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Laboratory Medicine

Immunology

Click here to view Immunology test information

Immunology is a part of the Haematology department and provides a high quality diagnostic service, committed to achieving and maintaining the highest possible standards; delivering a comprehensive consultative and diagnostic service throughout the Trust and beyond. Immunology is based solely on the York site and is open Mon-Fri 8.30-17.00.

Contacts for the Immunology Service:

For result and specimen enquiries Click Here

Contact details for the Immunology service email immunology.yth@nhs.net / anna.buxton@york.nhs.uk or telephone 01904 725738 (mon-fri 8.30-17.00)

For clinical advice please contact Professor Steve Holding via email Steve.Holding@hey.nhs.uk / steveholding@nhs.net or via telephone 01482 607710.

For Dr Gordins and Dr Khan (Consultant Immunologists) via secretaries 01482 461312

For Advice for Requestors and Information Regarding Service Delivery: Click Here

Test Repertoire

We have a comprehensive repertoire of tests available and we can also arrange for specimens to be sent to other laboratories for measurements if not performed at our York site.  Please see the Immunology test directory above.

Frequency of testing

The following assays are performed several times a week (Mon-Fri) Antinuclear antibody screen, ANCA(IIF), MPO, PR3, anti-GBM and Liver related antibodies, Rheumatoid factor, CCP, Coeliac screening, and Immunoglobulins.

All other assays are performed once a week.

Urgent Glomerular Basement Membrane, MPO and PR3 antibody assays will be performed if appropriate, on patients with suspected systemic vasculitis and or acute renal failure. Please contact the laboratory directly on 01904 725738 if this is required.

Turnaround Times

Turnaround times are calculated from the time of receipt in the laboratory to the time when the report is available to the user in an electronic format.  Paper copies of reports will take longer than the stated times.

As a guide Immunology tests are processed and reported electronically within the following times:

5-7 days - Antinuclear antibodies, Rheumatoid Factor, CCP, ANCA, Coeliac screening, Liver antibodies and GBM

7-14 days - Tissue specific antibodies, Intrinsic Factor antibodies, ENA profiles, anti-dsDNA, ENA screens and anti-phospholipid antibodies

Turnaround times for tests, e.g. neurological antibodies, referred to third part laboratories can be supplied on request; as a rule these take about 21 days to be processed.

Diagnosis and Monitoring of SLE/SCLE/LUPUS/MCTD

Initial screen: ANA, CRP. (ENA and phospholipid antibodies if pregnant).

Further tests if screen is positive: - anti-dsDNA, antibodies to ENAs, Cardiolipin antibodies, C3, C4, Immunoglobulin levels.

Monitoring: The half-life of antibodies is 3 weeks; therefore serial measurement of antibodies at weekly or fortnightly intervals is unhelpful. At each visit measurement of C3, C4, and CRP is advised with intermittent measurement of ANA and DNA antibodies.

Systemic Vasculitides

Initial screen: ANA, ANCA, MPO, PR3, C3, C4, CRP, RF, Immunoglobulins and Cryoglobulins.

Diagnosis: In patients with active untreated GPA, c-ANCA is present in >90% of cases. Although p-ANCA occurs in MPA, idiopathic pauci-immune glomerulonephritis and in a few patients with GPA, they are also present in a range of other autoimmune diseases e.g. SLE, RA, Ulcerative colitis.

Monitoring: In GPA patients CRP and ANCA at each visit. The half-life of the antibody is 3 weeks; frequent ANCA measurement i.e. weekly/fortnightly is unlikely to provide clinically useful information. In patients in remission, rising ANCA titres often precede a relapse.

Investigation of Renal Failure

ANA, C3, C4, CRP, ANCA, MPO, PR3, anti-GBM, cryoglobulins.

Serum immunoglobulins and electrophoresis

Urine electrophoresis

Monitoring bacterial infection: CRP

In view of its short half-life (6hrs approx) alternate day measurement is advised to check response to treatment.

Suspected Immunodeficiency

Please discuss with The Clinical Immunologist prior to requesting tests.

Web Page 59 Last Reviewed: 03/12/2020

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