophoritis. Antibodies to adrenal cortical cells are found in patients with autoimmune adrenalitis. These antibodies occur in low frequency in the normal population (more commonly in women and in the elderly). In patients with normal adrenocortical function, adrenal antibodies have a predictive value for the development of adrenocortical failure.   Dept: IMMVIRO 0.1 mL serum Negative one dilution Negative, +, ++, +++, ++++ 5 mL blood. Plain tube or separated serum.   TAT: 2 days   ADRENOLEUKODYSTROPHY (X-linked) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     Adult 12mL EDTA whole blood Paediatric minimum 2mL EDTA whole blood Prenatal fresh CVS or amniotic fluid   TAT: 4 weeks, unless urgent prenatal (3 – 5 days) 1295 Price exclusive of GST AFP (Alpha Fetoprotein)     Dept: BIOCHEM 0.3 mL serum. Non pregnancy 6 ng/mL Pregnancy Levels: Median at 16 weeks: 37 ng/mL 18 weeks: 50 ng/mL 20 weeks: 60 ng/mL 13%   Serum only 2 mL blood. Plain tube.   TAT: 1 day (not assayed at weekends) 11.39 Price exclusive of GST ALANINE (Referred test) Ideally taken at time of symptoms and/or hypoglycaemic episode. A plasma amino acid profile includes alanine quantitation and screens for other aminoacidopathies – see Amino Acids (plasma). Prior consultation with Chemical Patholgist required. (Provider: NATIONAL TESTING CENTRE ) Dept: BIOCHEM 200uL plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin, EDTA or Plain tube on ice. Transport: Frozen TAT: 1-2 weeks 218.1 Price exclusive of GST ALANINE AMINOTRANSFERASE (ALT or SGPT) Haemolysis causes false elevation.   Dept: IMMVIRO 0.08 mL heparin plasma or serum. < 45 U/L 8%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST ALBUMIN Prolonged stasis during venepuncture will give false high level.   Dept: BIOCHEM 0.08 mL heparin plasma or serum. 0 - 3 months 30 - 45 g/L 0 - 12 months 36 - 50 g/L 1 - 70 years 38 - 52 g/L > 70 years 36 - 50 g/L 5%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST ALBUMIN (Urine)     Dept: BIOCHEM 0.1 mL < 20 mg/L < 2.5 mg/mmol (Albumin:Creatinine ratio) for males < 3.5 mg/mmol for females 10%   Random urine or timed overnight or 24hr collection   TAT: 3 hrs   ALDOLASE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 500uL serum separated immediately. Consult Laboratory Report N/A   Blood - 5mL Plain tube. Transport: Chilled TAT: Not stated 39.57 Price exclusive of GST ALDOSTERONE     Dept: BIOCHEM 0.5 mL serum < 1 week: < 12,000 pmol/L 1 – 52 weeks: 160 – 3000 1 – 4 years 70 – 1000 Adult: Lying 30 - 450 Standing 100 - 860 @ level of 155 = 30%, at a level of > 490 = 15%   500 uL Serum/plasma (Hep- not EDTA) 2 mL blood. Plain tube. Heparin is acceptable.   TAT: 21 days   ALDOSTERONE (Urine)     Dept: BIOCHEM 1 mL urine 17 - 70 nmol/24hr assuming normal salt diet. 30%   24 hr urine or 5 mL sample thereof, and record 24hr volume. Preservative: Boric Acid, 10g/L is preferable but samples with no preservative are acceptable. Additive Nil - Boric Acid is Accepted   TAT: 12 weeks   ALKALINE PHOSPHATASE (ALP)     Dept: BIOCHEM 0.08 mL heparin plasma or serum. ………………Male………..Female 0 - 10 years: 80 - 350 80 - 350 11 - 14 45 - 400 45 - 300 15 - 19 45 - 200 45 - 250 20 - 49 40 - 110 40 - 100 50 - 59 40 - 120 40 - 120 Over 60 40 - 130 40 - 130 7%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST ALKALINE PHOSPHATASE ISOENZYMES - BONE SPECIFIC (Referred test) The source of a raised ALP is probably bone if the Gamma GT is normal, making isoenzyme identification unnecessary. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 2mL Heparin or Plain tube. Transport: Frozen TAT: 2 weeks 32.18 Price exclusive of GST ALPHA 1 ANTITRYPSIN (Faeces) (Referred test) This test is used as a measure of protein loss into the gut, e.g. protein-losing enteropathy. If Alpha 1 antitrypsin is elevated in the absence of a positive occult blood test, increased loss of plasma proteins from the bowel is present. If occult blood is positive, the Alpha 1 antitrypsin is at least partly derived from blood loss, but a coexistent protein losing enteropathy cannot be excluded. An approximate assessment of intestinal plasma protein loss can be made by estimating the clearance of Alpha-1-antitrypsin from plasma into faeces (i.e. the volume of plasma cleared by Alpha 1 antitrypsin per day).   Dept: IMMVIRO   <0.5 ug/g wet weight (children >1yrs old and Adult). Children less than 1yr old - reference interval to be determined N/A   3 day collection for clearance or for random sample at least 5g faeces. Faeces should be frozen during the collection period if possible. Random: 5g faeces (must be in pot, not on nappies) A clearance study: 3 day faecal collection (faeces should be frozen during collection period if possible) plus 5 mL blood in Plain tube for serum Alpha 1 antitrypsin assay. NB: A test for occult blood in faeces should also be performed to exclude bleeding as a cause of an elevated Alpha 1 antitrypsin.   TAT: 3 weeks 34.28 Price exclusive of GST ALPHA 1 ANTITRYPSIN PHENOTYPE (Referred test) Alpha-1-antitrypsin deficiency is an autosomal recessive disease characterised by reduced serum levels of alpha 1-antitrypsin. This deficiency causes a smoking-accelerated emphysema in the third and fourth decades. Approximately 15% of neonates with the ZZ phenotype of ?1AT develop hepatitis; 25% of these develop obstructive jaundice and cirrhosis and die before age 8. About 9% of adults with non-alcoholic cirrhosis are MZ phenotype. Deficiency alleles are associated with lower systolic blood pressure and Z alleles with increased risk of abdominal aortic aneurysm.   Dept: IMMVIRO 0.5 mL serum Phenotyping shows MM pattern in 82% of Caucasian population. N/A   5 mL blood. Plain tube or 0.5 mL separated serum.   TAT: 7 - 10 days 85 Price exclusive of GST ALPHA SUBUNIT (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL EDTA plasma or serum separated immediately Consult Laboratory Report N/A   Blood - 5mL EDTA or Plain on ice. Transport: Frozen TAT: Not stated 36.93 Price exclusive of GST Alpha Thalassaemia Gene studies (Referred test)   (Provider: AUCKLAND LAB PLUS ATTN Neil Van de Water ) Dept: HAEM 5mL Blood       5-10 mL Blood CPD tube. EDTA can be used but must be received at Labplus within 24 hours. Transport: Room Temperature   293.16 Price exclusive of GST ALPHA-1 ANTITRYPSIN For the detection of alpha-1-antitrypsin deficiency. Hereditary deficiency can be the cause of early onset emphysema, neonatal hepatitis or juvenile cirrhosis. Alpha-1-antitrypsin is an acute phase protein reactant and increased levels are observed in acute infection, rheumatic disease, neoplasm’s, hepatitis, cirrhosis, and in association with surgery. A deficiency could be masked if alpha-1-antitrypsin is increased due to a concomitant acute inflammatory response, or if the patient is on oral contraceptives. Low levels are also seen in children with respiratory distress syndrome, severe neonatal hepatitis, nephrotic syndrome (sometimes) and severe liver or pancreatic disease. Phenotyping will confirm if a decrease is due to a genetic deficiency.   Dept: IMMVIRO 0.3 mL serum 0.8 - 2.0 g/L 0.13 g/L g/L 5 mL blood. Plain tube or 0.3 mL separated serum.   TAT: 1 day 12.42 Price exclusive of GST ALUMINIUM (Plasma) Aluminium levels are higher in dialysed patients but should not exceed 2.0 umol/L. Reference: RCPA Manual of Use and Interpretation of Pathology Tests.   Dept: BIOCHEM 0.3mL 500uL Plasma - (Aluminium free tube) <0.3 umol/L (See notes below) 15% > 1.0 umol/L   Plasma Blood 5mL Trace element tube (Navy blue top) K2EDTA is the additive which has a blue label.   TAT: Fortnightly 31.05 Price exclusive of GST ALUMINIUM (Urine) (Referred test) Specimen collected post-shift for occupational monitoring (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL urine Consult Laboratory Report N/A   Urine - 20 mL collected at end of workers shift into an Aluminium free container Transport: Chilled TAT: 1 week 27.6 Price exclusive of GST AMIKACIN     Dept: BIOCHEM 0.2mL plasma Neonates Trough 2-5 ug/mL Peak 20-30 ug/mL Adults Trough <1 ug/mL Peak 56-64 ug/mL 15%   0.5 mL Heparin tube Trough is upto 2hrs pre dose Peak is 30 - 60 mins post dose. Transport: Frozen if sent from outside areas TAT: 3 hrs 16.66 Price exclusive of GST AMINO ACID QUANTITATIVE (Plasma) (Referred test) This test must be processed urgently. Please notify the Laboratory. This is the test of choice in screening for all aminoacidopathies. Specific amino acid quantitation will be reported in the profile.Ideally the sample should be taken at the time of acute symptoms. A brief clinical history is essential. (Provider: NATIONAL TESTING CENTRE ) Dept: BIOCHEM 200uL heparin plasma separated ASAP Consult Laboratory Report N/A   Blood - 3mL Heparin tube on ice. Plain tube on ice OK but not preferrred. Transport: Frozen TAT: 2 weeks 0 Price exclusive of GST AMINO ACIDS (Urine) (Referred test) Salient clinical details required. Collect at time of acute episode. (Provider: NATIONAL TESTING CENTRE, ATTN CLAIRE DE LEUN ) Dept: BIOCHEM 2mL urine Consult Laboratory Report N/A   Urine - Random Transport: Frozen TAT: 2 weeks 122.44 Price exclusive of GST AMIODARONE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin,EDTA or Plain tube. Transport: Chilled TAT: 3 days 35.2 Price exclusive of GST AMITRIPTYLINE (Referred test) For monitoring take specimen 18hours after dose.Supply dose, dose interval, dose time, collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain tube. Transport: Chilled TAT: 3 days unless urgent 23.47 Price exclusive of GST AMMONIA This test must be processed urgently. Please notify the Laboratory that the specimen is on its way. Ammonia levels may be elevated due to pre-analytical sources. These include: a) Poor collection technique. The skin must be thoroughly cleaned prior to collection. Haemolysed specimens and prolonged storage (even once frozen) will result in elevated levels making interpretation difficult. Ammonia can be performed on a micro-collect, but the slower collection procedure increases the level. b) Exogenous sources of ammonia, e.g. smokers (patient or phlebotomist), cleaning solutions and urine may lead to elevated levels.   Dept: BIOCHEM 0.2 mL EDTA plasma transported frozen within 24 hrs. Haemolysed specimens are unsuitable. < 50 umol/L 15% at 65 umol/L, 10% at 236 umol/L   3 mL blood in EDTA tube on ice. Send to laboratory on ice within 15 minutes of collection. For paediatric patients a minimum of 1 mL blood (full micro tube) is required.   TAT: 2 - 3 hrs 41.4 Price exclusive of GST AMNIOTIC FLUID BILIRUBIN (Referred test)     Dept: BIOCHEM   Consult Laboratory Report N/A   Amniotic Fluid - 5mL protected from light. Transport: Chilled TAT: Not stated   AMNIOTIC FLUID CHROMOSOME ANALYSIS   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO   Consult Laboratory Report     15mL amniotic fluid   TAT: 18 days 466 Price exclusive of GST AMOEBA CULTURE – FREE LIVING (Acanthamoeba, Naegleria fowleri)     Dept: BACTO CSF 0.5mL       Eye specimens for Acanthamoeba– corneal scrape, contact lens case, direct inoculation of plates. Cerebrospinal fluid or tissue if amoebic meningitis is suspected. CSF must be transported immediately to the Lab   TAT: Microscopy on CSF samples - <1 hour Culture – 7 days 40 Price exclusive of GST AMOXAPINE (Referred test) Take Specimen 18hours after dose.Supply dose, dose interval, dose time, collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain tube. Trough Specimen: 18hrs after dose Transport: Chilled TAT: 3 days unless urgent 23.47 Price exclusive of GST AMPHETAMINES (Urine) Results are reported as negative or unconfirmed positive. They are for clinical use only and cannot be used for forensic or employment purposes.   Dept: BIOCHEM 0.3 mL Nil 3%   5 mL random urine   TAT: 3 hrs 8.8 Price exclusive of GST AMYLASE (Total Amylase)     Dept: BIOCHEM 0.08 mL heparin plasma or serum. Waikato - 25 - 135 U/L T Labs - 30 – 110 U/L 3%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 3.62 Price exclusive of GST AMYLASE (Urine)     Dept: BIOCHEM 0.2 mL urine Random: < 500 IU/L 3% Turnaround Time:   Random or 24 hr urine. No preservative.   TAT: 3 hrs 3.62 Price exclusive of GST ANAEROBE CULTURE Most anaerobes are slow growing. The presence of most anaerobes can be indicated on preliminary examination of culture after 48 hours incubation. A report is issued on negative cultures at 48 hours and cultures are re-incubated for a further 3 days with an amended report issued if growth occurs.   Dept: BACTO         Acceptable specimens are: Fluid aspirate. Biopsy material surgically obtained. Swab surgically obtained when aspiration is not feasible. Transtracheal aspirate. Material from percutaneous lung puncture. Deep aspirate of open soft tissue wound or ulcer obtained through decontaminated adjacent skin. Aseptic collection to avoid surface contamination. Transport immediately to the laboratory.   TAT: Gram Stain - same day. Culture - 5 days. 31.05 Price exclusive of GST ANDROSTENEDIONE     Dept: BIOCHEM 0.3 mL serum 2 -13 nmol/L 20%   200 uL Serum only 2 mL blood. Plain tube.   TAT: 1 week 33.12 Price exclusive of GST ANEUPLOIDY FISH SCREEN   (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     Amniotic Fluid - 3mL   TAT: 3 days 353.51 Price exclusive of GST ANGELMAN (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     FISH - 4mL heparin whole blood - deletion 75 % Molecular test - 12 mL EDTA - uniparental disomy 25% Paediatric minimum 2mL EDTA whole blood   TAT: 6 weeks   ANGIOTENSIN CONVERTING ENZYME (ACE)     Dept: BIOCHEM 0.1 mL heparin plasma or serum < 18 years 20 - 110 U/L = 18 years 12 - 68 U/L 20%   2 mL blood- Heparin or Plain tube.   TAT: 1 week 22.77 Price exclusive of GST ANTENATAL SCREEN     Dept: HAEM         Blood group, Antibody Screen - 6mL blood. Crossmatch tube (Pink top EDTA) HbSAg, Syphilis, Rubella, HIV- 7 mL blood. Plain tube. CBC - 5 mL blood. EDTA tube.       ANTENATAL SCREEN (subsequent)     Dept: HAEM         Blood Group, Antibody Screen - 6mL blood. Crossmatch tube (Pink top EDTA) CBC 5 mL blood.EDTA tube.       ANTI NMO IgG (Referred test) Neuromyelitis optica (NMO, also known as Devic’s disease and optic-spinal multiple sclerosis (MS) is a severe idiopathic inflammatory demyelinating disease that selectively affects optic nerves and the spinal cord, typically spares the brain, and generally follows a relapsing course. Seropositivity for NMO antibody IgG (NMO-IgG) allows early diagnostic distinction between NMO (73% positive, 91% specific) and multiple sclerosis (0% positive).   Dept: IMMVIRO   Negative N/A   5 mL blood. Plain tube or 2.0 mL separated serum.   TAT: 3 weeks 750.28 Price exclusive of GST ANTIARRHYTHMIC DRUGS (Referred tests)     Dept: BIOCHEM 2mL (Heparin plasma or serum for each drug) Therapeutic Intervals: Disopyramide: 11 - 26 umol/L Flecainide (trough):630 – 2100 nmol/L Quinidine: 6 – 13 umol/L Procainamide: 17 – 34 umol/L N/A   5 mL blood for each drug. Heparin or plain tube. Trough Specimen: <15 minutes pre next dose   TAT: Not stated   ANTIBODIES TO IgA (Referred test) Treatment of IgA deficient individuals with parenteral Ig preparations, including IVIG, can lead to anaphylactoid or anaphylactic reactions associated with production of IgE or IgG antibodies to IgA. Screening for anti-IgA antibodies in patients with IgA deficiency being treated with IVIG is useful and considered indicated because anti-IgA antibodies are found in 29% of primary IgA deficiency, 22% of hypogammaglobulinaemia & 60% of combined IgA - IgG2 deficiency.   Dept: IMMVIRO 0.3 mL serum Negative N/A Negative or Positive 5 mL blood. Plain tube or 0.3 mL separated serum.   TAT: 1 week 18.76 Price exclusive of GST ANTI-CARDIOLIPIN ANTIBODIES Antiphospholipid syndrome (APS) is associated with the presence of antibodies that recognise negatively charged phospholipids. These antibodies can cause a wide variety of clinical symptoms including venous and arterial thrombosis, thrombocytopenia, cerebral vascular accidents, recurrent fetal miscarriage, pulmonary hypertension, seizures and migraine. The most commonly tested phospholipid is cardiolipin. Anticardiolipin antibodies occur in patients with systemic lupus erythematosus (SLE) or lupus-like illnesses, other chronic illnesses (especially neoplastic disease involving immunoglobulin producing cells), infectious diseases (e.g. syphilis and HIV), in conjunction with certain drug therapies, and with advanced age. Cardiolipin antibodies are associated with the lupus inhibitor and with false positive syphilis serology. Levels may fluctuate spontaneously with time and it is recommended that positive results be confirmed by a follow-up assay in approximately 8 weeks. Cardiolipin antibodies may also occur in otherwise normal individuals   Dept: IMMVIRO 0.5 mL serum. The use of plasma is not recommended because of the possibility of contamination of plasma with platelets. Platelets can affect the results by reacting with anti-phospholipid antibodies. Sera exhibiting a high degree of haemolysis icterus, lipaemia, or microbial growth should not be used because these conditions may cause aberrant results. IgG - 0-8 GPLU IgM - 0-8 MPLU +/- 2 units   0.1 mL serum 5 mL blood. Plain tube.   TAT: 1 week 24.84 Price exclusive of GST Anti-CCP antibodies Anti-CCP antibodies are not a screening test for rheumatoid arthritis, but may be useful where the rheumatoid factor is negative or in unusual clinical situations with, for example, a monoarthritis and positive rheumatoid factor. Anti-CCP antibodies are highly specific for rheumatoid arthritis but they are less sensitive than rheumatoid factor. They can be positive in rheumatoid factor negative rheumatoid arthritis and are associated with more severe disease. The levels of anti-CCP antibodies tend to remain stable during disease modifying anti-rheumatic treatment compared to the rheumatoid factor. Immunology at Health Waikato Laboratory use the third generation CCP kit.   Dept: IMMVIRO 100 uL serum <20 units Negative 21-39 units Weak Positive 40 – 59 units Moderate positive >60 units Strong Positive     5mL blood. Plain tube. (EDTA, citrate and heparin may be used) 0.5 mL serum, Minimum 100 uL serum   TAT: 1 week 51.75 Price exclusive of GST ANTICONVULSANT DRUGS     Dept: BIOCHEM 0.2 mL heparin plasma, (2mLs serum – ethosuximide). Therapeutic Interval Carbamazapine (Tegretol) 17 - 34 mol/L (Multiple drug regimen) 34 - 50 umol/L (Single drug regimen) Ethosuximide 280 - 560 umol/L Phenobarbitone 65 - 170 umol/L Phenytoin (Dilantin) 40 - 80 umol/L Valproic Acid (Epilim) 300 - 700 umol/L     2 mL blood - Heparin tube. 5 mL blood – Plain tube (Ethosuximide – referred test)   TAT: 3 hrs , except Ethosuximide (Referred test) = 3 days   ANTI-FACTOR XA ASSAY (Heparin Assay) (Low MW Heparin Monitoring)     Dept: HAEM 1.0 mL frozen plasma   25%   4.5 mL blood. Citrate tube, spun   TAT: 2 h 87.98 Price exclusive of GST ANTI-GAD ANTIBODIES (GADA) (Anti Glutamic Acid Decarboxylase Antibodies) Anti GAD Antibodies are highly predictive (approximately 80%) of Type 1 diabetes. They are also detectable in “stiff man syndrome” (60 - 100%). They are useful in combination with IA2 antibodies for screening or to establish the significance of other antibodies. Positive results are consistent with Type 1 diabetes. Antibody prevalence in young Type 1 diabetic patients: GADA = 65 - 80%, IA2A = 40 - 60%, Islet Cell antibodies = 80 - 90%, Insulin autoantibody = 50 - 70%, GADA +/or IA2A = >90%. Negative results are consistent with Type 2 diabetes, but do not exclude Type 1. (10% of Type 1 are negative for both GADA and IA2A). GADA and IA2A are always performed as a pair of tests on every sample and need not be repeated for 5 years.   