Antithrombin activity

See thrombophilia screen.

APC resistance

See thrombophilia screen.

APTT ratio (activated partial thromboplastin time ratio)

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround: 1 working day

Reference range:

0.8 - 1.2

APTT ratio - Therapeutic Heparin Ratio

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround: 1 working day

Reference range:

2.0 – 2.5

B₁₂ (vitamin B₁₂) (click here for folate)

 /

5 mL clotted blood

Turnaround: 24h (weekdays)

Reference range:

197 - 866 pg/mL

5 x 4 mL EDTA blood

Referred by Haematology Department by agreement of consultant haematologist.

Turnaround: 2-4 weeks

Interpretive report

Bleeding Time

Available only after referral to consultant haematologist.

Test done on patient, not sample.

Turnaround time: 2 weeks

Reference range not applicable - see report.

Bone Marrow Aspiration

Requires referral to consultant haematologist.

Turnaround time: <1 week (1+ week for trephine)

Interpretive clinical report

CD4/8 counts  

Immunohaematology test - click here

Chimerism studies

5 x 4 mL EDTA blood

Referred by Haematology Department by agreement of consultant haematologist.

Turnaround: 2-4 weeks

Interpretive report

Chromosome studies for haematological investigation

10 ml EDTA blood. Discuss with consultant haematologist before collection.

Turnaround time: 2 weeks

Interpretive report

Coagulation factor assays

Only available after discussion with consultant haematologist.

1.8 mL Na-citrate blood, take with minimal stasis, must be filled to the line.

Please contact laboratory before collection for guidance on volume of blood required for factor in question. Send to laboratory as soon as possible.

	Reference range:
Factor II	79 - 150%
Factor V	62 - 139%
Factor VII           Must be performed on a fresh specimen	50 - 150%
Factor IX	65 - 150%
Factor X	75 - 131%
Factor XI	65 - 150%
Factor XII	50 - 150%
Factor XIII screen           2 tubes required             Only performed Monday to Thursday             Must arrive in the lab before 12 noon             TAT if prearranged 48hrs, otherwise 1 month Reference range: See report.

Turnaround time: 1 month unless notified as urgent. Urgent results available within a few hours.

Coagulation screen

(INR and APTT ratio)

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround time: 1 working day (2 hours if identified as urgent).

Reference ranges:

INR: 0.8 - 1.2

APTT ratio: 0.8 - 1.2

D-dimers (fibrin degradation products, FDP)

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround time: 1 working day (2 hours if identified as urgent).

Reference range:

<224 ng/mL

Unable to report on samples from pregnant patients or patients on anticoagulant therapy.

Erythrocyte sedimentation rate (ESR)

4 mL EDTA blood

Turnaround time: 1 working day 

Reference range:

0 to 15 mm in 1 hr

EMA test for red cell membrane abnormalities (e.g hereditary spherocytosis)

4 mL EDTA blood (1 mL minimum)

Only available after by prior arrangement with haematology staff. Samples to be taken in the morning to allow sufficent time for posting. Blood should also be taken from the affected parent as a positive control.

Turnaround time: 2 days

See report.

Factor V Leiden 

See thrombophilia screen.

Fibrinogen

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround time: 1 working day

Reference range:

2.0 - 4.0 g/L

Folate (click here for B₁₂)

 /

5 mL clotted blood

Turnaround: 24h (weekdays)

Reference range:

B₁₂ and folate assays are done in Biochemistry but interpreted in Haematology - please contact Biochemistry for technical/analytical queries, Haematology for clinical interpretation and advice.

Full Blood Count (FBC)

Following guidance form the Pathology Harmony group and the DOH we have changed the units that Haemoglobin and MCHC are reported. From 9am on 25/3/13 results are reported in g/L rather than g/dL.

4 mL EDTA blood

Erroneous results can arise from aged samples (elevated mean cell volume), and contaminated samples (from drip lines).

Please send separate sample if requesting with Biochemistry EDTA tests (e.g. HbA_1c)

Turnaround time: 1 working day (2 hours if identified as urgent).

