Long Bank Holidays are a different problem from out of hours work
and certainly if indicated I try to offer any test during these periods
providing I have the staff to do it.
However, in the case of a patient with fulminant liver failure many
tests other than copper need doing. In many hospitals the virology
for instance will be sent away and may take a few days to return.
Transplantation will either be done on clinical grounds, never mind
the aetiology or all test results will be required before a decision
can be made. Hepatitis is far more common than Wilsons and in
fulminant liver failure interpretation of serum copper can be
misleading.
Hence as I always believe the unusual urgent test must be
discussed with the lab and clinicians should be willing to be guided
as much my laboratory 'experts' as by their clinical colleagues.
Mike Addison
Dr G.Michael Addison
Royal Manchester Children's Hospital
Pendlebury
Manchester M27 4HA
United Kingdom
Tel 0161-727-2250(AM)or 0161-220-5342(PM)
FAX 0161-727-2249
Email [log in to unmask]
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