Dept: IMMVIRO 0.2 mL serum Normal 0 – 10 U/Ml   U/mL 5 mL blood. Plain tube or separated serum Serum preferred (EDTA OK)   TAT: 2 weeks   ANTI-IA2 ANTIBODIES (IA2A) (Anti Islet Antigen 2 Antibodies) This antibody is highly specific for Type 1 Diabetes. Antibody prevalence in young Type 1 patients is 40 – 60%, but in conjunction with GADA >90%. Antibodies are less common in adults than children. Tests should be performed near the time of onset as antibodies slowly disappear after diagnosis (this may take some years). Insulin dependent (type 1) diabetes (IDDM) is typically characterised by the presence of antibodies to a variety of proteins found in the islets of Langerhans. Antibodies are frequently present years before the onset of symptoms and are therefore useful to predict future diabetes. Antibodies are not present in non--insulin dependent (type 2) diabetes, and therefore antibody tests are useful to distinguish between these forms of diabetes. IA2A is also known as ICA 512. GADA and IA2A are always performed as a pair of tests on every sample. If tests have been performed, retesting is not necessary if within five years. Negative results are consistent with Type 2 Diabetes, but do not exclude Type 1. (10% of Type 1 are negative for both GADA and IA2A). One antibody positive = moderate risk (dependent on antibody level). Two or more antibodies= very high risk of insulin requiring diabetes.   Dept: IMMVIRO 0.2 mL serum 0 – 15 U/Ml N/A U/mL Serum preferred (EDTA plasma OK) 5 mL blood. Plain tube or separated serum.   TAT: 1 – 2 weeks   ANTIMICROBIAL SUSCEPTIBILITY TESTING The provision of clinical details and specimen site are essential for determining the significance of isolates and the need for susceptibility testing. Antibiotics are selected for sensitivity tests according to the site and the organism isolated. Susceptibility testing is performed on all non fastidious bacteria, Yeasts from invasive sites, and Mycobacteria tuberculosis. Results are reported as: Sensitive Infecting organism is inhibited by levels of antimicrobial agent attained in the blood or tissue on usual dosage, including oral administration where applicable. Intermediate: This category includes strains whose MICs approach usually attainable blood and tissue levels and response rates may be lower than for susceptible isolates. The immediate category implies clinical applicability in body sites where the drugs are physiologically concentrated or when high dosage of the drug can be used. Resistant: Infecting organism is resistant to usually achievable systemic concentrations of the antimicrobial agent.   Dept: BACTO         Culture from referring laboratory. Date of subculture should be indicated. Specimens from which significant bacterial pathogens have been isolated will have susceptibility testing performed as part of routine culture.   TAT: 24-72 hours   ANTIMONY (Urine) (Referred Test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random Transport: Chilled TAT: 3-4 weeks 70.39 Price exclusive of GST ANTI-MULLERIAN HORMONE (Referred Test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL serum or plasma       Blood - 5mL Plain, Heparin or EDTA tube. Transport: Frozen TAT: 2 weeks 50.98 Price exclusive of GST ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) This test screens for both C-ANCA and P-ANCA. Serum is screened by indirect immunofluorescence and ELISA tests for antibodies to PR3 and MPO. Indications for requesting test: 1. Chronic destructive disease of the upper airways 2. Pulmonary nodules, non-malignant 3. Subglottic stenosis of the trachea 4. Pulmonary-renal syndrome 5. Glomerulonephritis 6. Suspected vasculitis 7. Mononeuritis multiplex 8. Retro-orbital mass Indirect Immunofluorescent Interpretation Titres: 1:16 - normal. ?1:32 - inconclusive alone, significant if anti-PR-3 or MPO ELISA's are positive. 1:64 or greater - positive result confirmed if anti-PR3 or MPO ELISA's are positive. Pattern: C-ANCA - strongly associated with Wegener's granulomatosis (positive in 85 to 100% of patients with active generalised disease, less frequently in patients with limited disease). P-ANCA - associated with vasculitides (microscopic polyarteritis, idiopathic necrotising and crescentic glomerulonephritis, Churg-Strauss syndrome). Also associated with non-vasculitic conditions such as SLE, inflammatory bowel disease, primary sclerosing cholangitis (which may also give an 'atypical' immunofluorescence pattern) and others. Anti-PR3 and MPO ELISA Tests Normal: < 5 U/mL Anti-PR 3 is usually positive with a C-ANCA pattern, and its detection increases the likelihood of Wegener's granulomatosis. Anti-MPO is often positive with a P-ANCA pattern, and its detection increases the likelihood of ANCA related vasculitis (microscopic polyarteritis, idiopathic necrotising and crescentic glomerulonephritis, Churg-Strauss syndrome). If P-ANCA pattern is not associated with anti-MPO antibodies (as occurs in ~ 50% of cases) diagnosis of vasculitis is much less likely, and SLE, inflammatory bowel disease, primary sclerosing cholangitis etc. should be considered. Immunofluorescent titres and ELISA values may fall with treatment, and increase during disease exacerbation. Anti-PR-3 may become negative in treated or quiescent Wegener's granulomatosis, when the indirect immunofluorescence is still positive   Dept: IMMVIRO 0.1 mL serum < 1:16 Not known Negative or a pattern and titre if positive 5 mL blood. Plain tube or 0.1 mL separated serum   TAT: 2 – 5 days 70.38 Price exclusive of GST ANTI-NUCLEAR ANTIBODY (ANA) Antinuclear antibodies react with antigens located in the cell nucleus, some of which are also expressed in the cytoplasm. ANA are associated principally with autoimmune connective tissue diseases. 1. Virtually all cases of SLE have a positive ANA. 2.ANA's are found commonly in the following rheumatic diseases: Sjogren's syndrome Scleroderma Mixed connective tissue disease Rheumatoid arthritis Polymyositis/dermatomyositis 3. ANA's also occur in many organ-specific autoimmune diseases: Autoimmune thyroiditis Autoimmune chronic active hepatitis 4.ANA's may be associated with some chronic infections: Subacute bacterial endocarditis 5.Positive ANA's are found in approximately 5% of the normal population (usually in low titre). Positive ANA's (>40) specimens should automatically be analysed for antibodies to extractable nuclear antigens (ENA) and double stranded DNA. A centromere pattern is particularly associated with limited scleroderma (CREST syndrome). Other patterns such as diffuse or speckled have much less disease specificity.   Dept: IMMVIRO 0.1 mL serum <1:40 (reported as negative) Systemic autoimmune disease is usually associated with titres > 1:80. +/- 1 dilution Negative, 1:40, 1:80, 1:160, 1:320, 1:640, 1:1280, 1:2560, >1:2560 5 mL blood. Plain tube or 0.1 mL separated serum   TAT: 2 days 7.25 Price exclusive of GST Antinuclear antibody pattern     Dept: IMMVIRO               22.77 Price exclusive of GST ANTI-PURKINJE CELL ANTIBODIES (Referred test) When anti-purkinje cell antibodies are requested the following tests are performed: purkinje cell (PC Ab/Yo)abs, ANNA-1/Hu neuronal nuclei abs and ANNA-2/Ri neuronal nuclei abs. These antibodies are found in patients with subacute or paraneoplastic cerebellar degeneration which is a rare complication of some gynaecological cancers (most frequently ovarian cancer) and rarely breast cancer and Hodgkin disease.   Dept: IMMVIRO 1 mL serum Negative N/A   10 mL blood. Plain tube or 1mL separated serum.   TAT: 4 - 6 weeks 265 Price exclusive of GST ANTI-SACCHAROMYCES CEREVISIAE IgG & IgA ANTIBODIES (ASCA) (Referred test) Crohn’s disease (CD) and ulcerative colitis (UC) both cause inflammation of the intestine, but have different clinical presentations and treatment options. CD usually affects the lower portion of the small intestine, but can affect any part of the digestive tract. Inflammation is asymmetrical and segmental and extends deep into affected tissues. In UC, inflammation is confined to the colon and rectum, is symmetrical, uninterrupted from the rectum proximally, and involves inflammation of the top layers of the lining of the colon and rectum. Antibodies (IgG and IgA) to Saccharomyces cerevisiae (a yeast) are found to be significantly more prevalent in patients with CD (60-70%) compared to patients with UC (10-15% or healthy controls (0-5%). IgG and IgA S. cerevisae antibodies are highly specific for Crohn’s disease (95% -0 100%) and therefore, may be clinically useful in helping to differentiate between CD and UC.   Dept: IMMVIRO 0.5mL serum <20 units/mL N/A units/mL 5 mL blood. Plain tube or separated serum   TAT: 4 weeks 167.55 Price exclusive of GST ANTI-THROMBIN III (Anti-thrombin III)     Dept: HAEM 0.5 mL double spun, frozen plasma 80 - 120% 6% (for levels >30%) 17% (for levels<30%)   Citrate tube, spun 4.5 mL blood. Citrate tube.   TAT: 1 week 18.11 Price exclusive of GST APOLIPOPROTEIN E (Genotyping) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL EDTA whole blood Consult Laboratory Report N/A   Blood - 5mL EDTA tube. Transport: Chilled TAT: Not stated 146.67 Price exclusive of GST APOLIPORPROTEINS (A1,B) (Referred test) Patient fasting (14hrs) (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 500uL plasma or serum Consult Laboratory Report N/A   Blood - Fasting(14hrs). 5mL Heparin, EDTA or Plain tube. Transport: Chilled TAT: 3 days 28.2 Price exclusive of GST APT TEST Test for differentiation of maternal/foetal in vomitus/stool etc.   Dept: HAEM   Reported as blood of neonatal or maternal origin     Blood stained stool, vomitus or gastric aspirate.   TAT: 4 hours 5.69 Price exclusive of GST APTT (Activated Partial Thromboplastin Time) The APTT is an overall evaluation of the intrinsic system of coagulation, testing for factors VIII, IX, XI, XII, prekallikrein and high molecular weight kininogen. The APTT is used for monitoring heparin anticoagulant therapy, detects inhibitors of blood coagultion and monitors replacement therapies.   Dept: HAEM 500uL 25 - 40 secs (Waikato) 20 – 34 secs (Tokoroa and Te Kuiti) 25 – 38 secs (Thames) 5% Time in secs 4.5 mL blood. Citrate tube   TAT: 1 h   APTT correction     Dept: HAEM 500uL Reported as correction, no correction or partial correction N/A   4.5 mL blood. Citrate tube   TAT: 4 h 7.76 Price exclusive of GST ARSENIC (Urine) (Referred test) Industrial samples collected on 4th day of working week. Inorganic arsenic levels are not effected by organic arsenic of dietary origin (i.e. fish). Urine chromium may be assayed on the same sample. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL urine Consult Laboratory Report N/A   Urine - 10 mL random. Industrial specimens collected on day 4 of working week. Transport: Chilled TAT: 1 week 61.67 Price exclusive of GST ASCORBIC ACID (Vitamin C) (Referred test) Where possible arrange for the patient to present at Health Waikato Laboratories otherwise the referring laboratory must undertake the pretreatment step and send the treated samples on ice. Reagents and notes can be supplied to those labs wishing to pretreat the specimens. Please contact Biochemistry (ph 07 8398726 ext 6142) (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM Pretreated plasma and pretreated leucocytes - see note. Consult Laboratory Report N/A   Blood - 2X 5mL Heparin tubes on ice sent to lab within 1 hour of collection. Transport: Frozen TAT: 1 week 41.12 Price exclusive of GST ASPARTATE AMINOTRANSFERASE (AST or SGOT)     Dept: BIOCHEM 0.08 mL heparin plasma or serum. <2yrs 0 – 80 U/L 2 – 10yrs 0 – 60 U/L >10yrs 0 – 45 U/L 9%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST ASPERGILLUS PRECIPITINS The determination of precipitins (which are IgG) to A. fumigatus is useful in aiding the diagnosis of sensitisation of A. fumigatus or of saprophytic colonisation by the organism (usually in lung cavities). The number of bands is also of value diagnostically. One or two bands may indicate any form of aspergillosis, but generally this number appears in patients with allergic aspergillosis. Three or four precipitin bands is strongly suggestive of either aspergilloma or allergic bronchopulmonary aspergillosis. Immunocompromised patients may not demonstrate detectable precipitin bands even with culture proven aspergillosis.   Dept: BIOCHEM 0.4 mL serum Negative N/A Negative or Positive and the number of precipitin bands 10 mL blood. Plain tube or 0.4 mL separated serum   TAT: 3 - 7 days 31.5 Price exclusive of GST ASPERGILLUS-IgE SPECIFIC ANTIBODIES Specific IgE to Aspergillus is helpful in confirming a diagnosis of allergic broncho-pulmonary aspergillosis (ABPA). Other tests, which also aid in diagnosis, are: 1. Total serum IgE - Refer IgE Most patients with ABPA, have total serum IgE levels of >1000kU/L although levels vary with disease activity. 2. Aspergillus precipitins – Refer Aspergillus precipitins. 3. Skin prick testing with Aspergillus extract.   Dept: IMMVIRO 100uL serum 0 – absent or undetectable +/- one unit 0 – absent or undetectable 1 – low 2 – moderate 3 – high 4 – 6 – very high 50-100 uL serum 5 mL blood   TAT: 1 week 40.37 Price exclusive of GST ATAXIA TELEGIECTACIA     Dept: CYTO         12 mL EDTA whole blood   TAT: 6 weeks   AUTOIMMUNE PROFILE Autoimmune profile includes the following tests: Rheumatoid Factor C-Reactive Protein Tissue Autoantibodies Antinuclear Antibody (ANA) See individual tests for further information   Dept: IMMVIRO 0.6 mL serum       5 mL blood. Plain tube or 0.5 mL separated serum       AVIAN PRECIPITINS (Referred test) Test range includes:-pigeon serum -budgerigar serum -poultry serum -pigeon faeces -budgerigar faeces Detection of precipitating antibodies supports the diagnosis of extrinsic allergic alveolitis in a patient with appropriate history of exposure and presentations   Dept: IMMVIRO 0.2 mL serum Not detected   Not detected, weak or strong positive 5 mL blood. Plain tube or minimum 200 uL separated serum   TAT: 1 - 2 weeks 25.79 Price exclusive of GST AZOTHIOPRINE (AZT, 6-TGN) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL EDTA whole blood Consult Laboratory Report N/A   Blood - 5mL EDTA tube. Transport: Chilled TAT: 2 days 152.49 Price exclusive of GST BARBITURATES (Urine) (Referred test)     Dept: BIOCHEM 0.3 mL Nil N/A   5 mL random sample   TAT: 2 days   BARBITURATES (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random Transport: Chilled TAT: 3 Days 9.4 Price exclusive of GST BARMAH FOREST VIRUS (Referred test) Acute sample should be collected within five days of illness. A convalescent sample is required 10-14 days later. A detail of recent travel to endemic areas is required. Samples are referred to ESR, Wellington for testing. IgG and IgM serology is performed.   Dept: IMMVIRO 300uL     Negative or reactive with appropriate comment 5ml Plain tube blood or 500uL serum   TAT: 1 week   BCR-ABL MOLECULAR STUDIES (Referred Test) Must arrive at Health Waikato Laboratory by 10.00 am on day of collection. Lab Supply Services must be notified in advance to book courier. DO NOT SEND ON FRIDAYS (Provider: AUCKLAND LAB PLUS ATTN Neil Van de Water ) Dept: HAEM 10mL or minimum of 10 million cells     Negative or Positive 10mL Blood CPD, or Bone Marrow in CPD. Transport: Room Temperature TAT: One Week 277.75 Price exclusive of GST BENCE JONES PROTEIN (Free Light Chains ) (Urine) Immunofixation will be performed on all urine requests for Bence Jones protein. Bence-Jones protein consists of free monoclonal light chains of immunoglobulin. Its presence usually indicates a B-cell malignancy where the production of light chains exceeds that of the associated immunoglobulin heavy chain. Its presence in myeloma has prognostic significance, and is likely to be associated with renal tubule damage and amyloidosis. Its absence may be as a consequence of impaired renal function. For monitoring purposes, it can be approximately quantitated by visualisation of the electrophoretic strip. A urine specimen must always be sent to the laboratory for detection of light chains (Bence-Jones protein) if myeloma is suspected. About 20% of cases will have light chains in the urine, but no paraprotein band in the serum   Dept: IMMVIRO 5 mL Nil detected. N/A Negative, Positive and any relevant comment. If quantitation required need 10mL urine (Screen) Random. No preservative (or protein will be denatured). (Quantitation) 24hr collection. No preservative (or protein will be denatured).   TAT: 5 days 60 Price exclusive of GST BENZODIAZEPINES (Urine) Results are reported as negative or unconfirmed positive. They are for clinical use only and cannot be used for forensic or employment purposes.   Dept: BIOCHEM 0.3 mL Nil 5%   5 mL random sample   TAT: 3 hrs 8.8 Price exclusive of GST BETA 2 MICROGLOBULIN B2 Microglobulin is found on the cytoplasmic membrane of nucleated cells and is shed into the circulation probably as a result of membrane turnover or cell death. Increased levels are found in patients with impaired glomerular filtration e.g. acute and chronic renal failure. In patients with normal renal function, increased levels may occur with B cell lymphoproliferative states e.g. myeloma, lymphoma or amyloidosis, infections e.g. HIV or in states of immune stimulation e.g. rheumatoid arthritis, SLE and sarcoidosis. Monitoring B2M has clinical utility in myeloma, lymphoma and HIV infection. Multiple myeloma: A good indicator of prognosis, and for monitoring disease progress, irrespective of therapeutic modality. The concentration correlates with the tumour cell mass. The outcome of bone marrow transplantation is also predicted by the pre-transplantation level of B2 microglobulin. HIV: An indicator of prognosis and disease progression. A concentration >4.0mg/L is associated with increased progression to AIDS.   Dept: IMMVIRO 0.1 mL serum Up to 50 years:1.2 – 2.5 mg/L Over 50 years 1.4 – 3.2 mg/L. +/- 0.23 mg/L 5 mL blood. Plain tube or 0.1 mL separated serum.   TAT: 2 days 22.77 Price exclusive of GST BETA 2 (B2) INTERFERON NEUTRALISING ANTIBODIES (Referred Test) Multiple sclerosis (MS) patients may fail to respond well to Interferon B (IFNB) therapy for a number of reasons. A potential explanation for this is the development of neutralising antibodies to IFNB (NAB). These antibodies are thought to bind to the drug and prevent its binding to target receptors. Testing for NAB may provide clinically useful information in any patient receiving IFNB but particularly when relapses or MRI activity continue to be seen despite treatment. The clinical significance of NAB and the appropriate response to a positive NAB test remain controversial and no clinical guidelines exist at this time.   Dept: IMMVIRO 1mL serum       5 mL blood. Plain tube or 1 mL separated serum. NB. Sample must be taken at least 24 hours after treatment with IFNB.   TAT: 4 weeks 7 Price exclusive of GST Beta 2 glycoprotein I antibodies A specific marker in suspected anti-phospholipid syndrome. (Provider: AUCKLAND LAB PLUS ) Dept: IMMVIRO 200uL serum <20 units   units 5 mL blood. Plain tube or minimum 200 uL separated serum.   TAT: 3 weeks 25.25 Price exclusive of GST BETA 2 MICROGLOBULIN (Urine) The concentration may help define the degree of renal tubular dysfunction   Dept: IMMVIRO 25 mL <0.44 mg /L     Urine: 25 mL , collected at high diuresis, and with the pH adjusted to between 6 and 8 on collection.   TAT: 3 days 22.77 Price exclusive of GST Beta HYDROXYBUTYRATE (OHB) Ketones include acetoacetic acid, beta-hydroxybutyric acid and acetone. The relative proportions of all ketones depend on the severity of the ketosis and the availability of NADH for metabolism. Beta-hydroxybutyric acid (OHB) can be added up to 4 hrs post collection. If outside this time frame, a new specimen must be collected.   Dept: BIOCHEM 0.2 mL plasma or serum (Frozen) <0.3 mmol/L ( overnight fast) @ level of 1.25 = 5%, @ level of 0.29 = 15%   2 mL blood – heparin tube   TAT: 3 hrs 15.53 Price exclusive of GST beta-HCG (Human Chorionic Gonadotropin, Intact Molecule plus beta-Subunits - Pregnancy Screening and Gestational Age) In a normal early pregnancy, levels should rise by 65% each 48 hrs, or 114% over 72 hrs. Approximately 80% of ectopic pregnancies have rate increases less than this. Menopausal women may have levels up to 14 IU/L. If level is >5 IU/L, suggest send repeat specimen and also request FSH. * Tokoroa are able to perform qualitative testing on urine.   Dept: BIOCHEM 0.5 mL plasma or serum Confirmation of pregnancy > 25 IU/L (Patients with levels between 5 - 25 IU/L should be re tested in 24 48 hours). Approximate levels in early pregnancy (IU/L): Weeks post LMP 4: 3 - 426 5: 19 - 7340 6: 1080 - 56500 10: 54100 - 288000 11%   2 mL blood - Heparin tube   TAT: 3hrs or1 hr urgent request. 13.82 Price exclusive of GST beta-HCG (Human Chorionic Gonadotropin, Intact Molecule plus beta-Subunits - Tumour Marker) Menopausal women may have levels up to 14 IU/L. If level is >1 IU/L, suggest send repeat specimen and also request FSH   Dept: BIOCHEM 0.5 mL serum or heparin plasma. < 1 IU/L 12%   Serum or Heparin 2 mL blood. Plain or heparinised tube.   