To add another dimension to this, many of us in the trace element labs
have recently invested in ICPMS which is by its nature a multielement
technique. By performing a multielement profile on all serum samples
(i.e. Zn, Cu, Se, Al) or on all blood samples (Pb, Cd, Hg, As, etc) are
we acting illegally? Or should we interpret the request for one element
as a general request for trace element investigations? Should we report
all data or just that requested? How about the unexpected abnormals?
We routinely assay copper and caeruloplasmin together on almost all
requests for either analyte (there are some labs who we know do their
own assays of one, or have categorically stated that they do not want
the other added). We view this as providing a better service when the
question is has this patient a disorder of copper metabolism.
Barry Sampson
Principal Biochemist and Honorary Lecturer
Trace Element Laboratory
Clinical Chemistry
Charing Cross Hospital & Imperial College School of Medicine London W6
8RF UK
Phone +44-020-8383 3644
Fax +44-020-8846-7007
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Trace Element Laboratory now on the Web at:
< http://home.clara.net/sampson1/html/laboratory.htm
<http://home.clara.net/sampson1/html/laboratory.htm> >
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of hallworth
Sent: Friday, February 20, 2004 8:22 PM
To: [log in to unmask]
Subject: Adding assays
My two penn'orth:
>1 Adding other thyroid-related assays after seeing the result after
>receiving a request for TSH
We always treat thyroid requests as a request for TFTs, whatever they
ask
for, so see 2
>2 Adding other thyroid-related assays after seeing the TSH result after
>receiving a request for "thyroid function tests"
Yes - do this routinely
>3 Adding hCG assay to a sample from a young woman with suppressed
>gonadotrophins
Almost certainly, provided clinical details appropriate
>4 Adding a tumour marker assay on a hypercalcaemic sample with
>suggestive clinical details.
No - as Trevor says, it would be a fishing expedition
>5 Adding total protein assay to a request for "LFT" in order to detect
>asymptomatic paraproteinaemia
Unlikely, unless there was a reason to think of paraproteinaemia
>6 Adding GGT assay after seeing the results following a request for
>"LFT"
Would have done it in the first place, so not applicable!
Mike Hallworth
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------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.
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