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Routine Tests in Immunology

The Department of Immunology, through its service lab, conducts various routine tests including for research purposes. These include:

  • Cytokine Assessment: The production of cytokines including interleukin-1 (IL-1), IL-10, IFN-gamma, GM-CSF, and TNF, in patient serum.
  • Immunoglobulin G (IgG) Subclasses: Determination of levels of IgG subclasses (IgG 1-4) to help diagnose chronic viral or bacterial infections.
  • Tissue Typing: The Lab also performs tissue typing for patients with various diseases and those waiting for transplants. This includes screening for preformed antibodies and cross-matching for organ or bone marrow transplants.
  • Complement Protein Tests: Certain conditions, such as systemic lupus erythematosus and recurrent bacterial infections, may involve deficiencies in complement proteins. The Immunology Lab measures complement activity by estimating C1q, C3, and C4, using laser nephelometry. Nephritic factors are also tested and detection of C1 esterase.
  • Diagnostic Tests for Infectious Diseases: The Lab offers a variety of tests for infectious diseases like HIV and hepatitis.
  • Autoimmune Disease Investigations: Specialized tests are also conducted to identify autoimmune diseases and serum protein irregularities. Routine tests include:
    • IFA Tests: We investigate anti-nuclear antibodies (ANA) and anti-nuclear factors (ANF) against various targets, including smooth muscle, parietal cells, and mitochondria. We also test for antibodies to dsDNA, Smith antigen (SM), Scl70, Jo-1, RO, and L antigens.
    • Antibody Determinations: We use various methods to test for anti-cardiolipin, anti-thyroid, anti-adrenal, and anti-pancreatic antibodies, as well as rheumatoid factor.
Routine Diagnostic Assays
Test Comments
Autoantibody Tests
Antinuclear Factor (ANF/ANA) Used for autoimmune profiling in diseases like systemic lupus erythematosus (SLE) and thyroid disorders.
Anticardiolipin Antibodies (ACLA)
Anticardiolipin IgG and IgM (Elia G and Elia M) Anti-cardiolipin antibodies are a form of anti-mitochondrial antibodies which can either be beta-2 glycoprotein 1 dependent or independent. They are present in several diseases like SLE and antiphospholipid syndrome.
Beta-2 glycoprotein 1 in IgG and IgM
Extracellular antibodies
Rheumatoid Factor (RF) Nephelometry provides fast and accurate RF titers.
Thyroid Antibodies
Antineutrophil Cytoplasmic Antibodies (ANCA) All positive ANCAs are checked for PR3-ANCA antibodies.
Anti-Glomerular Basement Membrane (anti-GBM) Antibodies A screening test for Goodpasture's syndrome
HLA/Tissue Typing
HLA B27 and DR Typing Used for leukocyte identification related to transplantation and disease associations.
Allergy Tests
Total IgE Measures total IgE levels in serum.
Phadiotop Identifies specific allergens and IgE levels. Screens allergies to tree pollens, weed pollens, mould & yeasts, grass, mites, and food mixes.
IgG Subclasses Assesses IgG subclass deficiencies related to infections.
Secretory IgA (sIgA) Valid for diagnosing hepatobiliary diseases, including liver conditions and cancer.
HLA Antibody Screening Identifies specific antibodies to HLA antigens.
HIV  
HIV-1 and HIV-2 Ab/Ag High through-put automated screening and confirmatory testing for HIV-1 and 2.
Automated testing (high volume)
Hepatitis A, B and C Automated testing includes Hepatitis A IgM, Hep B Surface Ag, Hep B Surface Ab, Hep B Core Total Ab, Hep B Core IgM, Hep B E Ag, Hep B E Ab and Hep C Antibody
TORCHES Rapid automated screening of IgG and IgM to Toxoplasmosis, Rubella, Cytomegalovirus and Syphilis.
Manual testing (batched)
EBV, HSV 1 and 2, VCV, Mumps, Hep E Manual ELISA testing of IgG and IgM to multiple viruses including Mumps, Herpes simplex virus 1 and 2, Ebstein Barr virus, Varicella zoster virus and Hepatitis E.
H. Pylori ELISA for antibody to Helicobacter Pylori, a cause of gastritis and peptic ulcer disease.
Haematology Routine Diagnostic tests
ABO blood group Manual blood grouping is performed to screen for ABO incompatibility in pregnancy.
Other red cell markers/antibodies  
Rhesus blood group Manual testing for the presence of specific antigens on red blood cells and/or antibodies to these antigens. Particularly useful when screening for RH incompatibility to prevent complications to newborns.
Indirect and direct coombs

A full test list is available on the NHLS handbook or upon request.

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