TAT: 2 days 13.82 Price exclusive of GST BICARBONATE (Standard – Included in blood gas profile)     Dept: BIOCHEM N/A > 2 yrs 21 - 27 mmol/L 0D - 2yrs 18 - 23 mmol/L 10%   Whole blood (arterial or venous) collected into a heparinised blood gas syringe, well mixed, capped with filter cap & sealed with blood. Transport at ambient temperature. Must be analysed within 30 minutes.   TAT: 30 mins (blood gas syringe)   BICARBONATE (Total)     Dept: BIOCHEM Plasma or serum, separated ASAP and sent frozen with minimal headspace. 22 - 29 mmol/L 10%   2 mL blood - Heparin tube.   TAT: 3 hrs 10.35 Price exclusive of GST BILE ACIDS (Bile Salts) (Referred test) Patient fasting overnight. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL EDTA plasma or serum Consult Laboratory Report N/A   Blood - Patient fasting overnight. 5mL EDTA or Plain on ice. Transport: Frozen TAT: 1 Day when urgent 77.43 Price exclusive of GST BILIRUBIN (Delta) (Referred test) Baby must be >14 days of age. (Provider: THAMES HOSPITAL LABORATORY ) Dept: BIOCHEM 0.5mL serum or plasma protected from light. Consult Laboratory Report N/A   Blood - 3mL Heparin or Plain tube protected from light. Transport: Chilled TAT: 1 week 0 Price exclusive of GST BILIRUBIN (Total) - Conjugated fractions can be determined on request if the total bilirubin is elevated. - This analysis cannot be performed if there is excessive haemolysis. - Samples for bilirubin can have values decreased by up to 50 % per hour by light exposure. Specimens for investigation of jaundice should therefore be protected from light.   Dept: BIOCHEM 0.08 mL heparin plasma or serum, protect from light Age Total Bilirubin (µmol/L) Cord Blood = 50 Up to 24 hrs = 150 = 24 hrs to < 48 hrs = 200 = 48 hrs to < 72 hrs = 250 = 3 days to < 7 days = 300 = 7 days to < 3 weeks = 100 = 3 weeks to < 4 weeks = 50 = 4 weeks < 25 Action cut points for treatment and monitoring of newborn hyperbilirubinaemia. Refer to neonatal unit protocol. 6%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST BILIRUBIN (Conjugated) This analysis cannot be performed if there is excessive haemolysis Not performed on adults if Total Bilirubin < 25 umol/L   Dept: BIOCHEM 0.08 mL heparin plasma or serum, protect from light Age Direct Bilirubin Comment (µmol/L) Neonate < 20 or 10% >30 µmol/L require attention Adult < 5 <10% total or up to 30% of total at low levels 7%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 6.21 Price exclusive of GST Bilirubin urine Refer to Microbiology Urine Culture   Dept: BIOCHEM         Fresh random urine     6.21 Price exclusive of GST BIOPSY CULTURE     Dept: BACTO         The addition of a small amount of saline to the container will prevent the biopsy from drying out. If Legionella is suspected do not add saline, as it is inhibitory. Transport to laboratory as soon as possible.   TAT: Gram stain – same day Culture – 5 days 46.58 Price exclusive of GST BIOPSY SPECIMENS FOR ROUTINE HISTOLOGY     Dept: HIST         Endoscopic biopsy, punch biopsy, needle core biopsy Immerse in 10% buffered formalin immediately Fixation Time: Minimum 4 hours   TAT: 1-2 working days from receipt. 1-3 working days from receipt when immunohistochemical tests are required   BISMUTH (Urine) (Referred test)   (Provider: ENVIRONMENTAL LABORATORY SERVICES, LOWER HUTT ) Dept: BIOCHEM 30mL urine Consult Laboratory Report N/A   Urine - Random collected at end of shift at the end of the working week for workplace exposure. Transport: Chilled TAT: 1 week 0 Price exclusive of GST BK VIRUS (Referred test) (from A+ laboratory) BK virus is usually acquired in early childhood with seroconversion rates rising to nearly 100% by the age of 10-11 years. Primary infection in healthy subjects is essentially asymptomatic with the virus persisting thereafter in the kidneys and peripheral white blood cells. Reactivation of the virus with shedding in the urine occurs frequently in the immunosuppressed and has a low predictive value for BK disease. BK viraemia is a better correlate of BK virus neuropathy in renal transplant recipients and is probably also a better predictor of BK disease in haematopoietic stem cell transplant patients.   Dept: IMMVIRO       Negative or copies/ml. 4 mL EDTA whole Blood Urine may NOT be sent.   TAT: Referred to A+ laboratory 137.81 Price exclusive of GST Bleeding time Test no longer performed. Has been replaced by platelet function analysis (PFA-100)   Dept: HAEM               20.7 Price exclusive of GST BLOOD CULTURES Blood cultures collected from outside the hospital into bottles other than Bactec will be processed manually with the same turn around time. If suspecting Mycobacterial or Fungal bacteraemia special culture media is available (Myco/F Lytic) on request from the laboratory Ext. 8646. For Leptospirosis blood culture refer to Leptospirosis culture   Dept: BACTO       A report is issued on negative cultures at 36 hours and any positive cultures detected after that will have an amended report issued. All positive cultures will be reported by phone to medical staff immediately. Updated results will be entered onto the computer daily. Blood culture media is available from Propharma via weekly orders. For urgent supplies out of hours contact Duty Manager. Blood culture stocks held in the wards should be kept to a minimum because of the relatively short shelf life of the media. Store in a cool; dry place (2-25?c) out of direct sunlight. Collect prior to antibiotic treatment where possible. The volume of blood collected is the most important factor in the sensitivity of organism detection. High volume blood cultures drawn serially return the best yield. Adults: Aerobic (silver) and Anaerobic (gold) BACTEC bottles In cases of PUO three serial sets are recommended Optimum blood volume 8-10 mLs. Do not overfill bottles (i.e. >10mls) Minimum blood volume 3 mLs Children: Paeds Plus (pink) BACTEC bottle Optimum blood volume 1-3 mLs Minimum blood volume 0.5 ml Specimen Collection Refer to IV and Related Procedures Manual for detailed blood culture collection procedures (B22, C23). Remember to mark and fill to desired level. Using aseptic technique: Fill with bottle standing upright. Fill aerobic bottle first. Collect before any other required blood tubes are filled. If several sets are collected from different sites on the same patient, remove all bar code labels and stick them to the patient form. Label the bar code labels on the request form and the bottles with the site.   TAT: 6 days   BLOOD FILM If referring film from a referral laboratory, please include a copy of the Haematology analyser printout, and any other pertinent laboratory results and clinical findings.   Dept: HAEM 4mL       4 mL blood EDTA tube, or unstained blood film.     8.8 Price exclusive of GST BLOOD GASES (Blood) * * The reference interval quoted is for non fasting plasma glucose. Whole blood glucose is approximately 10% lower than the quoted reference interval, assuming the haematocrit is normal   Dept: BIOCHEM 0.3 mL whole blood – collect and transport anaerobically. 37oC breathing air. Acid Base Status Arterial pH: 7.35 - 7.45 Venous pH: 7.32 - 7.42 PO2: 2days – 60yrs 83 - 108 mmHg PCO2: Arterial 34-45 mmHg Venous 37 – 48 mmHg HCO3- (Std) >2 yrs 21 - 27mmol/L HCO3- (Std) 0-2Y 18-23 mmol/L B.E -2 to +2 mmol/L Electrolytes and Glucose Sodium 138 – 145 mmol/L Potassium 3.6 – 5.2 mmol/L Chloride 95 – 110 mmol/L Glucose (non fasting) 3.5 – 7.7 mmol/L Lactate 0.6 – 2.4 mmol/L Haemoglobin: (Adult Male) 130-180 g/L (Adult Female) 115-165 g/L FCOH: (Non smokers) 0-2.0% (Including smokers) 0-5% Methaemoglobin 0-1.5% pH: +/- 0.003; pCO2: +/-1.6 mmHg; pO2: +/- 4.4 mmHg; Na:+/-3.2 mmol/L; K:+/- 0.05; iCa: +/- 0.02; Cl: +/- 2.4 mmol/L; Glu: +/-0.12 mmol/L; Lactate: +/-0.2mmol/L; Hb: +/- 2.2g/L   1.5 mL arterial blood in heparinised syringe. Transport to Laboratory within 10 minutes of collection. Micro blood gases (venous - capillary) are available at Waikato and Thames Hospitals, but are not appropriate for pO2 or pCO2 estimation.   TAT: 30 mins 15.53 Price exclusive of GST BNP ( NT-proBNP)     Dept: BIOCHEM 0.3 mL plasma or serum Transport ambient or chilled. The reference range in healthy people is < 40 pmol/L. Levels > 220 pmol/L for this method strongly suggest heart failure in newly symptomatic (breathless) patients, but all clinical information should be taken into account. In between these levels, heart failure is still possible. 6%   2 mL blood - heparin tube.   TAT: 3 hrs 41.4 Price exclusive of GST BONE BANK TISSUES     Dept: BACTO       A report is issued on negative cultures at 36 hours and any positive cultures detected after that will have an amended report issued. Surgical collection of tissue and immediate transport to the laboratory in a sterile container.   TAT: Culture – 6 days   Bone Marrow (Preparation) (Cytogenetics)   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO             TAT: 72 hours 285 Price exclusive of GST Bone Marrow (Receipt) (Cytogenetics)   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO             TAT: 24 hours   BONE MARROW EXAMINATION Phone Haematology Laboratory (8219). Referral form to Haematology consultant   Dept: HAEM               186.5 Price exclusive of GST BONE MARROW KARYOTYPE Please provide clinical details (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO Bone marrow aspirate       Bone marrow aspirate taken into heparin RPMI (as for flow cytometry). Transport medium for off-site laboratories is also provided from the cytogenetics laboratory.   TAT: 18 days, usually less than one week 570 Price exclusive of GST BONE/LIMBS     Dept: HIST         Surgically removed tissue/organ Specimen Collection: Immerse in 10% buffered formalin immediately Fixation Time: Minimum 8-24 hours Decalcification: 1-7 days   TAT: 2-8 working days from receipt 3-9 working days from receipt when immunohistochemical tests are required.   BORDELLA PERTUSSIS ANTIBODIES (IgG & IgA) The test of choice for diagnosing Whooping Cough in its early stages is PCR from a nasopharyngeal swab. Beyond 2 or 3 weeks of symptoms, the organisms are seldom detected so serology must be relied upon. High levels of IgG antibody are moderately predictive of recent (<6/12) infection with or vaccination for Bordetella pertussis. IgA testing enables diagnosis of additional cases and is considered to reflect mucosal infection rather than vaccination. Low levels of antibody may be detectable for several years due to boosting by related antigens in Haemophilus influenzae and Bordetella parapertussis. IgM Enzyme Immuno Assays have not been validated against proven cases so this test is no longer offered. In secondary infection (i.e. re-infection or previous vaccination with waning immunity) IgA and IgG antibodies will be positive.   Dept: IMMVIRO 0.1 mL serum Negative IgG At Neg/Rea cut-off of 10:1 Panbio unit At Rea/Hi Rea cut-off of 20: 2 Panbio unit Negative (<10 Panbio units) Low Positive (10 – 20 units) High Positive (>20 units) with appropriate comments. 3 mL blood. Plain tube or 0.1 mL separated serum. Method: EIA   TAT: 2weeks 37.26 Price exclusive of GST BORDETELLA PERTUSSIS PCR Test normally performed on hospitalised patients only   Dept: IMMVIRO         Specimen Required: Dry per-nasal swab or nasopharyngeal aspirate Specimen Collection: Swab collection: use a thin wire dry swab and insert gently into nostril until it reaches the posterior nares. Leave in place 15 to 30 seconds before withdrawing. Send to the laboratory dry. Kits containing a swab and collection instructions are available from laboratory Ext. 8646   TAT: 1 day 62.1 Price exclusive of GST BORRELIA BURGDORFERI SEROLOGY (Lyme disease antibodies) (Referred test). Epidemiology Borrelia burgdorferi, a tick-transmitted spirochete, is the etiological agent of Lyme Disease. It occurs in the U.S.A., Europe, Scandinavia and parts of Asia. Clinical Features The disease generally occurs in stages, however, the early stages of the illness may be asymptomatic and the patient may present with late manifestations. Stage 1: characteristically involves the skin with the development of a red lesion near the site of the tick bite called erythema migrans. This may develop within a few days to weeks following a tick bite and may be associated with symptoms of headache, malaise, myalgia, fever, arthralgia, fatigue and lymphadenopathy. Stage 2: is characterised by neurological, cardiac and musculo-skeletal involvement and may appear from weeks to months following Stage 1. Stage 3: Infection usually begins months to years later and is characterised by arthritic symptoms, generally the large joints being affected. The knees are the most commonly affected and arthritic symptoms may recur for years. Similarly sometimes following long periods of latent infection, chronic neurologic manifestations may develop e.g. encephalopathy, polyneuropathy or leukoencephalitis. Diagnosis: Sometimes it is possible to culture B. burgdorferi from skin lesions but it is uncommon to do so from blood or CSF and virtually never from joints. Diagnosis is therefore based primarily on positive serology in the appropriate clinical context. Significant results for B. burgdorferi are indicated when the IgM / IgG are positive and when cross-reactivity with Treponemal infection and ANA has been excluded. Sero-conversion occurs slowly and therefore may be negative early in the course of infection, however after 4 - 6 weeks, more than 90% have a positive IgG response. Patients usually remain sero-positive for years with slow decline in antibody titres with antibiotic therapy. Patient sera reactive for either IgG or IgM will be tested for possible cross-reactivity caused by either Treponemal antibody or ANA.   Dept: IMMVIRO 0.5 mL serum N/A N/A   5 mL blood. Plain tube or 0.5 mL separated serum.   TAT: 3 weeks. 57.39 Price exclusive of GST BOWEL     Dept: HIST         Surgically removed tissue/organ Specimen Collection: Immerse in 10% buffered formalin immediately Fixation Time: Minimum 8-24 hours   TAT: 2-4 working days from receipt 3-7 working days from receipt when immunohistochemical tests are required.   BOWEL CANCER (Gene Testing) (Referred Test) LabPlus sends this test to GTG, Melbourne (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     12 mL EDTA whole blood (3 tubes)   TAT: 3 months   BRCA1 and BRCA2 (Referred test for hereditary breast and ovarian cancer) Specimens will not be analysed without evidence that appropriate genetic counselling has been provided (NRGS 0800 476 123). Consent forms and a pedigree detailing clinical information must accompany BCRA testing requests (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     16 mL EDTA whole blood   TAT: Variable, dependent upon family history. DNA and RNA extraction and storage may be the appropriate strategy. 3000 Price exclusive of GST BREAST     Dept: HIST         Surgically removed tissue/organ Specimen Collection: Immerse in 10% buffered formalin immediately Fixation Time: Minimum 24 hours   TAT: 3-4 working days from receipt including x-ray 3-7 working days from receipt when immunohistochemical tests e.g. oestrogen/progesterone receptors, c-erbB2 oncoprotein are required.   BREAST LUMPECTOMY/HOOKWIRE     Dept: HIST         Surgically removed tissue/organ Submit to Histology Laboratory in Buffered formalin. Fixation Time: Minimum 8-24 hours   TAT: 2-4 working days from receipt including x-ray 3-7 working days from receipt when immunohistochemical tests e.g. oestrogen/progesterone receptors, c-erbB2 oncoprotein are required.   BROMIDE (Methyl Bromide) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 4mL plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain collected at end of workers shift. Transport: Chilled TAT: 2 weeks 58.67 Price exclusive of GST Bronchial washings or BAL     Dept: HIST         If microbiology is required on the specimen that must be done first.     49.79 Price exclusive of GST BRUCELLA CULTURE If Brucella is suspected, please indicate clinical details on the form, as the duration of culture needs to be extended to 10 days   Dept: BACTO       A report is issued on negative cultures at 36 hours and any positive cultures detected after that will have an amended report issued. Blood Culture bottles (aerobic + anaerobic). Specimen Collection: Collect prior to antibiotic treatment where possible. Refer to Blood Culture protocol for collection technique   TAT: 10 days 31.05 Price exclusive of GST BRUCELLA SEROLOGY (IgG & IgM) Cross-reactions have been shown to occur with Yersinia enterocolitica. Serological support for the diagnosis of Brucellosis requires demonstration of a four-fold rise in antibody titre between acute and convalescent sera, or demonstrate a falling titre after treatment, or demonstrate IgM antibodies. Current Case Definition: Brucellosis has been eradicated from cattle in this country, and locally acquired infection is now very rare in New Zealand. Diagnosis of human brucellosis in patients with recent symptoms and no history of overseas travel should be made with great caution. A confirmed case is one that has: a clinically compatible illness and either isolation of Brucella species from a clinical specimen, or a four-fold or greater rise in Brucella antibody titre between acute and convalescent phase serum obtained two or more weeks apart and tested at the same time in the same laboratory. A probable case is one that has: a clinically compatible illness and supportive serology, i.e. a Brucella IgG titre greater than or equal to 160 in one or more serum specimens obtained after the onset of symptoms   Dept: IMMVIRO 0.3 mL serum Negative 8% Negative = <20, or a titre 10 mL blood. Plain tube or 0.3 mL separated serum.   TAT: 1 week 36.23 Price exclusive of GST Brushings.     Dept: HIST         Please make 3-4 thinnish smears, rapidly fix in alcohol, and if possibility of malignant lymphoma, please make 1-2 rapidly air-dried smears for special stains.     49.79 Price exclusive of GST BUPRENORPHINE (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random Transport: Chilled TAT: 1 week 40.45 Price exclusive of GST C.pneumoniae IgG     Dept: IMMVIRO         Testing no longer available       C1 ESTERASE INHIBITOR (Antigenic) Acquired C1 inhibitor deficiency can occur rarely in SLE and B cell lymphomas. Acquired C1 inhibitor deficiency can be distinguished from the hereditary form by measuring C1 q levels, which are low in the acquired form but normal in the inherited. Patients who present with angioedema may have C1 inhibitor deficiency. The angioedema associated with this condition is not associated with urticaria. This clinical feature helps to distinguish it from the very much more common allergic or idiopathic angioedema. Hereditary angioedema is a rare disorder resulting from an autosomal dominant deficiency of C1 inhibitor. This deficiency produces an uncontrolled activation of the early components of the classical complement system, with generation of a kinin-like substance that causes recurrent angioedema of the gastrointestinal and genitourinary tracts and the larynx. The subcutaneous and submucosal oedema is usually harmless, but when the larynx is involved, death may occur due to respiratory obstruction and asphyxiation. Depressed levels of total haemolytic complement activity, C4 and C2 may be manifestations of an underlying deficiency of C1 inhibitor. C2 is low during acute attacks. Clinical attacks of oedema are accompanied by the appearance of free active C1 in the plasma and by falls in the levels of C4 (which are subnormal even during asymptomatic intervals) to undetectable. Diagnosis is most simply and reliably made by the C4 level, a normal value virtually excludes the diagnosis. Some people synthesise an abnormal C1 inhibitor protein that is reactive in immunoassays, but devoid of the ability to inhibit the C1 enzyme, so that direct immunoassays for C1 inhibitor may not detect all cases.   Dept: IMMVIRO 0.2 mL serum C1 Esterase Antigen 0.21 - 0.35 g/L N/A   5 mL blood. Plain tube or 0.2 mL separated frozen serum. Serum is essential, (EDTA plasma only if C1 Activation specifically requested). NB: Sample must be received in the Laboratory, separated & frozen within 1 hour of collection. If despatched from outside Hospital, serum must still be frozen on arrival in Laboratory. This test must be processed urgently. Please notify the Laboratory that the specimen is on its way.   