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Specialist Chemical Pathology

The Specialist Chemical Pathology Laboratory of LabPLUS is one of New Zealand's premier reference laboratories. The extensive range of analytes offered by the department provides its clients with a service that is focused and unique.

The department consists of the following sections: Specialist Biochemistry (incorporating Endocrinology, Special Techniques, Trace Metals and Antenatal Down Screening), Newborn Baby Metabolic Screening, Biochemical Genetics and Clinical Metabolic Service and Chromatography (incorporating Toxicology and HPLC). The experienced Chemical Pathologists, Scientists and technical staff can assist in providing an in depth clinical interpretation of tests.

Key Contacts

Specialist Testing

The Endocrinology Group offers both a hormone and tumour marker measurement service and a consultation service.

The Clinical Head welcomes enquiries about the tests provided and is available to make clinical comments on the results for both diagnosis and treatment. Enquiries are also welcomed regarding research studies using both current assays provided and development of new assays for clinical research.

The endocrinology group of LabPLUS measures hormones used in the diagnosis and monitoring of patients. These assays may be found in the LabPLUS Test Guide.

Key contact

Technical Specialist Linda Henderson

The Special Techniques Section generally undertakes tests where the demand for them can be variable including but not limited to porphyrins, sweat tests, blood and plasma cholinesterase, and faecal chymotrypsin. Although many assays are performed by traditional manual procedures, automated modern technology is used where possible.

Key contact

Technical Specialist Lynette Kilgour

The Trace Metals Section is supervised by a Scientific Officer and specialises in the measurement of trace elements by utilising inductively coupled plasma mass spectrometry (ICP-MS) technology. This technique allows measurements to be made on a range of sample types including whole blood, serum, plasma, urine and liver biopsy samples, where specimen requirements depend on the element to be analysed.

The measurement of non-essential trace elements, including lead and mercury, plays an important role in poisoning detection, as well as monitoring occupational exposure.

Participation in Australian based external survey programmes ensure that quality results to industry standards are provided. The continual review of new techniques and assays allow for improvement to the existing service.

Key contact

Technical Specialist Sandra Fitzpatrick

Antenatal Down screens pregnant women for the possibility of having an infant with a chromosome abnormality and other conditions, and symptomatic people for the possibility of having an inborn error of metabolism.

Antenatal screening for Down syndrome and other conditions

Please visit the National Screening Unit website for information.

Key contacts for Antenatal Screening

LabPLUS

Canterbury Health Laboratories

First trimester or second trimester screen

Maternal serum screening is a screen for Down Syndrome and other conditions.

Principally this involves either a first trimester serum screen combining the nuchal translucency ultrasound measurement with maternal PAPP-A and free beta HCG or a second trimester Screen achieved by performing a blood test measuring AFP, free beta HCG , unconjugated Estriol and Inhibin A. A computer algorithm compares the levels to those found in the affected and unaffected pregnancies and adds the maternal age risk to estimate the overall risk.

A first trimester screen for chromosome abnormalities may be done after 9 completed weeks and before 13 weeks 6 days.

A second trimester screen may be done after 14 weeks and before 20 weeks 6 days. A screen for neural tube defects will be included in screens done after 15 completed weeks.

The Ministry of Health National Screening Unit website has further information.

The National Screening Unit (NSU) funds all first trimester screens combined with a nuchal translucency scan measurement to give an overall risk. The NSU also funds a second trimester serum screen where a combined nuchal translucency and first trimester screen has not been done. This may be due to late booking or when a nuchal translucency has not been measured for some reason.

The Ministry of Health National Screening Unit website on screening options for antenatal screening for Down syndrome and other conditions has further information.

We provide request forms and patient information sheets with backup telephone explanations whenever required to doctors and midwives wishing to offer this service to their patients.

Second trimester request forms and information are also available on the Ministry of Health NSU website.

Key contacts

Newborn Metabolic Screening and Biochemical Genetics

For information about the Newborn Metabolic Screening programme please refer to the following website:

Ministry of Health National Screening Unit: About the Newborn Metabolic Screening Programme

Any further questions can be emailed to the laboratory

Key contacts

This discipline covers the diagnosis and treatment of inborn errors of metabolism or inherited metabolic diseases. Generally due to enzyme deficiencies, these conditions can present in many different ways at any age, although they are most common in infancy and childhood. There are over 400 of these disorders.

Diagnosis involves testing blood (cells or plasma), urine or cultured cells for either metabolites indicative of the disorders or the possibly defective enzymes.

The most common biochemical genetics tests are:

For intermediary metabolite disorders

  • Plasma aminoacids (aminoacid analyser) for aminoacidopathies, for example PKU and cystinuria etc
  • Urine organic acids (GC-MS) for disorders like propionic acidemia, methylmalonic acidemia
  • Blood acylcarnitines (tandem MS) for fatty acid oxidation disorders, for example MCAD

For storage disorders

  • Urine electrophoresis for mucopolysaccharidoses, for example Morquio syndrome

The clinical metabolic service cares for patients with diagnosed metabolic disease.

Key contacts

Chromatography

The Toxicology section undertakes therapeutic drug monitoring and testing to detect illicit and pharmaceutical drugs in patients and clients for cases of drug abuse and compliance investigation.

Key contact

Scientific Officer Dr Hima Madhavaram

 

The HPLC section undertakes specialist testing using the High Performance Liquid Chromatography (HPLC) techniques. The tests performed in this section include specialised therapeutic drug monitoring and measurement of vitamins, porphyrins and biogenic amines. This section is involved developing new tests for emerging therapeutic drugs.

Key contact

Scientific Officer Dr Gerald Woollard