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Hi Kirsty We have been using this approach for about 7-8 years now. We used to phenotype all requests but the workload was killing us. We reviewed all data and set our cut-off for reflex phenotyping at 1.5g/L. This works well and our data suggests that we only miss a few MS types (particularly if there is an acute phase reaction present) but MS is unlikely to be of clinical significance. Of course we still do the phenotype on all direct requests from the Medical Officers but we have not seen a change in the ordering habits since the introduction of this reflex test approach. Our LIS has been set to automatically request the Pi on AAT levels <1.5g/L. Certainly all pathological phenotypes (SZ, MZ, ZZ, Nulls, M(malton) etc) have been picked up with this cut-off - even in the presence of a severe acute phase reaction (CRP >100mg/L). Regards Sandra Klingberg Supervising Scientist Pathology QLD - Central Laboratory ----- Original Message ----- From: "Kilpatrick, Kirsty" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, May 30, 2008 6:26 PM Subject: FW: Alpha 1 antitrypsin > Dear All > We are currently assessing the concentration at which we reflex > alpha-1-antitrypsin samples for phenotyping. We would be grateful if > anyone who provides this service could advise us of their laboratory > protocol. If your protocol involves a cut-off (rather than phenotyping > all requests) we would be obliged if you would send us the data to > substantiate this cut-off. > > Thanks in advance > > Kirsty > > Kirsty Kilpatrick MRCPath > Clinical Scientist > Biochemistry Department > Gardner Robb Building > Belfast City Hospital > BT9 7AD > > ------ACB discussion List Information-------- > This is an open discussion list for the academic and clinical > community working in clinical biochemistry. > Please note, archived messages are public and can be viewed > via the internet. Views expressed are those of the individual and > they are responsible for all message content. > ACB Web Site > http://www.acb.org.uk > List Archives > http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html > List Instructions (How to leave etc.) > http://www.jiscmail.ac.uk/ > ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/