TAT: 5 - 7 days 25.88 Price exclusive of GST C1 ESTERASE INHIBITOR FUNCTION (Referred test) C1 inhibitor levels are reduced in cases of hereditary angioedema. In this condition, 85 % of patients will have decreased antigenic and functional C1 inhibitor levels, whereas 15% will have a dysfunctional protein (normal or high antigenic assay, low functional assay). The C4 component of complement is almost invariably low in cases of hereditary · angioedema, and C2 is low during acute attacks   Dept: IMMVIRO 0.2 mL serum C1 Esterase Function 5 – 10 U/mL N/A   Serum is essential, (EDTA plasma only if C1 Activation specifically requested). 10 mL blood. Plain tube or 0.2 mL separated serum NB: Sample must be received in the Laboratory separated and frozen within 1 hour of collection. If despatched from outside Hospital, serum must still be frozen on arrival in the Laboratory. This test must be processed urgently. Please notify the Laboratory that the specimen is on its way.   TAT: 7 - 10 days   C3 NEPHRITIC FACTOR (Referred test) C3 nephritic factor is an autoantibody directed against activated Factor B of the alternate complement pathway. It is found most commonly in Type II MPGN (Membranoproliferative Glomerulonephritis), but is also associated with partial lipodystrophy, post-streptococcal glomerulonephritis, SLE, and idiopathic rapidly progressive glomerulonephritis   Dept: IMMVIRO 0.4 mL plasma (EDTA) Not detected N/A Not detected or detected 5 mL blood, EDTA tube or 0.4 mL separated, frozen plasma (serum or plasma. Plasma more stable) NB: Sample must be received in Laboratory within 1 hour of collection. If despatched from outside Hospital, plasma must still be frozen on arrival in Laboratory. This test must be processed urgently. Please notify the Laboratory that the specimen is on its way.   TAT: 10 - 14 days 55.16 Price exclusive of GST CA 125 (Carbohydrate Antigen 125 for investigation of Ovarian Cancer) It must be noted that cancers other than ovarian (e.g.. Pancreatic, colorectal, lung, breast) may give raised levels as will some benign gynaecologic tumours and inflammatory processes. Raised levels may be seen in pregnancy, various autoimmune diseases, hepatitis, chronic pancreatitis, endometriosis, PID, renal failure, and cirrhosis of the liver. Levels may also change throughout the menstrual cycle.   Dept: BIOCHEM 0.3 mL serum < 21 U/mL 10%   Serum only 2 mL blood. Plain tube   TAT: 2 days 15.53 Price exclusive of GST CA 15-3 (Carbohydrate Antigen 153 for investigation of Breast Cancer) It must be noted that malignancies other than breast cancer (e.g. lung and ovarian) may show elevated levels as will some benign conditions of the breast & liver   Dept: BIOCHEM 0.3 mL serum < 42 U/mL 15%   Serum only 2 mL blood. Plain tube.   TAT: 2 days 15.53 Price exclusive of GST CA 19-9 (Carbohydrate Antigen 199 for investigation of GI Cancers) Elevated levels may be found in cancers of the pancreas, stomach, intestine, lung and some other non GI cancers. Elevated levels may also be present in some benign and inflammatory diseases of the GI tract and liver, including cystic fibrosis.   Dept: BIOCHEM 0.3 mL serum < 25 U/mL 15%   Serum only 2 mL blood. Plain tube.   TAT: 2 days 15.53 Price exclusive of GST CA 72-4 (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 300uL plasma or serum. Consult Laboratory Report     Blood - Heparin, EDTA or plain tube. Transport: Frozen TAT: Assayed twice weekly 134.36 Price exclusive of GST CADASIL (NOTCH 3) (Referred Test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4 ml EDTA whole blood   TAT: 6 weeks 431.62 Price exclusive of GST CADMIUM (Referred test) State whether patient smoker or non-smoker. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL K2 EDTA whole blood Consult Laboratory Report N/A   Blood - 5mL K2 EDTA Trace Element tube. Transport: Chilled TAT: 1 week 41.69 Price exclusive of GST CADMIUM (Urine) (Referred test) Ensure that hands are washed and clothes are free of cadmium contamination before collection. To minimise contamination of the sample from tobacco, the sample should be collected in a smokefree environment. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 20mL urine Consult Laboratory Report N/A   Urine - Random. Refer to Patient Preparation. Transport: Chilled TAT: 7 days 41.69 Price exclusive of GST CAFFEINE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Chilled TAT: 1 week 23.47 Price exclusive of GST CALCITONIN     Dept: BIOCHEM 0.5 mL serum <10 pg/mL (Children <3 yrs may have higher levels) 12%   200 uL Serum only 5 mL blood. Plain or Heparin tube. Send to laboratory without delay. Allow serum to clot at 4oC, then separate in a cold centrifuge and freeze.   TAT: 1 week 51.75 Price exclusive of GST CALCIUM Avoid stasis as this artifactually raises calcium. Corrected Calciums will be automatically performed on adults when a Calcium is requested.   Dept: BIOCHEM 0.08 mL heparin plasma or serum. 1 - 3 days = 1.80 - 2.80 mmol/L 4 - days - 1 year = 2.10 - 2.80 mmol/L > 1 year = 2.10 – 2.55 mmol/L 4%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST CALCIUM (Ionised) Contact Biochemistry prior to collection.   Dept: BIOCHEM 1.5 mL in a blood gas syringe or 3mL in a red top tube or 4 mL in a gel separator tube. Serum: 1.16 - 1.32 mmol/L Whole Blood: 18 - 60 yrs 1.15 - 1.27 mmol/L 60 - 90 yrs 1.16 - 1.29 mmol/L >90 yrs 1.12 - 1.32 mmol/L +/- 0.02 mmol/L   Patient ideally fasting. Collect 1.5 mL blood without a tourniquet into a 3 mLblood gas syringe or 0.5 mL into a 1mL blood gas syringe. The syringe should be tightly sealed, and transported on ice. Alternatively collect in to a red top tube or gel separator tube and transport to the Laboratory for separation within 4 hours.   TAT: 30 mins 15.53 Price exclusive of GST CALCIUM, CORRECTED FOR ALBUMIN CONCENTRATION Measured calcium is corrected to the mean value of the reference interval for albumin in ambulant adults, which is 40 g/L. This calculation is not appropriate for paediatric patients up to 3 months, and is only an approximation for patients with severe disturbances in albumin concentration and other protein abnormalities. Not calculated when the Albumin is <25 or >50 as results become misleading. Direct measurement of ionised calcium may be more useful.   Dept: BIOCHEM 0.1 mL (Heparin plasma or serum) 2.1 - 2.55 mmol/L     2 mL blood - Heparin tube 2 mL blood - Plain tube (" T" Laboratories)   TAT: 3hrs 4.66 Price exclusive of GST CALCULUS ANALYSIS (Renal/Gall stones) The stone(s) will be photographed and qualitative analysis for common inorganic constituents performed. Gallstones will be analysed for cholesterol and bilirubin content.   Dept: BIOCHEM     N/A   Whole stone. Stone must be >3mm in diameter to allow analysis. Do NOT add formalin.   TAT: 1 week 56.93 Price exclusive of GST CALPROTECTIN (Faeces) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2 – 3g faeces Consult Laboratory Report N/A   Faeces Transport: Chilled TAT: 2 weeks 100.55 Price exclusive of GST CAMPYLOBACTER JEJUNII     Dept: BACTO         Serology testing for Campylobacter jejunii is not available.       CANDIDA SEROLOGY Candida serology is no longer offered due to lack of sensitivity and specificity. Serological tests for invasive candidiasis have poor sensitivity and specificity and are only recommended for established sepsis in the compromised individual. Results in “Systemic Candida Syndrome” are unreliable, impossible to interpret and not recommended.   Dept: IMMVIRO                 CANNABINOIDS (Urine) Results are reported as negative or unconfirmed positive. They are for clinical use only and cannot be used for forensic or employment purposes.   Dept: BIOCHEM 0.3 mL Nil 15%   5 mL random urine.   TAT: 3 hrs 8.8 Price exclusive of GST CAPD FLUIDS All microscopy results and initial positive culture results are faxed to CAPD unit.   Dept: BACTO         CAPD fluid bag or an aseptically collected aliquot of fluid (at least 100mLs). Tests performed: WBC and RBC count Gram stain, WBC differential and culture are performed if bag is the first taken from an episode of peritonitis, as indicated by cell count, or depending on the patients’ previous CAPD fluid results. If the WBC differential is lymphocytic, the specimen is referred for mycobacteria culture.   TAT: Microscopy – 2 hours Culture 5 days 36 Price exclusive of GST CARBAMAZEPINE (Tegretol) – Also See ANTICONVULSANTS     Dept: BIOCHEM 0.2 mL heparin plasma or serum. Therapeutic Interval: 34 - 50 umol/L (single drug regime) 17 - 34 umol/L ( multiple drug regime) 7%   2 mL blood - Heparin tube. Sampling Time: With patient at steady-state samples should be drawn immediately before the next dose (trough value).   TAT: 3 hrs 10.35 Price exclusive of GST CARBOHYDRATE DEFICIENT TRANSFERRIN (CDT) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 200uL serum Consult Laboratory Report N/A   Blood - 5mL Plain tube. Transport: Chilled TAT: 2 weeks 111.49 Price exclusive of GST CARBON MONOXIDE (Whole blood) (Carboxyhaemoglobin)     Dept: BIOCHEM 0.5 mL in a 3. mL blood gas syringe Interpretation: % Hb saturated with CO. 0 - 5%: Normal (includes smokers) 15 - 20%:Toxic symptoms 50 - 70%:Unconsciousness > 70% : Toxic (often fatal) 0.2%   Either 1.5 mL collected into a heparinised blood gas syringe, or 5 mL whole blood in a heparinised vacutainer. Referred samples: Seal heapinized blood into vials with minimum airspace and send frozen.   TAT: 30 mins 15.53 Price exclusive of GST CARDIAC ANTIBODIES (SKELETAL MUSCLE ANTIBODIES) (Referred test) Skeletal Muscle Antibodies are found in approximately 30% of patients with myasthenia gravis and almost 100% with associated thymoma are positive for skeletal muscle antibodies. They are also detected in 84% of patients with Rheumatic Fever, 76% of uncomplicated streptococcal infections, 27% of miscellaneous autoimmune diseases, and 10% of blood donors.   Dept: IMMVIRO 0.5 mL serum Negative Analytical Error: 1 dilution Negative or titre. 5mL of blood. Plain tube or 0.5 mL separated serum.   TAT: 2 weeks 26 Price exclusive of GST CARNITINE (Plasma) (Referred test) Acylcarnitine profile is the test of choice for screening of fatty acid oxidation defects (Guthrie card). See Acylcarnitine profile. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL plasma or serum Consult Laboratory Report N/A   Blood - 5mL EDTA, Heparin or plain tube on ice. Transport: Frozen TAT: 4 weeks 129.03 Price exclusive of GST CARNITINE (Urine) (Referred test) Acylcarnitine profile is the test of choice for screening of fatty acid oxidation defects (Guthrie card). See Acylcarnitine profile. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL urine Consult Laboratory Report N/A   Urine - Random Transport: Frozen TAT: 1 month 129.03 Price exclusive of GST CAROTENOIDS (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL plasma or serum protected from light Consult Laboratory Report N/A   Blood - 5mL Heparin, EDTA or Plain tube protected from light. Transport: Chilled TAT: 10 days 25.82 Price exclusive of GST CAT SCRATCH DISEASE SEROLOGY (Referred test) Definition: Cat scratch disease is a self-limiting febrile illness with localised lymphadenopathy caused by Bartonella henselae, a Gram negative bacterium that is transmitted to people by cat scratches. Clinical: Subacute self-limiting illness, with malaise, low-grade fever, and regional lymphadenopathy. - 1-3 weeks after a cat scratch develop a raised inflammatory nodule. A vesicle or eschar may appear at site of skin injury. - 3 - 6 weeks after cat scratch develop regional lymphadenopathy (axillary > cervical > preauricular > submandibular > epitrochlear > femoral > inguinal). - Initially nodes tender and swollen, occasionally suppurate, then become non-tender, firm, enlarged nodes (may last for months). Diagnosis of Cat Scratch Disease: Classic definition: 3 of 4 criteria met, or typical silver-staining bacteria identified on histopathology of lymph nodes, primary skin or eye lesions. History of contact with cats and the presence of a scratch or primary dermal lesion or eye lesion. - Positive skin test for cat scratch disease. - Negative studies for other causes of lymphadenopathy. - Lymph node biopsy showing histologically multiple granulomatous abscesses. Serology Indirect fluorescent-antibody assay (sensitivity 88%, specificity 94%). Cross reactivity occurs with Chlamydia and other Bartonella species and this should be considered with unexpected serological results.   Dept: IMMVIRO 0.2 mL serum Not detected. N/A   5 mL blood. Plain tube or 0.2 mL separated serum, minimum Paired sera should be obtained wherever possible: acute sample – as early as possible in the illness, and convalescent sample 2-3 weeks after onset.   TAT: 2 weeks 25.22 Price exclusive of GST CATECHOLAMINES (Plasma) (Referred test) The test of choice for phaeochromocytoma screening is 24 hr Urinary Catecholamines. Plasma catecholamine analysis is only performed as part of a postural tilt test. In this case please contact the laboratory for a collection protocol. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL EDTA plasma Consult Laboratory Report N/A   Blood - 4mL EDTA tube Contact laboratory for collection protocol. Transport: Deep frozen TAT: 2 weeks 62.56 Price exclusive of GST CATECHOLAMINES (Urine) (Specific) (Referred test) Interferences, Specificity and Limitations (as provided by CHL) Compounds that directly interfere in the assay a. Methyldopa (contained in Aldoclor, Aldomet, and Aldoril). This compound has a very similar retention time to epinephrine and may obscure it. b. L Dopa (levodopa; contained in Sinemet, Larodopa, Bendopa). This contains Dopa and large amounts in plasma may obscure norepinephrine as well as dopamine. c. Carbidopa, Sinemet contains carbidopa as well as L-Dopa. Two extra peaks in the nor/epinephrine region could be due to carbidopa. This compound is therefore a potential interfering agent. d. The following drugs contain epinephrine, which will interfere with epinephrine measurement. Medihaler - EPI, MicroNEFRIN, Sus-Phrine, Vaponefrin. e.The following drugs contain dopamine: Intropin f. Beta-Blockers especially Labetolol. The assay used is an HPLC method, which is not interfered with by diet. If the patient is on antihypertensive therapy with Aldomet or Beta-Blockers, it may not be necessary to stop the medication provided drug details are noted on the request form. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 20mL acidified urine Consult Laboratory Report N/A   Urine - 24hr collected with acid preservative. Children - Random Urine with Acid added on receipt in laboratory. Transport: Chilled TAT: 1 Week 34.8 Price exclusive of GST CATHETER TIP CULTURE Culture is not performed on urinary catheter tips   Dept: BACTO         Distal portion of IV catheter   TAT: 2 days 31.05 Price exclusive of GST CD4 LYMPHOCYTE COUNT Please include WBC and differential results with referred specimen. Indicate if other lymphocyte subsets required>   Dept: HAEM 1mL blood 0.51-1.15 x109/L (adult) 14%   4 mL blood EDTA tube. Transport: Ambient TAT: 1 day 56.93 Price exclusive of GST CEA (Carcino-Embryonic Antigen)     Dept: BIOCHEM 0.3 mL serum Normal: < 4 ng/mL Borderline: 4 - 6 ng/mL Smokers: <10 ng/ml 15%   Serum prefered 2 mL blood. Plain tube.   TAT: 1 day (not assayed at weekends) 14.49 Price exclusive of GST CELL MARKER STUDIES (Lymphocyte Cell Markers)     Dept: HAEM 10mL       10 mL blood. Heparin tube.For bone marrow, FNA or tissue from biopsy, use RPMI media available from flow cytometry section (Ext. 8462). Transport: Ambient TAT: 2 days 331.2 Price exclusive of GST CERULOPLASMIN Oral contraceptives and pregnancy will increase levels. Increased levels are also found in patients who have chronic infections, degenerative diseases, leukaemia, Hodgkin’s disease, other malignant tumours, rheumatoid arthritis, or hyperthyroidism. Decreased levels are observed in newborn infants and patients with nephrosis. The main diagnostic significance is with the low levels seen in Wilson’s disease (hepatolenticular degeneration) which is a familial condition where copper is deposited in the liver, kidney and lenticular nucleus of the brain.   Dept: IMMVIRO 0.3 mL serum 0.25 - 0.7 g/L 0.10 g/L g/L 5 mL blood. Plain tube or 0.3 mL separated serum   TAT: 1 day 18.11 Price exclusive of GST CHARCOT-MARIE-TOOTH NEUROPATHY (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO         4 mL EDTA blood   TAT: 3 weeks   Chikungunya serology     Dept: IMMVIRO         500uL serum       CHITOTRIOSIDASE (Referred test)   (Provider: ADELAIDE WOMENS AND CHILDRENS HOSPITAL ) Dept: BIOCHEM 0.2mL serum Consult Laboratory Report N/A   Blood -3mL Plain tube Transport: Frozen TAT: 1 month 215.51 Price exclusive of GST CHLAMYDIA PCR     Dept: BACTO         Dry swab, with metal or plastic stem (urethral, cervical, eye, rectal, throat, nasopharyngeal) or first catch urine. Chlamydia trachomatis inhabits columnar and cuboidal epithelial cells only. Purulent discharges are inappropriate specimens and should be cleaned from the site before sampling. Specimen Transport: Swabs and Urine samples are stable at room temperature for 24 hours. Specimens that cannot be transported to the laboratory within 24 hours may be refrigerated for up to 4 days. Specimen Collection Urine: 15-20 mL first voided urine (passed no earlier than 2 hours after the previous void). Midstream urines are not normally processed. In exceptional circumstances i.e. a further specimen is impossible to obtain, the specimen will be tested and released with a comment indicating that a first catch urine is preferred. Cervical Sample: Wipe endocervix with swab to remove excess mucus or pus. Discard swab. Insert swab into endocervical area and leave in place for 20 seconds, rotate and remove swab without touching vaginal surfaces. A vaginal swab is acceptable if a cervical swab cannot be collected. Urethral Sample: Patient preferably will not have urinated one hour prior to sampling. Insert a small dacron swab 2-4cm into urethra. Rotate swab gently but firmly and withdraw. Conjunctival Sample: Incubation period in new-borns is 4-14 days. Apply a topical anaesthetic to the eye/s. Remove any purulent discharge with a swab and discard swab. Using a new swab, firmly swab the inner surface of the lower, then upper eyelid. Use separate swabs if sampling both eyes.   TAT: 2 days Monday – Friday. Not processed on weekends. 30 Price exclusive of GST Chlamydia psittaci IgG     Dept: IMMVIRO         Testing no longer available       Chlamydia trachomatis IgG     Dept: IMMVIRO         Testing no longer available       CHLORAMPHENICOL (Referred test) Prior consultation with Chemical Pathologist required (Provider: PRINCESS ALEXANDRA HOSPITAL, AUSTRALIA ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Serum Transport: Frozen TAT: 1 week 55.13 Price exclusive of GST CHLORIDE     Dept: BIOCHEM 0.1 mL (heparin plasma or serum) 0 – 30 days: 95 – 113 mmol/L. > 30 days: 95 – 110 mmol/L. 3%   2 mL blood - heparin tube. Or can be performed as part of a Blood Gas profile.   TAT: 3 hrs 2.33 Price exclusive of GST CHLORIDE URINE     Dept: BIOCHEM 0.1 ml - please state volume. 110 - 250 mmol/24hrs 5%   24 hr urine collected with no preservative   TAT: 3 hrs 2.25 Price exclusive of GST CHLORPROMAZINE (Largactil) (Referred test) Take specimen 18 hrs post dose. Supply dose, dose interval, dose time and collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL plasma or serum protected from light Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain tube protected from light Transport: Chilled TAT: 3 days 24.71 Price exclusive of GST CHOLESTEROL     Dept: BIOCHEM 0.08 mL heparin plasma or serum. Desired Adult Level: 3.0 - 4.9 mmol/L (Auckland Regional Quality Assurance Group recommendation). 6%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.59 Price exclusive of GST CHOLINESTERASE (Phenotyping) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL EDTA plasma or whole blood or 1mL heparin plasma Consult Laboratory Report N/A   Blood - 5mL EDTA or Heparin tube. Transport: Chilled TAT: 2 weeks 205.31 Price exclusive of GST CHOLINESTERASE (Pseudocholinesterase) Acute organophosphate poisoning:- Request plasma cholinesterase. Chronic organophosphate poisoning: - Request plasma and red cell cholinesterase. Suxamethonium (scoline) sensitivity:- Request plasma cholinesterase. The specimen must not be taken within 24 hrs following scoline administration, or within 2 weeks of a blood transfusion.   Dept: BIOCHEM 0.1 mL serum, Heparin or EDTA plasma Female: <16 yrs 5300 – 12900 U/L 16 – 39 yrs 4300 – 11200 U/L >40 yrs 5300 – 12900 U/L Pregnant or on hormonal contraceptives: 18 – 41 yrs 3700 – 9100 U/L Male: All ages 5300 – 12900 U/L 20%   2 mL blood - Plain or Heparin or EDTA tube   TAT: 1-2 weeks 10.35 Price exclusive of GST CHOLINESTERASE (Red Cell) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL heparin or EDTA whole blood Consult Laboratory Report N/A   Blood - 5mL Heparin or EDTA tube. Transport: Chilled TAT: 1 week 23.47 Price exclusive of GST CHORIONIC VILLUS (Chromosome Analysis)   (Provider: AUCKLAND LAB PLUS ) Dept: CYTO         20mg villi   TAT: 18 days 511.58 Price exclusive of GST CHROMIUM (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random. Industrial samples to be collected on day 4 of working week. Transport: Chilled TAT: 1 week 30.51 Price exclusive of GST CHROMOGRANIN (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM >1mL heparin or EDTA plasma Consult Laboratory Report N/A   Blood - 5mL Heparin or EDTA tube. Serum is unacceptable. Transport: Frozen TAT: 3 weeks 161.98 Price exclusive of GST CHROMOSOMES   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO         Blood: 4mL heparin, Bone marrow: aspirate Amniotic fluid: 12 – 16 mL CVS; available aspirate Solid tissue: as available   TAT: 18 – 28 days   Chronic Lymphocytic Leukaemia FISH Panel   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO         4 ml whole blood (Heparin-green top) or Bone marrow aspirate   TAT: 14 days 1168.85 Price exclusive of GST Chronic Myeloid Leukaemia (FISH) t(9;22)   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO         4 ml whole blood (Heparin-green top) or Bone marrow aspirate   TAT: 7 days 414 Price exclusive of GST CHYMOTRYPSIN (Faecal) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5g faeces Consult Laboratory Report N/A   Faeces - 5g Transport: Chilled TAT: 3 days 64.57 Price exclusive of GST CIRCULATING IMMUNE COMPLEXES (C1q Binding) (Referred test) C1q BINDING ASSAY – See CIRCULATING Presence of immune complexes in serum can occur at low levels in non-pathological conditions. The quantitation of immune complexes by the C1q binding assay has diagnostic and prognostic value in a limited number of clinical disorders. In RA, little useful additional information is gained above that achieved by measuring RF. However, in selected disorders, e.g. infective endocardititis, diffuse interstitial lung disease and vasculitis, elevated concentrations may be found, which will alert the clinician to a possible immune complex pathogenesis and determining sequential concentrations maybe useful in monitoring response to treatment.   Dept: IMMVIRO 0.2 mL serum 0 - 40 ug/mL Not known Negative <40 ug/mL Equivocal 40 – 50 g/mL Positive >50 g/mL 5 mL blood. Plain tube or separated serum   TAT: 7 - 10 days 35.12 Price exclusive of GST CITRATE (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - 24hr collected with acid preservative. Nil preservative acceptable but not preferred. Transport: Frozen TAT: 1 week 69.72 Price exclusive of GST CJD (Creutzfeldt-Jakob Disease) For tests relating to CJD consult Medical Microbiologist Dr Chris Mansell   Dept: IMMVIRO         CSF for 14-3-3 protein: Routine processing Brain or Tonsil Biopsy: Do not open as decontamination difficult EDTA blood for PRNP gene: Do not open to avoid contamination of sample Check sample identity is in order       CK ISOENZYME ELECTROPHORESIS (Referred test) Qualitative results reported with the predominant enzymes noted CKMM, CKMB, CKBB (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 100uL plasma or serum Consult Laboratory Report N/A   Blood - 2mL Heparin or Plain tube. Transport: Chilled TAT: 10 days 64.57 Price exclusive of GST CKMB (Referred Test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 200uL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Frozen TAT: 2 days 18.46 Price exclusive of GST CLOMIPRAMINE (Referred test) Take specimen 18 hrs after dose. Supply dose, dose time, dose interval and collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain tube. Transport: Chilled TAT: 3 days 20.57 Price exclusive of GST CLONAZEPAM (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Frozen TAT: 2 weeks 51.58 Price exclusive of GST CLOSTRIDIUM DIFFICILE TOXIN Clostridium difficile toxin should be considered in any patient that is on antibiotics or has been on antibiotics up to six weeks prior to developing diarrhoeal symptoms. Patients who have been in hospital for more than 3 days and were not admitted with gastrointestinal symptoms are unlikely to have a food borne infection and are more likely to have symptoms due to Clostridium difficile toxin. Specimens received on patients who have been in hospital for more than three days are therefore only tested for Clostridium difficile toxin unless culture is specifically requested.   Dept: BACTO         Faeces   TAT: 48 hMonday to Friday. Test not performed at weekends. 36.23 Price exclusive of GST CLOZAPINE (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Chilled TAT: 3 Days 35.95 Price exclusive of GST CMV (PCR)     Dept: IMMVIRO 500uL plasma per cryovial.       Two EDTA whole blood tubes       CMV IgG Avidity     Dept: IMMVIRO         500 uL serum     53.82 Price exclusive of GST CMV IgM (Confirmation)     Dept: IMMVIRO         500 uL serum     25.88 Price exclusive of GST COAGULATION FACTOR ASSAYS (Factors II-XII)     Dept: HAEM 1.0 mL frozen citrate plasma 50-150% 14%   4.5 mL blood. Citrate tube spun   TAT: 1 week. 2 hrs if urgent.   COAGULATION SCREEN Tests included in Coagulation screen vary at the T sites. Contact local laboratory to ascertain what the local profile is.   Dept: HAEM 2 - 3mL frozen plasma See individual tests: Prothrombin Ratio APTT TCT (thrombin clotting time) Fibrinogen     4.5 mL blood. Citrate tube.   TAT: 2 h 25.88 Price exclusive of GST COBALT (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random. Transport: Chilled TAT: 3 Weeks 70.39 Price exclusive of GST COCAINE (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - Random Transport: Chilled TAT: 3 days 10.06 Price exclusive of GST COCCIDIOIDOMYCOSIS SEROLOGY (Referred test) • Coccidioides immitis is a fungus found mainly in soil in the desert regions of southwestern parts of the US, in Mexico, in Central America, and in parts of South America. • During one part of the fungus' life cycle, it is airborne. That's when it is most dangerous. Those with Coccidioidomycosis have inhaled this infective fungus. • The lungs are the most commonly affected. In severe cases, Coccidioidomycosis can also involve the kidneys lymph system, brain, and spleen. • Symptoms include cough, weight loss, and fatigue. Meningitis is a common complication when Coccidioidomycosis is left untreated. • About 60% of infections cause no symptoms and are only recognised later by a positive coccidioidin skin test. In the remaining 40% symptoms range from mild to severe. People with a compromised immune system tend to have more serious infections. Individuals with AIDS are at higher risk for pulmonary coccidioidomycosis, and the disseminated and cutaneous forms of the disease.   Dept: IMMVIRO 0.5mL serum Negative N/A Negative or Positive and any relevant comments. 5 mL blood. Plain tube or separated serum   TAT: 8 weeks   COELIAC SCREEN If a coeliac screen is requested testing for tissue transglutaminase IgA antibodies will be performed. Depending on this result further testing may be performed. (gliadin IgG and IgA Antibodies, endomysial IgA Antibodies and serum IgA). See individual tests for further information.   Dept: IMMVIRO 0.3 mL serum       5 mL blood. Plain tube or 0.3 mL separated serum       COENZYME-Q (Referred test) Patient should be fasting (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL heparin plasma protected from light Consult Laboratory Report N/A   Blood - 5mL Heparin tube protected from light Transport: Frozen TAT: Not Stated 80.44 Price exclusive of GST COLD AGGLUTININ SCREEN     Dept: BB         6 mL blood. Crossmatch tube, (Pink top EDTA)       COLLAGEN BINDING ASSAY     Dept: HAEM 0.5 mL frozen plasma 50 - 150% >30% is 11% <30% is 27%   Citrate tube - Do not spin 4.5 mL blood. Citrate tube.   TAT: 1 week 25.88 Price exclusive of GST COLLAGEN VASCULAR SCREEN Collagen Vascular Screen includes the following tests: Rheumatoid Factor Tissue Autoantibodies Glomerular Basement Membrane Antibodies Antineutrophil Cytoplasmic Antibodies (ANCA) C. Reactive Protein See individual tests for further information.   Dept: IMMVIRO 0.3 mL serum       5 mL blood. Plain tube or 0.3 mL separated serum       COMPLEMENT If total complement is required – see Total complement. Elevated C3 & C4 concentrations occur in inflammatory disorders. Low C3 reflects activation of either the classical or alternate pathways. Low C3 with a normal C4 occurs with isolated alternative pathway activation. Depressed C3 levels occur in SLE, post infectious glomerulonephritis, glomerulonephritis associated with C3 nephritis factor, rheumatoid vasculitis, hereditary deficiency and severe liver disease. C4 levels will be depressed if utilisation by the classical pathway exceeds production. Depressed C4 levels occur in active SLE, hereditary angioedema and hereditary deficiency states. Background Complement comprises a group of protease precursors and regulating proteins produced by the liver and present in normal serum. When activated they act as mediators of inflammation and immune effectors. Foreign surfaces, e.g. bacterial cell walls (alternative pathway), or antibody bound to antigen (classical pathway) causes sequential activation in a cascade effect. The central reaction involves the deposition of large amounts of C3b on pathogens and immune complexes, which acts as an opsonin facilitating phagocytosis. By-products of this reaction, anaphylotoxins, act as powerful mediators of inflammation. The terminal complement components can cause direct damage to targets by formation of the membrane attack complex (MAC). Classical pathway Ag + Ab-C1-C4-C2-C3-C3b + anaphylotoxins-C5-C6-C7-C8-C9 (MAC). Alternative pathway Bacterial wall + Factor B-C3-C3b + anaphylotoxins-C5-C6-C7-C8-C9 (MAC) The main functions of the complement cascade are in defence against infections, predominantly bacterial, and in clearance of immune complexes. Complement deficiencies can lead to poor immune complex clearance and lupus-like syndromes (classical pathway deficiencies (C1, 2 and 4) are rare), severe pyogenic bacterial sepsis (alternative pathway and C3 deficiencies) or systemic Neisserial infections (terminal complement components and MAC). These can be caused by inherited deficiencies or functional abnormalities, depletion due to chronic activation or abnormalities of regulatory proteins. Deficiency or functional impairment of the classical pathway regulatory component C1 inhibitor leads to inappropriate production of anaphylotoxins and hereditary angio-oedema. The production of complement components can be increased by systemic inflammation as part of the acute phase response, and reduced by hepatic impairment. Reduction of individual components commonly reflects chronic activation of that pathway.   Dept: IMMVIRO 0.3 mL serum (Plain tube) (a) Complement (C3) 0.8 - 1.8 g/L (b) Complement (C4) 0.2 - 0.60 g/L C3: +/- 0.11 g/L C4: +/- 0.08 g/L grams/L 5 mL blood. Plain tube or 0.3 mL separated serum Serum is essential, (EDTA plasma only if C1 Activation specifically requested).   TAT: 3 days 45 Price exclusive of GST COMPLEMENT COMPONENTS (e.g. C2, C5 or C9) (Referred test) Homozygous deficiencies of early components of the classical pathway (C1, C2 and C4) are largely associated with SLE and related autoimmune disorders. Deficiencies of C5 - C8, properdin, C3 and C4B are associated with predisposition to serious infections with Neisseria spp. (Provider: AUCKLAND LAB PLUS ) Dept: IMMVIRO 0.2 mL serum each component C2 10-30 mg/L C5 60-90 mg/L C6 45-96 mg/L C7 50-85 mg/L C8 65-95 mg/L C9 125-265 mg/L N/A mg/L 5 mL blood. Plain tube or 0.2 mL separated serum   TAT: 7 - 10 days   Complement Pathway Activity Complement pathways (classical, alternative and the newly discovered lectin pathway) are measured by an ELISA that activates each specific pathway. The activity is detected by a labelled monoclonal antibody to C5-C9 complex (MAC). The main use of complement pathways is to detect either primary or secondary complement deficiency. Homozygous deficiency of an individual component will result in an absence of the affected pathway. In secondary deficiency, complement pathways can be used to monitor disease activity. Many persons who are in otherwise good health have absent lectin pathway responses. The clinical implications of this are unknown at present. (Provider: AUCKLAND LAB PLUS ) Dept: IMMVIRO         5mL serum tube (SST preferred) The specimen MUST be spun and separated within 1 hour. It should be sent frozen to the laboratory. Microcollects are not suitable for pathway activity assays due to contamination with tissue fluids.   TAT: 4 weeks 45.28 Price exclusive of GST Complete Blood Count A Complete blood count includes: Haemoglobin (Hb) Red cell count (RBC) Haematocrit (Hct) Mean red cell volume (MCV) Mean cell haemoglobin (MCH) Platelet count Total white cell count (WBC) WBC differential count Film appraisal of RBC, WBC & platelet morphology (if indicated)   Dept: HAEM 4mL blood (300uL in microtainer)       4 mL blood EDTA tube or 300 uL blood in microtainer. Transport: Ambient TAT: 30 mins for automated count, 2 hrs for blood film review. 8.8 Price exclusive of GST CONGENITAL ADRENAL HYPERPLASIA (Referred Test)   (Provider: MATER, BRISBANE ) Dept: CYTO   Consult Laboratory Report     12 mL EDTA whole blood (3 tubes)   TAT: 6 weeks 614.7 Price exclusive of GST CONNECTIVE TISSUE AUTOANTIBODIES Connective Tissue Autoantibodies include the following tests: Antinuclear Antibodies (ANA), C-Reactive Protein Extractable Nuclear Antigens (ENA) Screen. See individual tests for further information.   Dept: IMMVIRO 0.3 mL serum       5 mL blood. Plain tube or separated serum       CONNEXIN 26 (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4mL EDTA blood Transport: chilled TAT: 3 weeks 326.31 Price exclusive of GST COPPER     Dept: BIOCHEM 1 mL plasma from trace element tube Birth – 6 months 3.1 – 11.0 umol/L 6 months – 6 yrs 14.1 – 29.8 umol/L 6 yrs –12 yrs 12.6 – 25.1 umol/L Adult Male 11.0 – 22.0 umol/L Male > 60 yrs 13.3 – 26.7 umol/L Adult Female 12.6 – 24.3 umol/L Female > 60 yrs 13.3 –29.8 umol/L Pregnancy (at term) 18.5 –47.4 umol/L 10%   4 mL blood. K2EDTA Trace element (Navy blue top and blue label) tube preferred, but serum from plain tube and heparinised plasma are acceptable. Trace element tubes with either heparin or no additive are also acceptable.   TAT: 1 week 20.7 Price exclusive of GST COPPER (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL urine from acid washed bottle Consult Laboratory Report N/A   Urine - 24hr collected into an acid washed bottle. Transport: Chilled TAT: 1 week 29.96 Price exclusive of GST CORD BLOOD SCREEN     Dept: BB         Cord blood: Pink Crossmatch EDTA tube. 7 mL maternal blood (if baby is likely to need a transfusion): Pink Crossmatch EDTA tube.       CORNEAL SCRAPE CORNEAL SCRAPE When processing corneal scraping specimens, fungal, viral and acanthamoeba cultures will be done only at the specific request of the physician   Dept: BACTO         Direct inoculation of culture media at the time of specimen collection is advised. Contact laboratory staff (Ext. 8646) to provide media for specimen collection.   TAT: Gram stain – 1 hour Culture – 7 days 41.4 Price exclusive of GST CORTICOSTEROID BINDING GLOBULIN (CBG) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 100uL EDTA Plasma Consult Laboratory Report N/A   Blood - 5mL EDTA tube. Transport: Frozen TAT: 4 Weeks 29.4 Price exclusive of GST CORTISOL Please note that the lab neither supplies the synacthen nor performs the test. Please contact the Medical Day Care Unit or Pharmacy for further assistance.   Dept: BIOCHEM 0.3 mL plasma or serum. Transport chilled. 0700-1000 hrs: 200-700 nmol/L 1000-1400 hrs: 170-550 nmol/L Following Synacthen Stimulation (0.25 mg I.M.): an increase of 300 nmol/L or achieving a level of 550 nmol/L at any time. Following Dexamethasone Suppression (1 mg, oral given at 2400 hrs): 0800 hr level 50 nmol/L or below 12%   2 mL blood – Heparin tube   TAT: 3 hrs 12 Price exclusive of GST CORTISOL (Urine)     Dept: BIOCHEM 1 ml. State total volume. 33 - 286 nmol/24 hr. 15%   24 hr urine Additive - Boric Acid (10g/L) preferably but no preservative is also acceptable   TAT: 14 days   C-PEPTIDE     Dept: BIOCHEM 0.5 mL Serum, sent frozen 300 – 2350 pmol/L “Fasting C-peptide levels are higher in insulin resistance and obesity. Values between 300 – 750 pmol/L are typically seen in people with BMI <25. 10%   2 mL blood. Plain tube - kept cold.   TAT: 3 days 25.88 Price exclusive of GST C-PEPTIDE (Urine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 10mL aliquot from 24h urine. State volume. Consult Laboratory Report N/A   Urine - 24hour nil preservative Transport: Frozen TAT: 1 week 35.2 Price exclusive of GST C-REACTIVE PROTEIN In isolation it has no diagnostic role, but in conjunction with other clinical parameters it may provide useful information on the severity of certain disease processes. It is used for: Screening for inflammatory disease Monitoring disease activity Detection intercurrent infection in SLE and ulcerative colitis As a cardiac risk marker (see later in this section). Common Conditions Associated with Raised CRP Levels: All infections, hypersensitivity complications of infections, rheumatic fever Inflammatory diseases: Rheumatoid arthritis Ankylosing spondylitis Psoriatic arthritis Systemic vasculitis Polymyalgia rheumatica Reiter's disease Crohn's disease Allograft rejection: Renal transplantation Malignancy: Lymphoma Sarcoma Necrosis: Myocardial infarction Tumour embolisation Acute pancreatitis Trauma: Burns Fractures Conditions in which CRP levels poorly reflects degree of tissue inflammation/damage (ESR may be significantly elevated). SLE Systemic sclerosis Dermatomyositis Ulcerative colitis Leukaemia Graft-versus-host disease CRP is produced by the liver in response to cytokines generated by inflammation, and secreted by the liver in increased amounts within 6 hours of onset of an inflammatory stimulus. Removal of the inflammatory stimulus can lead to a fall in CRP levels reflecting its 6 hour half-life. Severe hepatocellular failure can interfere with the CRP response. The ESR is regarded as a better guide to the inflammatory response in the monitoring of certain diseases: Polymyalgia rheumatica Temporal arteritis Hodgkin's disease In patients with unexplained elevations of ESR, a normal C-reactive protein suggests that the underlying aetiology is non-inflammatory, and CRP is therefore a useful complementary test in this clinical situation. Use of CRP as a CVD risk marker CRP can be used as an additional risk marker in well patients (do not use if CRP > 10 mg/l). An unexpected elevated result should prompt a repeat investigation (e.g. after 4 weeks). CRP is most useful in patients with intermediate CVD risk; low and high risk patients are unlikely to be reclassified. CRP > 3 mg/l would favour intervention when the calculated CVD risk is below but close to the decision limit.   Dept: BIOCHEM 0.08 mL heparin plasma or serum CRP may be used as a marker of inflammation in unwell patients or as a CVD risk marker in currently healthy patients. <1 Low risk 1 - 3 Average risk >3 Increased risk 1.5 - 2 times. 7%   2 mL blood. Heparin tube.   TAT: 3 hrs 5.18 Price exclusive of GST CREATINE KINASE (CK) Values can be raised by exercise, intramuscular injection and bruising. Time of sampling is critical to interpretation of the results.   Dept: BIOCHEM 0.08 mL heparin plasma or serum. Male: 60 - 220 U/L Female: 30 – 180 U/L 4%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST CREATININE     Dept: BIOCHEM 0.08 mL heparin plasma or serum. 7 d – 1 m 20 - 60 µmol/L 1 m – 2 yr 20 - 50 2 yr – 4 yr 20 - 60 4 yr – 6 yr 25 - 65 6 yr – 10 yr 25 - 70 10 yr – 15 yr 40 - 80 Adult Male 60 - 105 Adult Female 45 - 90 7%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST Creatinine urine 24h     Dept: BIOCHEM 0.1 mL urine mmol/24 hr/kg Infant = 0.071 - 0.180 Child = 0.071 - 0.195 Adolescent = 0.071 - 0.265 Adult male = 0.124 - 0.230 Adult female = 0.097 - 0.177 To enable interpretation against these ranges, divide mmol/24hr result by the patient’s weight in kilograms. 4%   24 hr urine collection. No preservative (or HCL or NAOH)   TAT: 3 hrs 4.4 Price exclusive of GST CRH (Corticotrophin Releasing Hormone) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2.5mL EDTA plasma Consult Laboratory Report N/A   Blood - 10mL EDTA tube Transport: Frozen TAT: Not stated 90 Price exclusive of GST CRYOFIBRINOGEN (Plasma) Cryofibrinogenemia may be primary or secondary, due to tumours, necrosis acute and chronic inflammation and lymphoproliferative and autoimmune disorders. The test is used in the investigation of coagulation and other disorders involving cold intolerance.   Dept: IMMVIRO 2.0 mL plasma (EDTA) Negative. Trace amounts may not be significant N/A   7 mL blood, EDTA tube or separated plasma Collection Protocol: Blood must be collected into pre-warmed EDTA tubes kept at 37ºC and immediately transported to the laboratory. Please notify the laboratory before collecting the specimen. Inpatient: Notify the laboratory outpatients (ext. 8627) that a cryofibrinogen is requested, giving the patient details including location. A phlebotomist will arrange the appropriate collection. Outpatient: Immediately after collection into the pre-warmed tubes as above, place the specimen into a thermos with water at 37ºC. Immediately upon receipt of the specimen in the referring laboratory, centrifuge the specimen at 3000 rpm for 5 minutes at 37ºC. Separate the plasma and send the sample at ambient temperature to Health Waikato Laboratory.   TAT: 5 days 14.49 Price exclusive of GST CRYOGLOBULIN (Serum) When the screen is positive a cryocrit will be performed. If the result is 1% or greater an immunofixation will be performed on the initial sample to ascertain whether the cryoglobulin is monoclonal. Cryglobulins are proteins, which precipitate out when cooled below normal body temperature. If they are present in high concentration, they may occasionally precipitate out in small vessels and cause purpura or Raynaud’s phenomenon if the extremities of the body are exposed to a cold environment. About half of the cryoglobulins consist of a monoclonal immunoglobulin and they may precipitate out of the specimen unless the specimen is kept at 37oC. Patients on anticoagulant therapy (especially intravenous heparin) may produce a false positive “cryoglobulin” due to complex formation between heparin and fibronectin. Disorders producing small quantities involve a wide variety of infective and systemic autoimmune disorders. Those producing large quantities of cryoglobulins generally are either 1) B cell lymphoproliferative disorders in which the cryoglobulin is usually a single component or 2) essential mixed cryoglobulinaemia.   Dept: IMMVIRO 2mL serum Negative, trace amounts may not be significant.   Negative or trace. If positive, an estimate of small, moderate or large will be given and a cryocrit performed (see notes below). Cryocrit is reported as the percentage volume of cryoglobulin in the serum. 7 mL blood. Plain tube or 2 x 1 mL separated serum. Collection Protocol: Blood must be collected into pre-warmed tubes kept at 37ºC and immediately transported to the laboratory. Please notify the laboratory before collecting the specimen. Inpatient: Notify the laboratory outpatients (ext. 8627) that a cryoglobulin is requested, giving the patient details including location. A phlebotomist will arrange the appropriate collection at 37ºC. Outpatient: Immediately after collection into the pre-warmed tubes as above place the specimen into a thermos with water at 37ºC. Immediately upon receipt of the specimen in the referring laboratory, place the specimen into a 37ºC water bath for one hour to ensure complete clot formation. Centrifuge the specimen at 3000 rpm for 5 minutes at 37ºC. Separate the serum and send sample at ambient temperature to Health Waikato Laboratory.   TAT: 7 days, interim report available after 3 days. If positive a final report will take up to 12 days. 14.49 Price exclusive of GST CRYPTOCOCCAL ANTIGEN A qualitative screen is initially performed and positive screens are then titred. Culture for cryptococcus is performed in parallel on CSF specimens. All CSF's requesting cryptococcal antigen also have routine fungi culture performed.   Dept: BACTO         Cerebrospinal fluid or serum (plain red top blood tube). Plasma is not suitable.   TAT: 1 day 77.63 Price exclusive of GST CRYPTOSPORIDIA ANTIGEN     Dept: BACTO         Random faeces, three specimens collected on three consecutive days.   TAT: 48 hours Monday to Friday   CRYSTALS Crystal analysis is performed routinely on synovial fluids.   Dept: BACTO         Synovial fluid obtained by needle aspiration. Collection into a heparinised tube will prevent clot formation in patients with inflammatory conditions.   TAT: 2 h 28.88 Price exclusive of GST CSF (Cytology or Haematology) Please do not send CSF for cytological examination outside working hours unless prior notification is given.   Dept: HIST         CSF     49.79 Price exclusive of GST CSF (Microbiology) Specimens with microscopy indicating a possible viral infection will be referred for viral culture/Enterovirus RT-PCR   Dept: BACTO         Specimen collection should be prior to antibiotic administration where possible. Specimen should be collected aseptically into three separate CSF specimen tubes and labelled I, 2 and 3 in order of collection. Transport to the laboratory immediately. Routine Tests: Macroscopic examination WBC and RBC count Culture Protein and glucose analysis All specimens with a WBC count >5 will have a Gram stain and WBC differential performed Extra tests by request: Xanthochromia for investigation of SAH by spectrophotometry. Viral culture Fungal culture Mycobacterial culture Leptospirosis culture Cryptococcal antigen Amoeba microscopy and culture. PCR for bacterial pathogens – Meningococcus, Mycobacteria. PCR for HSV and Enteroviruses Syphilis serology Oligoclonal Bands Immunoglobulins Cytological Investigations   TAT: Microscopy - 1 hour – all results will be phoned to clinician. Culture – 5 days 46.58 Price exclusive of GST CSF Beta 2 TRANSFERRIN (Referred test) beta 2-transferrin is found in CSF, but should not be detected in nasal secretions. Detecting this protein in nasal or ear secretions suggests the possibility of CSF leakage.   Dept: IMMVIRO 0.2mL CSF 0.2 mL serum Not detected. N/A Not detected. A minimum volume of 0.5 mL of nasal or ear fluid and 2 mL blood, plain tube . NOTE: Viscous or purulent samples are not suitable for analysis.   TAT: 3 days. 45 Price exclusive of GST CSF CHEMISTRY A blood sample collected at the same time and analysed for glucose will help with the interpretation of the CSF glucose (normally approx. 70% of blood glucose).   Dept: BIOCHEM 0.5 mL (If xanthochromia included, protect from light) Glucose 2.8 - 4.4 mmol/L Protein 0.15 - 0.45 g/L Xanthochromia Nil detected. Glucose = 5%. Protein = 20 % at a level of 0.09 and 5% at a level of 0.61g/L Protein 17% at 0.07 g/L, 3% at 0.61 g/L   At least 0.5 mL CSF not contaminated by blood. (If xanthochromia included - protect from light)   TAT: 1 hr   CSF IMMUNOGLOBULINS CSF IgG/Albumin ratio : this is an index of local IgG production, adjusted for leakage of IgG due to blood brain barrier dysfunction. The ratio is increased when local CNS IgG synthesis is occurring. CSF IgG index: this is an index of local IgG production, adjusted both for leakage of IgG due to blood brain barrier dysfunction and for serum albumin and IgG concentration. This index is increased in more than 80% of cases of multiple sclerosis. It is not specific for MS, and is increased in any condition where there is local CNS IgG synthesis. NB. These parameters may be falsely elevated if their measurements were performed on a traumatic CSF tap.   Dept: IMMVIRO 0.5 mL CSF (1) Albumin 100-300 mg/L (2) IgG 8-64 mg/L (3) CSF IgG/ Alb Ratio 0.05 - 0.21 (4) CSF IgG index 0.3 -0.7 IgG: +/- 0.4 mg % IgA: +/- 0.1 mg % IgM: N/A Albumin: +/- 2 mg %   0.3 mL CSF Additional 1.0 mL required for immunophoresis requests. (See Oligoclonal Bands).   TAT: 1 day 24 Price exclusive of GST C-TELOPEPTIDE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 0.5mL EDTA plasma Consult Laboratory Report N/A   Blood - EDTA tube Transport: Frozen TAT: 1 week 32.18 Price exclusive of GST CYANIDE (Referred test) Suitable for toxic concentrations only (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mL heparin whole blood Consult Laboratory Report N/A   Blood - 5mL Heparin tube. Transport: Chilled TAT: 3 days 46.94 Price exclusive of GST CYCLOSPORIN (Blood) Organ Transplant Time Post Transplant Cyclosporin Level Kidney " <6 months 250 - 350 ug/L " >6 months 100 - 200 ug/L Liver " <1 month 350 - 450 ug/L " 2 - 6 months 250 - 350 ug/L " >6 months 170 - 240 ug/L Heart " <6 weeks 350 - 450 ug/L " 6 - 12 weeks 250 - 350 ug/L For bone marrow transplant, the therapeutic intervals vary with the type of transplant, i.e. allogenic, unrelated or syngenetic.   Dept: BIOCHEM 0.2 mL EDTA whole blood Values depend on type of transplantation, time post transplantation and immunosuppressive regime. The clinical utility of cyclosporin monitoring seems better defined as a means of preventing nephrotoxicity. 25% ng/mL. (= ug/L) 2 mL whole blood - EDTA tube. Taken as a trough.   TAT: Daily (Monday to Friday) 15.53 Price exclusive of GST CYCLOSPORIN (C2 monitoring) Organ Transplant Time Post Transplant Cyclosporin Target Kidney 1 month 1700 g/L 2 months 1500 g/L 3 months 1300 g/L 4-6 months 1100 g/L 7-12 months 900 g/L Liver <3 months 1000 g/L 4 - 6 months 800 g/L >6 months 600 g/L   Dept: BIOCHEM 0.2 mL EDTA whole blood Values depend on type of transplantation, time post transplantation and immunosuppressive regime. The clinical utility of cyclosporin monitoring seems better defined as a means of preventing nephrotoxicity. 20% ng/mL. (= ug/L) 2 mL whole blood. - EDTA tube Taken 2hrs +/- 10 mins post dose.   TAT: Daily (Monday to Friday) 15.53 Price exclusive of GST CYSTATIN C (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept:   2mL serum Consult Laboratory Report N/A   Blood - SST tube preferred. Plain tube acceptable. Transport: Frozen TAT: 1 week 76.62 Price exclusive of GST CYSTIC FIBROSIS (Gene Mutation) (Referred test) • all relevant family history is required, • appropriate counselling should be undertaken. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO 0.5mL EDTA blood Consult Laboratory Report N/A   Blood - 5mL EDTA tube Transport: Chilled TAT: 2 weeks 327.28 Price exclusive of GST CYSTINE (Urine screen) (Referred test)   (Provider: NATIONAL TESTING CENTRE, ATTN CLAIRE DE LEUN ) Dept: BIOCHEM 3.0mL urine Consult Laboratory Report N/A   Urine - Random Transport: Frozen TAT: 1 week 122.44 Price exclusive of GST CYSTINE (Urine quantitation) (Referred test) Only performed if qualitative screen positive or known cystinuria patient. (Provider: AUCKLAND LAB PLUS ) Dept: BIOCHEM 10mL urine Consult Laboratory Report N/A   Urine - 24hr nil preservative. Transport: Frozen TAT: 1 week 47.2 Price exclusive of GST Cytology Enquiries.     Dept: HIST         NORMAL WORKING HOURS are 0700 - 1530hrs. REPORTS Enquiries regarding reports should be made directly to the department. Please phone 8456, if no reply phone 8474 ENQUIRIES. Please do not hesitate to ring the department during working hours if you are unsure of specimen collection etc.       Cytology Staff.     Dept: HIST         Director of Histology/ Cytology. Dr Ian Beer office 8476 mobile 0274 777 326 Pathologist Dr Michael Arendse office 8004 mobile 0272 926 131 Pathologist Dr Sanjah Sinha office 8497 mobile 021 655 376 Technical Advisor Ann Darlington cyto lab 8456       Cytomegalovirus Syndromes associated with CMV include mononucleosis-like syndrome in young adults, cytomegalic inclusion disease in congenitally infected infants, pneumonitis in infants, interstitial pneumonia, retinitis and febrile illness among organ transplant and other immunocompromised patients and a post-transfusion syndrome.   Dept: IMMVIRO       Negative or reactive/positive with appropriate comment Urine, whole EDTA for CMV DNA(viral load) 5ml Plain or heparinised tube blood or 500 ul serum or plasma ) for IgG and IgM serology. (Infant and mother for congenital testing)   TAT: Viral culture 14 days maximum Viral serology 48 hrs CMV DNA/viral load 48 hrs if urgent   D-DIMER     Dept: HAEM   <500   mcg/L 4.5 mL blood, citrate tube   TAT: 1 hr 25.88 Price exclusive of GST D-DIMER (For investigation of PE/DVT)     Dept: HAEM   Thames <250 All other Labs Reported as Positive or Negative. N/A   Citrate tube, spun 4.5 mL blood. Citrate tube.   TAT: 1 h   DENGUE FEVER VIRUS (Referred test) Acute sample should be collected within five days of illness. A convalescent sample is required 10 to 14 days later. Detail of recent travel to endemic areas is required. Samples are referred to ESR for testing. IgG and IgM serology is performed.   Dept: IMMVIRO       Negative or positive with appropriate comment 5ml Plain tube blood or 500 uL serum   TAT: 1 week   Dengue Fever Virus NS1 Antigen     Dept: IMMVIRO         5ml Plain tube blood or 500 uL serum       DEOXYPYRIDINOLINE X-LINKS (DPD) (Urine)     Dept: BIOCHEM 0.5mL Males: 2.3 - 5.4 nmol DPD/mmol Creatinine Females: 3.0 - 7.4 nmol DPD/mmol Creatinine 20%   Urine 2nd morning void between 8am and 10am   TAT: 2 weeks 46.58 Price exclusive of GST DESIPRAMINE (Referred test) Take specimen 18hrs post dose. Supply dose, dose time, dose interval and collection time (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Pllain tube Transport: Chilled TAT: 3 days 23.47 Price exclusive of GST DHEA S (Dehydroepiandrosterone Sulphate)     Dept: BIOCHEM 0.3 mL serum Levels start to rise at adrenache, then:- Ranges for males are: 20 - 29 years 7.6 - 17.3 mol/L 30 - 39 3.2 - 14.1 40 - 49 2.6 - 14.3 50 - 59 1.9 - 8.4 60 - 69 1.1 - 7.8 70 - 79 0.8 - 4.7 Ranges for females: 20 - 29 y 1.8 - 10.3 mol/L 30 - 39 1.2 - 7.3 40 - 49 0.9 - 6.5 50 - 59 0.7 - 5.4 60 - 69 0.4 - 3.5 70 - 79 0.5 - 2.4 16%   2 mL blood. Plain tube.   TAT: 2 days 31.05 Price exclusive of GST DI HYDRO TESTOSTERONE (DHT) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL heparin plasma Consult Laboratory Report N/A   Blood - 5ml Heparin, EDTA and Plain tube Transport: Frozen TAT: 1 year 351.85 Price exclusive of GST DIAGNOSTIC PERITONEAL LAVAGE *Gram stain and culture are not included in routine examination and are done on request only   Dept: BACTO         Minimum of 10mL peritoneal lavage fluid. Tests: Cell count Presence and absence of fibre / food particles Amylase Gram stain* Culture*   TAT: Microscopy - 30mins Amylase - 1 hour Culture - 48 hours 37.6 Price exclusive of GST DIAZEPAM (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Chilled TAT: 3 days 41.12 Price exclusive of GST DIC SCREEN This screen includes the following tests: Coagulation Screen D-Dimer Ethanol Gel test See individual tests for additional information   Dept: HAEM         Citrate tube, spun 4.5 mL blood. Citrate tube.   TAT: 2 h 53.82 Price exclusive of GST DICOPAC (Vitamin B12 Absorption)     Dept: BIOCHEM         This test is no longer available     186.3 Price exclusive of GST DIGOXIN Specimen must be taken at least 6 - 8 hours but not more than 24 hours after dose. Please note time and dose of digoxin on request form.   Dept: BIOCHEM 0.08 mL plasma or serum. Therapeutic Interval: 0.6 - 2.0 nmol/L Toxic level: Usually > 2.0 nmol/L @ level of 1.0 = 20% @ level of 2.5 = 10%   2 mL blood - heparin tube   TAT: 3 hrs 8.28 Price exclusive of GST DIPTHERIA ANTIBODIES (Referred test)     Dept: IMMVIRO 0.2 mL serum Interpretation provided with result. N/A   5 mL blood. Plain tube or 0.2 mL separated serum. Require a pre vaccination sample and another 2-3 weeks post vaccination.   TAT: 3 - 4 weeks 85.93 Price exclusive of GST DIRECT ANTIGLOBULIN TEST (Direct Coombs Test)     Dept: BB         6 mL blood. Pink crossmatch EDTA or purple EDTA       DISACCHARIDASE, DUODENAL Bx (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 5mg of tissue Consult Laboratory Report N/A   Duodenal biopsy (Transport on ice to laboratory ASAP. Do not place in formalin) Transport: Frozen TAT: 5 days 76.32 Price exclusive of GST DISOPYRAMIDE (Also See Antiarrhythmics) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5 mL Heparin or Plain tube. Transport: Chilled TAT: 4 days 49.27 Price exclusive of GST DNA ISOLATION AND STORAGE (Referred test) Sample for DNA isolation and storage should not be taken unless specific testing is intended. (Provider: AUCKLAND LAB PLUS ) Dept: CYTO         12 mL EDTA whole blood Amniocytes - two flasks CVS - two flasks, or two fresh frond (cleaned)   TAT: 7 days 159.38 Price exclusive of GST DONOR CORNEAL FLUID     Dept: BACTO         Corneal donor storage fluid Tests: Routine culture for aerobic bacteria and Fungal culture   TAT: Routine culture – 5 days Fungal culture – 4 weeks 31.05 Price exclusive of GST DOTHIEPIN (Prothiadene) (Referred test) Take specimen 18hrs after dose. Supply dose, dose time, dose interval and collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Plain tube. Transport: Chilled TAT: 3 days 23.47 Price exclusive of GST DOXEPIN (Referred test) Take specimen 18hrs after dose. Supply dose, dose time, dose interval and collection time. (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 3mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 10mL Heparin or Pllain tube Transport: Chilled TAT: 3 days 23.47 Price exclusive of GST DPT SCREEN (Diptheria, Pertussis and Tetanus Screen) DPT Screen includes the following tests: Diphtheria Antibodies, Pertussis Antibodies and Tetanus Antibodies. See individual tests for further information.   Dept: IMMVIRO 0.5 mL serum       5 mL blood. Plain tube or 0.5 mL separated serum       DRUG SCREEN (Urine) DRUG SCREEN FOR CLINICAL MANAGEMENT: This screen is used for managing abuse, poisoning and for detoxification purposes. The chain of custody procedure is not followed, and so the results cannot be used for legal/evidential purposes. The following classes of drugs are screened for: Amphetamines, Benzodiazapines, Cannabinoids, and Opiates. For possible overdose with other drugs, see specific drug listing for specimen requirements or phone biochemistry. DRUG SCREEN FOR EVIDENTIAL PURPOSES: This is for any situation where there may be any legal implications related to the test results (e.g. employment, occupational health screening, accident investigation, drug testing programmes, visa applications, court cases, etc) It is essential that the chain of custody procedure for specimen collection, identification and handling is followed for the result to be valid. Contact the laboratory phlebotomists (ext. 8627) to make arrangements for collection. The specimen will then be sent to Lab Plus, Auckland for screening and confirmatory testing if required. As this is not funded by the DHB primary referral contract, the requestor will then be invoiced by Lab Plus, Auckland. To help the laboratory when requesting overdose tests, please list all medications or drugs you suspect have been taken. A blood specimen is not generally useful unless a specific test is requested for which a quantitative analytical technique is available (e.g. Tricyclic screen). * The ‘T’ laboratories are able to perform qualitative testing for the major drug classes including tricyclic antidepressants and also have the facilities for evidential drug specimen collection.   Dept: BIOCHEM   Nil See individual tests Reported as Negative or Unconfirmed positive 35 mL fresh urine taken before administration of any therapeutic drugs.   TAT: 3h if urgent 124.2 Price exclusive of GST dsDNA ANTIBODIES (Anti DNA) dsDNA antibodies are considered to be a marker for systemic lupus erythematosus (SLE).They are the most frequently detected autoantibodies associated with SLE. The three basic objectives of dsDNA antibody tests are to diagnose SLE, evaluate the results of therapy, and determine the prognosis of SLE. dsDNA antibodies are rarely found in healthy individuals. (<0.1%).   Dept: IMMVIRO 0.1 mL serum < 4 IU/ml +/- 10%   2 mL blood. Plain tube or 0.1 mL separated serum   TAT: 1 week 22.77 Price exclusive of GST EBV DNA     Dept: IMMVIRO         EDTA whole sample.       ECHIS RATIO     Dept: HAEM 1.0 mL frozen plasma 0.8 -1.2 N/A   Citrate tube, spun 4.5 mL blood. Citrate tube   TAT: 2 h 17.6 Price exclusive of GST eGFR (estimated Glomerular Filtration Rate)     Dept: BIOCHEM   The glomerular filtration rate is >80 mL/min/1.73m2 in healthy people less than 50 years of age. However, the eGFR as calculated by the MDRD formula is not reported as a numerical value when it is >90 mL/min, as the calculation is inaccurate above this level. Interpretation: Significant change: A change in eGFR of greater than 15% in the results, from the same laboratory, indicates that the change is unlikely to be due to random variation. A patient showing a decrease of this magnitude (> 15%) should be referred to a Nephrologist. eGFR > or = 60 ml/min/1.7m2: Does not exclude renal disease, especially if proteinuria, abnormal urinary sediment, or hypertension are present. eGFR 30 - 59 ml/min/1.7m2: Indicates moderate renal disease. Avoid nephrotoxic drugs. Prescribe antiproteinuric drugs (ACEIs or ARBs) if appropriate. Consider referral to a Nephrologist. eGFR < 30 ml/min/1.7m2: Severe to end stage renal failure. The patient should usually be referred to a Nephrologist for assessment and management of renal replacement therapy. eGFR, using the MDRD formula, is UNRELIABLE in the following situations: 1. Acute changes in renal function. eGFR is valid only in subjects in a steady state with respect to plasma creatinine. 2. Dialysis-dependent patients. 3. Patients with unusually high or low muscle mass. In these situations, the creatinine clearance needs to be calculated by a different method (e.g. 24 hour creatinine clearance) 4. Exceptional dietary intake (high meat diet, creatinine supplements). 5. Children less than 18 years of age. 6. Pregnancy. 7. Non-Caucasians: for African- Americans, multiply the result by 1.21. The accuracy of the MDRD equation has not been established for Maori, Pacific Islanders, Chinese or other Asians. 8. Severe liver disease.     The estimated glomerular filtration rate (eGFR) is calculated using the MDRD (Modification of Diet in Renal Disease) equation, from the plasma creatinine, age and gender. The eGFR is useful as a screening test for chronic renal disease. The eGFR should not be used for drug dosing calculations: the Cockcroft-Gault equation should be used for this purpose. Please indicate this on request form if required.   TAT: 3 hrs 0 Price exclusive of GST ELUATE (RBC Bound Antibody)     Dept: BB         5 mL pink crossmatch EDTA tube       EMA BINDING TEST Please contact Flow Cytometry Laboratory to arrange.   Dept: HAEM 4mL blood Normal     4mL blood EDTA tube. Place at 4oC as soon as possible after collection and maintain at 4oC until analysed. EDTA blood from five normals, collected at approximately the same time as the patient, must be provided by the referring laboratory. Transport: Chilled TAT: 2 days 155.25 Price exclusive of GST ENDOMYSIAL ANTIBODIES (IgA) Serum IgA will be performed if a lack of fluorescence is noted when performing endomysial antibodies. Positive in approximate 99% of patients with untreated coeliac disease. IgA deficient patients with coeliac disease may be missed and therefore the combination of anti-gliadin and anti-endomysial antibodies may be a more sensitive screening test (the combination has a negative predictive value of 99%). Significance of a weak EMA is unknown. Also found in at least 60 - 70% of patients with dermatitis herpetiformis on a normal gluten-containing diet.   Dept: IMMVIRO 0.1 mL serum Negative Not known Negative, Equivocal, Weak Positive or Positive 5 mL blood. Plain tube or 0.2 mL separated serum   TAT: 5 - 7 days 20.7 Price exclusive of GST ENDOSCOPE / GASTROSCOPE STERILITY TESTING     Dept: BACTO         Approximately 30mL of post wash water collected in a sterile container. Record type of scope and unique identifier allocated to scope.   TAT: 48 h   ENDOTRACHEAL ASPIRATE     Dept: BACTO         Aspirate collected into a sterile container.   TAT: Gram stain – same day Culture – 2 days 40.37 Price exclusive of GST ENTAMOEBA HISTOLYTICA ANTIBODIES (Referred test) Serum anti-amoebic antibody tests are helpful in the diagnosis of invasive intestinal amoebiasis and are positive in approximately 85% of patients with biopsy proven disease. They are reported as positive in > 90% of patients with amoebic liver abscesses. Serology may be negative in patients with symptom duration of less than one week and should be repeated in one week if the diagnosis is still suspected.   Dept: IMMVIRO 250 uL serum Negative N/A Appropriate titre 5 mL blood. Plain tube or 200 uL separated serum   TAT: 1 - 2 weeks 69 Price exclusive of GST ENTEROVIRUS Includes Echovirus (30 serotypes), Coxsackie A virus (23 serotypes), Coxsackie B (6 serotypes), Poliovirus (3 serotypes). Enteroviruses are responsible for sporadic infections and epidemic disease outbreaks throughout the world. Spectrum of disease is wide. Enteroviruses may cause aseptic meningitis, paralytic disease, myocarditis, hand, foot and mouth disease, generalised disease in the newborn, pneumonia and other respiratory disease, rashes and eye infections. Any isolate is forwarded to ESR for sub-typing. Enterovirus RT-PCR is available for diagnosis of aseptic meningitis. It is only performed on CSF. Please telephone if urgent. Serology is available but is not considered useful.   Dept: IMMVIRO       Negative or positive         Enterovirus RNA     Dept: IMMVIRO         CSF     134.32 Price exclusive of GST EPSTEIN BARR VIRUS EBV causes infectious mononucleosis (glandular fever). A single serum can determine a patient’s immune and disease status in relation to EBV. EBV requests are screened by employing the anti-EBNA-1 IgG assay. If the EBNA-1 IgG test result is negative, additional VCA IgG and IgM testing will be performed. EBV PCR/viral load is also available from Auckland Laboratory. Please consult with virology department.   Dept: IMMVIRO       Negative or reactive with appropriate comment 5ml Plain tube blood or 500 uL serum   TAT: 48 hours 15.53 Price exclusive of GST ERYTHROCYTE SEDIMENTATION RATE (ESR)     Dept: HAEM 4mL blood ESR REFERENCE INTERVALS (mm/hr) Age Male Female 0-30 yrs 2-10 2-10 30-35 yrs 2-13 2-15 35-40 yrs 2-17 2-19 40-99 yrs 2-20 2-25 70% at 2-5mm/hr, 45% at 20-35mm/hr, 6% at>80mm/hr   4 ml EDTA whole blood (Waikato Hospital) 1.2mls Sodium Citrate-Specific ESR tubes (T-Hospitals)   TAT: 2 hr 7.45 Price exclusive of GST ERYTHROPOIETIN (EPO) (Serum) Specimens should be drawn as morning samples and at a consistent time if monitoring a patient. Whole blood must be allowed to clot at room temperature. Haemolysis may affect the result.   Dept: BIOCHEM 0.3mL serum or heparin plasma sent chilled 5 – 30 mIU/mL 17%   300 uL Serum/plasma (Hep- not EDTA) 2mL blood. Plain tube or heparin. EDTA unacceptable.   TAT: 2 weeks 20.7 Price exclusive of GST ETHANOL Do not swab the venepuncture site with alcohol. This test is not accepted for medico-legal purposes.   Dept: BIOCHEM Referring Laboratories - Fluoride/Oxalate tube, minimal headspace, must remain sealed, label for "Ethanol"   @ level of 4.5 = 15%, @ level of 38 = 5% Nil 2 mL blood - heparin tube   TAT: 3 hrs 8.28 Price exclusive of GST ETHANOL GEL TEST     Dept: HAEM   Negative N/A   4.5 mL blood. Citrate tube   TAT: 2 h 7.25 Price exclusive of GST ETHOSUXIMIDE (Also See Anticonvulsants) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Trough sample. Transport: Chilled TAT: 3 days unless urgent 70.39 Price exclusive of GST ETHYLENE GLYCOL (Referred test) Ethylene glycol presence can be indirectly estimated by use of the osmolar gap (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL heparin plasma – no head space Consult Laboratory Report N/A   Blood - Heparin tube Transport: Chilled TAT: Not stated 0 Price exclusive of GST EXON 12 OF JAK2 (Referred test)   (Provider: AUCKLAND LAB PLUS ATTN Neil Van de Water ) Dept: HAEM         Blood - 5-10mL CPD tube Transport: Room temperature   364.23 Price exclusive of GST EXTRACTABLE NUCLEAR ANTIGENS (SSA,SSB, RNP, Sm, Scl 70, Jo1) ENA Screens for Antibodies to Ro, La, and Jo 1 Extractable nuclear antigen antibodies are a group of antibodies directed at nuclear, and in the case of Jo1, cytoplasmic antigens, which have particular associations with various connective tissue disorders. Virtually all samples with positive ENA antibodies are ANA positive. Sm Antibodies to Sm are found in a small percentage of patients with SLE. These antibodies are highly specific for this disease. SSA (Ro) and SSB (La) Antibodies to SSA (Ro) and SSB (La) are found in cases of Sjogren's syndrome, SLE, and congenital heart block. RNP Antibodies to RNP are seen in cases of mixed connective tissue disease (overlapping features of SLE, systemic sclerosis; and polymyositis) but may be associated with other connective tissue diseases such as SLE. Scl-70 Antibodies to Scl-70 are found in 20 to 40% of patients with diffuse scleroderma and up to 20% of patients with limited scleroderma. These antibodies may be associated with a more severe disease course. Jo-1 Antibodies to Jo-1 are detected in approximately 25% of patients with myositis. The subgroup of myositis patients with anti Jo-1 tends to have associated interstitial lung disease. These antibodies are rarely seen in other autoimmune conditions. Antibodies to Jo-1 react primarily with cytoplasmic antigens (histidyl transfer RNA synthetase) and accordingly the ANA may be negative.   Dept: IMMVIRO 0.1 mL serum Negative 8% Negative or Positive with the Antigen specificity (RNP, Ro/SSA, La/SSB, Scl 70, Sm or Jo-1.) 5 mL blood. Plain tube, or 0.1 mL separated serum   TAT: 7 days if negative 2 - 3 weeks if positive 28.78 Price exclusive of GST FACTOR V LEIDEN (G1691A) Molecular testing for the Factor V Leiden mutation is performed with prothrombin (G20210A) mutation testing and is performed in preference to APC Resistance testing.   Dept: HAEM 0.5 mL EDTA blood Not detected N/A   5 mL EDTA   TAT: 1 week 49.68 Price exclusive of GST FACTOR VIII OR IX GENETIC STUDIES (Referred Test) Please provide names of other affected family members (Provider: AUCKLAND LAB PLUS ATTN N VAN DER WATER, HAEMATOLOGY ) Dept: HAEM 10mL CPD or EDTA whole blood       Blood - 1 x 9mL CPD (yellow top) or EDTA tube Transport: Ambient same day or overnight TAT: Not stated 231.98 Price exclusive of GST FACTOR VIII OR IX GENETIC STUDIES (Referred Test) Please provide names of other affected family members (Provider: AUCKLAND LAB PLUS ATTN N VAN DER WATER, HAEMATOLOGY ) Dept: HAEM 10mL CPD whole blood       Blood - 1 x 9mL CPD (yellow top) tube Transport: Ambient same day or overnight TAT: Not stated by referral laboratory 231.98 Price exclusive of GST FAECAL CULTURE Patients who have been in hospital for more than 3 days and were not admitted with gastrointestinal symptoms are unlikely to have a food borne infection and are more likely to have symptoms due to Clostridium difficile toxin. Specimens received on patients who have been in hospital for more than three days are therefore only tested for Clostridium difficile toxin unless culture is specifically requested by phone   Dept: BACTO         3 faecal specimens collected on three consecutive days Specimen Collection: Amount required is at least 1/4 filled container. If blood, mucous and pus are present, these portions should be sampled. Tests: Routine culture for enteric pathogens includes: Microscopy for WBC and RBC Culture for Salmonella, Shigella, Campylobacter, Yersinia, Aeromonas and Plesiomonas. Culture for E. coli 0157 is performed on children <12 years and bloody specimens. Giardia and Cryptosporidium antigen testing.   TAT: Microscopy – same day Culture – 2-3 days Giardia and Cryptosporidium antigen – 48hours Monday-Friday. 51.75 Price exclusive of GST FAECAL FAT Only performed following prior consultation with the Chemical Pathologist, Waikato Hospital.   Dept: BIOCHEM   Adult: < 6 g/day Child: < 2 g/day 10%   MUST be 3 day faeces collection into a pre-weighed container according to protocol (obtained from Biochemistry).   TAT: 1 week 155.25 Price exclusive of GST FAECAL FAT SCREENING TEST (Stain) This test is used as a screening test for fat malabsorption and should be followed by a full quantitative faecal fat examination unless clearly negative. This is because the interpretation is subjective and the faecal volumes are so variable   Dept: BACTO         One faecal sample Tests: Nile blue stain for presence of faecal fat globules   TAT: 2 h   FAECAL OCCULT BLOOD CONFIRMATION The confirmation test (OC-Light) is specific for human haemoglobin.   Dept: BACTO         Faeces sample tested as positive by occult blood screen   TAT: 1 day 20.7 Price exclusive of GST FAECAL OCCULT BLOOD SCREEN Occult blood screening cannot be considered conclusive evidence of the presence or absence of gastrointestinal bleeding or pathology. Haemoccult tests are designed for preliminary screening as an aid to diagnosis. The occult blood confirmation test is performed on all specimens positive by the Haemoccult screen test.   Dept: BACTO         Faeces – minimum 1g Gastric secretions and vomit are not suitable specimens Specimen Collection: As bleeding from gastrointestinal lesions may be intermittent, faecal specimens for testing should be collected from 3 consecutive bowel movements. For accurate results, patients must follow the “Patient Instructions” (available from laboratory ext.8646) 7 days prior to and during the sample period.   TAT: 2 h 5.2 Price exclusive of GST FAECAL PARASITE CONCENTRATION Routine faecal analysis includes examination for Giardia and Cryptosporidium – parasite concentration is only necessary when parasites other than Giardia and Cryptosporidium are suspected. Unless the patient has a history of overseas travel, recent immigration, eosinophilia and a history of >14 days diarrhoea,or is immunocompromised, parasite examination will be limited to Giardia/Cryptosporidium only   Dept: BACTO         Three fresh faecal specimens collected on separate days. Minimum specimen, approximately ½ teaspoon   TAT: 2 days, Monday – Friday 28.98 Price exclusive of GST FAECAL PARASITE STAIN Routine faecal analysis when performed includes examination for Giardia and Cryptosporidium – Parasite concentration and trichrome staining are only necessary when parasites other than Giardia and Cryptosporidium are suspected. Unless the patient has a history of overseas travel, recent immigration, eosinophilia with diarrhoea for >14 days, or is immunocompromised, parasite examination will be limited to Giardia/Cryptosporidium only.   Dept: BACTO         Three fresh faecal specimens, collected on separate days. Minimum sample, approximately ½ teaspoon   TAT: 2 days, Monday – Friday 25.88 Price exclusive of GST FAI (Free Androgen Index)     Dept: BIOCHEM   Female: < 160     Calculated to give an indication of androgen status in females only. Calculation: Testosterone x 1000 / SHBG   TAT: 2 days   FAMILIAL ADENOMATOUS POLYPOSIS (FAP) (Referred test) Specimens will not be analysed without evidence that appropriate genetic counselling has been provided (NRGS 0800 476 123) (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     12 mL EDTA whole blood   TAT: 6 weeks 461.03 Price exclusive of GST FAMILIAL HYPERALDOSTERONISM (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4mL EDTA whole blood   TAT: 6 weeks 214.2 Price exclusive of GST FAMILIAL MEDITERRANEAN FEVER (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4mL EDTA whole blood   TAT: 6 weeks 309.67 Price exclusive of GST FANCONI'S ANAEMIA   (Provider: WAIKATO DHB LABORATORIES ) Dept: CYTO   Consult Laboratory Report     This test must be must be arranged with the laboratory in advance. 4 mL Heparin whole blood   TAT: 18 days   FARMERS LUNG SEROLOGY (Micropolysporis faeni) (Referred test) Detection of precipitating antibodies supports the diagnosis of extrinsic allergic alveolitis in a patient with appropriate history of exposure and presentation.   Dept: IMMVIRO 0.3 mL serum Not detected     5 mL blood. Plain tube or 0.3 mL separated serum   TAT: 2 weeks 25.79 Price exclusive of GST FERRITIN For Ferritin results > 500 ng/mL - Ferritin results may vary significantly between laboratories. Patients being serially monitored for iron overload should have Ferritin levels measured by the same laboratory.   Dept: BIOCHEM 0.3 mL heparin plasma or serum Male: <4 months = 15 – 400 ng/mL 5M – 12M = 15 – 80 IY – 14Y = 15 – 150 15Y– 19Y = 15 – 170 20Y – 30Y = 20 – 320 30Y – 40Y = 20 – 400 >40 Y = 20 – 450 Female: <4 months =15 – 400 ng/mL 5M – 12M = 15 – 80 1Y – 14Y =15 –150 15Y – 19Y = 15 – 170 20Y – 30Y = 20 – 170 30Y – 40Y = 20 – 190 >40 Y =20 – 380 9%   2 mL blood – heparin tube   TAT: 3 hrs 6.73 Price exclusive of GST FIBROBLAST GROWTH FACTOR RECEPTOR (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4mL EDTA whole blood   TAT: 6 weeks 684.93 Price exclusive of GST FINE NEEDLE ASPIRATION collected by Pathologist/Radiologist     Dept: HIST         FNA of superficial masses is performed by a Pathologist, and prior arrangement with the department is requested. Please ring the FNA Services phone 021 240 7502 to arrange. Deep masses requiring ultrasound CT or image guidance localisation are performed by the Radiologists with the Cytologist in attendance. Again prior arrangement with the department is requested. Out of hour’s service - arrange through duty pathologist. Please phone hospital operator     199.14 Price exclusive of GST FIPL1-PDGRFA (Referred Test)   (Provider: AUCKLAND LAB PLUS ATTN Neil Van de Water ) Dept: HAEM 10 mL or at least 10 million cells       Blood - 10mL CPD (yellow top) tube or bone marrow in CPD. Transport: Ambient TAT: 1 week 277.75 Price exclusive of GST FISH (Specific)   (Provider: AUCKLAND LAB PLUS ) Dept: CYTO         4mL Heparin whole blood Bone marrow aspirate   TAT: 3 day to 3 weeks depending on test requested 1010.01 Price exclusive of GST FK506 (Tacrolimus) Trough Level: Collect immediately before the dose.   Dept: BIOCHEM 300uL EDTA whole blood 5 - 15 µg/L 20%   2 mL blood. EDTA tube Paediatric: 0.5 mL EDTA Transport: 2-8 degrees Celcius TAT: 3 times weekly 62.93 Price exclusive of GST Flavivirus serology     Dept: IMMVIRO                 FLECANIDE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5 mL Heparin or Plain tube Transport: Chilled TAT: Not stated 129.03 Price exclusive of GST FLUCLOXACILLIN (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube Transport: Chilled TAT: 2 Days 52.85 Price exclusive of GST FLUCYTOSINE (Fluorocytosine) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5 mL Heparin or Plain tube Transport: Chilled TAT: 1 day 51.16 Price exclusive of GST FLUID: PERITONEAL / ASCITES     Dept: BACTO 2 mL       Aseptically aspirated fluid into a sterile container. Specimen Collection: Anticoagulant may be inhibitory to some organisms therefore is not recommended for specimens requiring culture. Collection of a separate aliquot with anticoagulant is advised for microscopy. Tests: Macroscopic examination WBC and RBC count Gram stain WBC differential Aerobic and anaerobic culture Chlamydia PCR if clinically indicated or requested.   TAT: Microscopy – 2 hours Culture – 5 days Chlamydia PCR – 2 days 46.58 Price exclusive of GST FLUID: PLEURAL, PERICARDIAL     Dept: BACTO         Aseptically aspirated fluid. Specimen Collection: Specimens should be collected into a sterile container. Anticoagulant may be inhibitory to some organisms, therefore is not recommended for specimens requiring culture. Collection of a separate aliquot with anticoagulant is advised for microscopy. Inoculation of blood culture bottles is advised where enough volume of fluid is available. Tests: Macroscopic examination WBC and RBC count. Gram stain. WBC differential. Aerobic culture. Pleural fluids will have protein and LDH analysis performed and any other biochemical testing on request. For pH analysis, a separate aliquot of sample must be received in a syringe to ensure anaerobiasis. For glucose analysis, fluid should be collected into a grey top fluoride tube. Pleural fluids suggestive of empyema or lung abscess will be cultured for anaerobes. Pericardial fluids that are visibly blood stained will be tested for haemoglobin and protein estimations to ensure the specimen is pericardial fluid and not blood.   TAT: Microscopy – 2 hours Culture – 5 days 37.88 Price exclusive of GST FLUORIDE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 4mL serum Consult Laboratory Report N/A   Blood - 10mL Plain tube. Transport: Chilled TAT: 2 days 78.1 Price exclusive of GST FLUORIDE (Urine)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 20mL urine Consult Laboratory Report N/A   Urine - Random taken at end of shift. Transport: Chilled TAT: Weekly 78.1 Price exclusive of GST FLUOXETINE (Prozac) (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL serum Consult Laboratory Report N/A   Blood - 5mL Plain tube. Transport: Frozen TAT: Not stated 356.86 Price exclusive of GST FOLATE Haemolysis will falsely raise the serum folate level.   Dept: BIOCHEM 0.3 mL serum or plasma. Protect from light. Normal: 9 – 45 nmol/L Borderline: 7 - 9 nmol/L 10% at 17nmol/L   2 mL blood. - Heparin ( but not lithium Heparin gel tube) or Plain tube   TAT: 3 hrs 4.66 Price exclusive of GST FOLATE (Red Cell)     Dept: BIOCHEM 100 uL EDTA whole blood. Please state haematocrit. Protect from light. 800 - 2500 nmol/L 30% at a level of 640 nmol/L , 15% at a level of 1200 nmol/L   2 mL blood - EDTA tube.   TAT: Daily Mon -Fri 6.77 Price exclusive of GST FRAGILE X SYNDROME (Referred test) Referral reasons plus adequate information and family history must be submitted with the specimen. (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     12mL EDTA whole blood Paediatric: 2-3mL EDTA whole blood Prenatal: fresh CVS or amniotic fluid, parental bloods (EDTA – 4mL)   TAT: 6 weeks 353.51 Price exclusive of GST FREE FATTY ACIDS (Non Esterified Fatty Acids) (Referred test) Patient fasting (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 250uL EDTA plasma Consult Laboratory Report N/A   Blood - 5mL EDTA tube on ice Transport: Freezer TAT: As requested 35.2 Price exclusive of GST FREIDREICH'S ATAXIA (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept: CYTO   Consult Laboratory Report     Adult – 12mL EDTA whole blood Paediatric – minimum 2mL EDTA whole blood   TAT: 6 weeks unless urgent 728 Price exclusive of GST FRISIUM (Clobazam) (Referred test)   (Provider: AUCKLAND LAB PLUS ) Dept: BIOCHEM 1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Plain or Heparin tube. Transport: Frozen TAT: 2 weeks 53.58 Price exclusive of GST FROZEN SECTION FOR IMMEDIATE DIAGNOSIS Requests for frozen section should be booked in advance with the Laboratory (Ext. 8480). Frozen section service is available during the working hours of 0700-1730hrs. Outside these hours, frozen section is arranged through the On Call Pathologist. Note: Frozen Section test is done on fresh tissue so no cases querying TB should be booked or will be completed by staff. Please inform the Laboratory if the request is cancelled or delayed, as staff are standing by. The following details are required at booking: 1. Date & Time of procedure 2. Patient’s name and NHI no. 3. Specimen type and number of specimens to be sent 4. Query diagnosis 5. Operating theatre 6. Your contact details, pager no.   Dept: HIST         Surgically removed tissue/organ, biopsy tissue Specimen Collection: Fresh specimen i.e. without any fixative, immediately delivered directly to the Histopathology Laboratory. Include a telephone number for reporting on request form.   TAT: Within 20-30min from receipt for a single specimen Multiple specimens will require an extended period of time   FRUCTOSAMINE (Referred test) Haemolysed specimens are unacceptable (Provider: DIAGNOSTIC MEDLAB, AUCKLAND ) Dept: BIOCHEM 0.1mL heparin plasma or serum Consult Laboratory Report N/A   Blood - 5mL Heparin or Plain tube. Transport: Chilled TAT: 1 week 10.44 Price exclusive of GST FSH (Follicle Stimulating Hormone)     Dept: BIOCHEM 0.3 mL plasma ( Note: serum from gel tubes only stable 48 hrs 2-8 C) or serum 0 - 9 yrs 0 - 6.5 IU/L 10 - 15 yrs Prepubertal 0 - 6.5 IU/L Levels rise during puberty towards adult range. Males 2 - 12 IU/L Females: Follicular 3 - 10 IU/L Mid cycle 4 - 25 IU/L Luteal 2 - 8 IU/L Postmenopausal >20 IU/L Pregnant <1 IU/L 7%   2 mL blood - Heparin tube.   TAT: 3 hrs 9 Price exclusive of GST FT3 (Free Triiodothyronine)     Dept: BIOCHEM 0.3 mL plasma or serum 4 days – 10 yrs: 3 – 10 pmol/L Adult: 3.8 – 6.2 pmol/L 15%   2 mL blood - heparin tube.   TAT: 3 hrs 6.73 Price exclusive of GST FT4 (Free Thyroxine)     Dept: BIOCHEM 0.3 mL plasma ( Note; serum from gel tubes only stable 48 hrs at 2 - 8 C) or serum 4 – 7 days: 16 – 40 pmol/L 8 - 30 days: 15 – 35 pmol/L 31 days – 1year: 12 – 32 pmol/L 1 yr – 15 years: 10 – 24 pmol/L 15 years and over: 10 – 20 pmol/L 7%   2 mL blood - heparin tube   TAT: 3 hrs 6.73 Price exclusive of GST Galactomannan Antigen Invasive Aspergillosis (IA) is a severe complication of immunosuppressive treatment. IA is difficult to diagnose by direct microscopy and culture, with most cases typically being diagnosed at post-mortem. High Resolution chest CT and galactomannan are currently the mainstays of IA diagnosis. The recently published EORTC definitions of Invasive Fungal Disease require: i) a patient factor, immunosuppression, ii) a clinical criterion, generally CT findings, and iii) a mycological criterion, microscopy, culture or antigen test, among which galactomannan (GM) is the most practicably achievable. Early commencement of antifungals in treatment of neutropenic sepsis is likely to be beneficial but the agents are expensive and may have significant adverse effects, so precise diagnosis is of great benefit for patient management. Serum galactomannan testing has been validated against the EORTC definitions and in addition may be detected 5 – 8 days before clinical manifestations of IA, promising an application in guiding preemptive treatment.   Dept: IMMVIRO 0.8mL serum. Once separated serum must be frozen within 48 hours and sent to the laboratory on ice. Galactomannan Index <0.5 15% Galactomannan Index value Serum galactomannan index =0.5 Reactive. Two consecutive reactive results in the context of appropriate clinical features suggest possible Invasive Aspergillosis. BAL galactomannan index 0.5 - <1.5 Weakly Reactive. Clinical significance is uncertain. Interpret in conjunction with other investigations. BAL galactomannan index =1.5 Reactive. Evidence for Invasive Aspergillosis. 5mL blood. Plain tube or separated serum. Bronchoalveloar lavage.   TAT: Batched weekly 51.75 Price exclusive of GST GAMMA GLUTAMYL TRANSFERASE (GGT)     Dept: BIOCHEM 0.08 mL heparin plasma or serum 0 – 6 mths 0 – 150 U/L > 6 mths (Male) 0 - 60 U/L > 6 mths (Female) 0 - 50 U/L 8%   2 mL blood - Heparin tube 2 mL blood - Plain tube (‘T’ Laboratories)   TAT: 3 hrs 2.33 Price exclusive of GST GASTRIC ASPIRATE (Neonates)     Dept: BACTO         Minimum of 0.5mL   TAT: Gram stain – same day or done urgently (1 hour) by phoned request. Culture – 2 days 41.4 Price exclusive of GST Gastric Washings ( cytology).     Dept: HIST         All gastric washings should be packed on ice as soon as they are collected, and transported to the laboratory immediately.       GASTRIN (Referred test) Patient fasting overnight (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 1mL serum Consult Laboratory Report N/A   Blood - Patient fasting overnight. 5mL Plain tube on ice. Transport: Frozen TAT: 10 days 64.57 Price exclusive of GST Gelsolin   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO         4mL EDTA   TAT: 6 weeks   General culture (Virology)     Dept: IMMVIRO         CSF, eye swabs, urine, faeces, skin swabs     56.93 Price exclusive of GST Genital swab (Virology     Dept: IMMVIRO         Green viral swab     45.54 Price exclusive of GST GENITAL SWABS – FEMALE VULVAL     Dept: BACTO         Bacterial transport swab (blue top)   TAT: Gram stain – same day Culture (including routine bacterial culture, and yeast) – 2 days 27 Price exclusive of GST GENITAL SWABS – MALE URETHRAL / PENILE A separate specimen is required for Chlamydia PCR – First Catch Urine or dry swab.   Dept: BACTO         Bacterial transport swab (blue top).   TAT: Gram stain – same day Culture (including routine bacterial culture, yeast and Neisseria gonorrhoea) – 2 days 25.87 Price exclusive of GST GENTAMICIN (Also See Antibiotic Assays)     Dept: BIOCHEM 0.08 mL plasma or serum See Antibiotic assays @ level of 1.8 = 20%, @ level of 7.0 = 5%   2 mL blood - Heparin tube.   TAT: 3 hrs 14.75 Price exclusive of GST GIARDIA SPECIFIC ANTIGEN     Dept: BACTO 0.5mL equivalent       Random faeces, three specimens collected on three consecutive days.   TAT: 48 hours Monday to Friday 31.05 Price exclusive of GST GILBERT’S DISEASE (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: CYTO   Consult Laboratory Report     4mL EDTA whole blood   TAT: 6 weeks 73.9 Price exclusive of GST GLIADIN ANTIBODIES (IgG & IgA) The diagnosis of coeliac disease (gluten sensitive enteropathy) is confirmed by small bowel biopsy. The characteristic histological finding is subtotal villous atrophy. Small bowel biopsies are taken endoscopically, and are a significant procedure for the patient to go through. Serological testing for coeliac disease has a role in disease screening, identifying the majority of patients who are likely to be biopsy negative and therefore reducing the number of endoscopies performed. However, serological tests are not intended to replace biopsies for the confirmation of positive cases. There are four antibodies that can be detected in cases of coeliac disease: anti-gliadin, anti-endomysial, tissue transglutaminase and anti-reticulin. Over 90% of patients with active coeliac disease (pre-diet) will have positive antibodies (either IgG or IgA or both). Patients with IgA deficiency may produce only IgG antibodies. To maximise sensitivity and specificity, anti-endomysial antibodies should also be requested. Absence of antigliadin & endomysial antibodies has a 99% negative predictive value for active coeliac disease. Levels of both antibodies may fall rapidly within 6 months of instituting a therapeutic diet. If only one of the antigliadin antibodies - either IgA or IgG is elevated, coeliac disease is less likely, however, it has to be borne in mind that co-existing Immunoglobulin deficiency especially of IgA may lead to false negative results. Of any single serological test anti-endomysial antibodies have the highest sensitivity and specificity (see Endomysial Antibodies). Dietary monitoring: Likely results of patients on a gluten-free diet: Good adherence to the diet: Both anti-gliadin IgA and IgG are below their respective cut-off values. Anti-gliadin IgG is less specific, but more sensitive for coeliac disease then IgA antibodies. The disappearance of IgG antibodies may take 6 – 12 months on a strict gluten free diet. Poor adherence to the diet: Antigliadin IgA and/or IgG may be elevated, except in cases of IgA deficiency. Non adherence to the diet: Results of both IgA and IgG are comparable to those of untreated coeliac disease. Anti-gliadin antibodies are also found in patients with dermatitis herpetiformis.   Dept: IMMVIRO 0.1 mL serum 0 - 20 8% Units 5 mL blood. Plain tube, or 0.1 mL separated serum   TAT: 5 days. 16.56 Price exclusive of GST GLIVEC (Referred test) Consult laboratory prior to collection (Provider: AUCKLAND LAB PLUS ) Dept: BIOCHEM EDTA plasma or serum. Consult Laboratory Report N/A   Blood - 2X 5mL EDTA or Plain. Transport: Ambient   0 Price exclusive of GST GLOMERULAR BASEMENT MEMBRANE ANTIBODIES Detection of GBM antibodies is important in the diagnosis of Goodpastures syndrome. (Rapidly progressive Glomerular Nephritis combined with lung haemorrhage). These antibodies are rarely seen in the normal population and uncommonly detected in renal diseases due to other causes. Titres are usually highest at presentation and may decline with treatment. Once GBM antibodies are lost they usually remain absent, and transplantation at this stage is rarely complicated by recurrent disease.   Dept: IMMVIRO   Negative N/A Negative, Positive 1:5, Positive 1:40, Positive 1:160 etc 5 mL blood. Plain tube or 0.1 mL separated serum   TAT: 2 days 31.5 Price exclusive of GST GLUCAGON (Referred test)   (Provider: CANTERBURY HEALTH LABORATORIES ) Dept: BIOCHEM 2mL EDTA plasma Consult Laboratory Report N/A   Blood - 5 mL EDTA tube Transport: Frozen TAT: Not stated 50.66 Price exclusive of GST GLUCOSE Reference range is for fluoride specimens only. Specimens received in tubes other than fluoride oxalate (grey top) will be processed but results should be treated with reserve. If fasting specimen , should be a minimum of 8 hrs fasting for pregnant women and 10hrs for non pregnant and males.   Dept: BIOCHEM 0.08 mL fluoride plasma – frozen Fasting: 3.5 – 5.4 mmol/L - Normal 5.5 – 6.0 mmol/L - This does not exclude diabetes. 6.1 – 6.9 mmol/L - Impaired fasting glucose >7.0 mmol/L - Diabetic Non Fasting: 3.5 - 7.7 mmol/L - Normal >11.1 mmol/L - Diabetic 5%   2 mL blood - Fluoride tube. 2mL blood - Fluoride or Plain tube (“T” Labs).   TAT: 3 hrs 2.33 Price exclusive of GST GLUCOSE (Urine)     Dept: BIOCHEM 0.08 mL urine 0.1 - 0.8 mmol/L 5%   Random urine only, no additive   TAT: 3 hrs 2.33 Price exclusive of GST GLUCOSE 6 PHOSPHATE DEHYDROGENASE ASSAY (G6PD) (Red cell)     Dept: HAEM 1mL blood 146-376 U/10E12 RBC     4 mL blood EDTA or Heparin. Transport: Chilled TAT: 1 week 248.4 Price exclusive of GST GLUCOSE 6 PHOSPHATE DEHYDROGENASE SCREEN (G6PD) (Red cell) If screen test is abnormal a full G 6-PD assay will be performed.   Dept: HAEM 1mL Normal. N/A   4 mL blood EDTA or Heparin. Transport: Chilled TAT: 1 week. Same day if required urgently 25.88 Price exclusive of GST GLUCOSE CHALLENGE TEST (Gestational Diabetes Screen) PATIENTS MUST NOT EAT DURING THE TEST The test is a screening test for gestational diabetes using a 50g glucose or glucose polymer load. It should not be confused with the glucose tolerance test. It is usually carried out at 24 - 28 weeks’ gestation. The glucose solution for this test should be obtained from the Pharmacy. 200 mls of solution is given orally. (This is equivalent to 50 g of glucose.) This should be measured accurately into a separate drinking vessel. The patient must be non- fasting. • The patient should be seated and not smoke throughout the test. • Have the patient drink the glucose solution within a period of 5 mins. • Note the time of the dose.   Dept: BIOCHEM   If the 1 hour glucose value is >7.8 mmol/L, then the GLUCOSE TOLERANCE TEST (Gestational) should be performed.     Take a blood sample (2mL blood, fluoride tube) for glucose analysis exactly 1 hour after the dose is taken.     2.33 Price exclusive of GST GLUCOSE TOLERANCE TEST 1. Laboratory Phlebotomists carry out this test. Bookings for tests at Waikato Hospital should be made in advance by paging Phlebotomists directly. 2. The patient must be at rest and not smoke during the procedure. 3. For three days prior to the test, the patient must be on a diet containing no less than 200 g of carbohydrate daily. 4. Do not perform this test on a very ill patient, a known diabetic, or on any patient within 2 months of surgery. 5. The glucose polymer solution for this test should be obtained from the pharmacy. Following a 10 hour fast, an oral dose of glucose polymer is given.. The whole bottle of 300mls is to be taken. The solution is, equivalent to 75 g of glucose. Please note: The price for a Glucose Tolerance Test is the sum of the number of glucose readings undertaken.   Dept: BIOCHEM   Diagnosis of Diabetes Mellitus (all values are for venous plasma, fluoride tube). If symptoms; Fasting glucose >6.9mmol/L OR 2hr value >11.0 on one occasion. If no symptoms; As above but on TWO subsequent occasions. Impaired fasting Glycaemia; Fasting glucose of 6.1 - 6.9mmol/L and 2hr glucose (if measured) < 7.8mmol/L. Impaired Glucose Tolerance; 2hr glucose 7.8 - 11.0mmol/L and fasting glucose (if measured) <7mmol/L. Position Statement of Australian Diabetes Society, NZ Society for the Study of Diabetes, RCPA & AACB. MJA 1999; 170, 375-8     2 mL blood, fluoride tube, taken at the following intervals: Fasting and 2 hours post dose.       GLUCOSE TOLERANCE TEST (Gestational) 1. Laboratory Phlebotomists carry out this test. Bookings for tests at Waikato Hospital should be made in advance by paging Phlebotomists directly. 2. The patient must be at rest and not smoke during the procedure. 3. For three days prior to the test, the patient must be on a diet containing no less than 200 g of carbohydrate daily. 4. Do not perform this test on a very ill patient, a known diabetic, or on any patient within 2 months of surgery. 5. The glucose polymer solution for this test should be obtained from the pharmacy. Following an 8 hour fast , an oral dose of glucose polymer is given.. The whole bottle of 300mls is to be taken. The solution is, equivalent to 75 g of glucose.   Dept: BIOCHEM 0.08 ml fluoride plasma (frozen) Fasting glucose < 5.5 mmol/L 2 Hour glucose < 9.0 mmol/L 5%   2 ml blood - fluoride tube Fasting pre-dose and 2 hour post dose.     3.42 Price exclusive of GST GLYCINE (CSF) (Referred test) Taken in conjunction with plasma glycine to provide Glycine:CSF Glycine ratio to exclude Non Ketotic Hyperglycinaemia (NKH).   Dept: BIOCHEM 0.5 mL Frozen on dry ice. Consult Laboratory Report N/A   0.5ml Must be void of blood. If the CSF appears blood stained ensure Microbiology does a cell count before sending.   TAT: 1 - 2 weeks 0 Price exclusive of GST GLYCINE (Plasma) (Referred test) Performed as part of amino acid profile - see Amino acids (plasma). (Provider: NATIONAL TESTING CENTRE ) Dept: BIOCHEM 200uL heparin plasma frozen ASAP CSF 500uL minimum - must be void of blood. If the CSF appears blood stained, ensure Microbiology does a cell count before sending. Consult Laboratory Report N/A   Blood -1mL Heparin tube on ice sent to lab immediately. Ideally taken at time of symptoms. CSF - 0.5mL void of blood Transport: Frozen TAT: 1-2 weeks 0 Price exclusive of GST GLYCOSAMINOGLYCANS (Mucopolysaccharides) (Urine) (Referred test) Salient clinical details required. (Provider: NATIONAL TESTING CENTRE, ATTN CLAIRE DE LEUN ) Dept: BIOCHEM 5mL urine Consult Laboratory Report N/A   Urine - Fresh Random. Transport: Frozen TAT: 2 weeks 120.13 Price exclusive of GST GM1 ANTIBODIES (Ganglioside Monosialic Acid, GM1) (Referred test) Gangliosides, a family of glycolipids characterised by the presence of sialic acid are widely distributed throughout the cell membrane and constitute a potential component of specific receptor sites for hormones and neurotransmitters. In the nervous system, gangliosides are found on the cell body of motor neurons, the axon and the neuromuscular junction. Moreover, ganglioside monosialic acid GM1 is a well-known receptor for cholera toxin and the disialyl ganglioside, GD1b, is a specific receptor for tetanus toxin. GM1 antigen is present in both axolemma and myelin sheath and is concentrated at synaptic terminals where it is accessible to an immune response. A predominant epitope expressed by GM1 is galactosyl (B1-3) N-acetylgalactosamine. This epitope is also expressed by asioalo - GM1, and GD1b. IgM response to GM1, is found in patients with lower motor neuron diseases with or without paraproteinema. IgM GM1 antibodies are also found in patients with multifocal motor neuropathy, motor or sensorimotor neuropathy and IgM paraproteinemias with neuropathy. Low titres of IgM GM1 antibodies are detected in other neurologic diseases (multiple sclerosis, amyotrophic lateral sclerosis (ALS) and some normal individuals. In a recent study in patients with neurological diseases, GM1 antibodies were found in 90% of patients presenting with a motor neuropathy, most often multifocal conduction blocks.   Dept: IMMVIRO 0.2 mL serum and/or CSF Serum <2 units/mL Low titre 2 - 5 units/mL Moderate titre 6 - 10 units/mL High titre >10 units/mL     Serum or CSF Serum preferable   TAT: 3 - 4 weeks 230 Price