Reference ranges: see below

Glandular Fever screen (Paul Bunnell, infectious mononucleosis, EBV)

5 mL clotted or 4 mL EDTA blood (can be done on sample sent for FBC).

Reports show that around 10% of adults and 50% of young children can have a negative IM screen despite showing many typical clinical symptoms.

Turnaround time: 1 working day

Reference ranges not applicable - see report.

Glucose-6-phosphate dehydrogenase screen (G6PD)

4 mL EDTA blood

Falsely high G6PD results may be seen after a haemolytic crisis due to increased reticulocytes which have higher G6PD levels than mature red cells.

Turnaround time: 1 week 

Reference range:

146 - 376 IU per 10¹² RBC

Haemoglobinopathy screen (includes HbA₂, HbF quantitation)

4 mL EDTA blood

For investigation of haemoglobinopathies e.g HbS,HbC, beta thalassaemia

Turnaround time: 3 working days (unless Hb variant found).

Reference ranges:

Haemoglobin HbA₂: 2.0 - 3.2 %

Haemoglobin F (adults): ≤ 1.0 %

Samples are referred by Haematology Department after initial investigation for confirmation of haemoglobinopathy / thalassaemia by HPLC or molecular analysis. This requires 2 x 4 mL EDTA blood.

Turnaround time: 4-6 weeks

Haemosiderin

(test done by Cytology)

20 mL early morning urine.

Discuss with consultant haematologist before collection.

Turnaround time: 2 working days        

Interpretive clinical report

Heinz bodies

4 mL EDTA blood

Turnaround time: 2 working days

Reference ranges not applicable - see report.

Heparin Assay (Anti-Xa)

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

For monitoring LMW heparin.

Blood should be taken 4-6 hours after administration of heparin.  This test can only be added to a request within 4 hours of sample collection.

Reference range:

Therapeutic range: 0.4 - 1.0 iu/mL

Prophylaxis range: 0.1-0.3 iu/mL

Heparin Induced Thrombocytopenia test (urgent)

3 x 1.8ml Na-citrate and 1x 5 mL clotted blood.

Referred by Haematology Department by agreement of consultant haematologist.

Turnaround time: within 1 week (urgent)

Interpretive report

HLA-B27

Immunohaematology test - click here

Immunohaematology Tests

Click here for more immunohaematology test information.

INR

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround time: 1 working day

Reference range:

0.8 - 1.2

JAK2 mutation

2 x 4 mL EDTA blood

Referred by Haematology Department by agreement of consultant haematologist.

Turnaround: 2-4 weeks

Interpretive clinical report.

Leukaemia immunophenotyping

Immunohaematology test - click here

Lupus anticoagulant

2 x 1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

May be requested as part of thrombophilia screen, or as a separate test as in neurological or autoimmune investigations or recurrent miscarriage. May be affected by presence of heparin in levels greater than 1U/mL.

See Turnaround time: 1 month

Reference range:

<1.20

Lymphocyte subsets (B, T, NK cell counts)

Immunohaematology test - click here

Malarial parasites

4 mL EDTA blood

Turnaround time: same day

Confirmation of malaria sub type - 4 mL EDTA blood and slides referred by laboratory. Turnaround time: 1 week

Plasma viscosity

4 mL EDTA blood

Turnaround time: 5 days unless specified as urgent.

Reference range:

1.50 - 1.72 cP

Platelets

see FBC - click here

Platelet Aggregation

Special collection bottles.

Available only after discussion with consultant haematologist.

Reference ranges not applicable - see report.

Platelet Function Studies 

2 x 1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Available only after discussion with consultant haematologist.

Turnaround time: same day

Reference range not applicable - see report.

Protein C

See thrombophilia screen. 

Protein S

See thrombophilia screen. 

Prothrombin gene mutation

See thrombophilia screen.

Pyruvate kinase, red cell

4 ml EDTA (adult), 1 ml EDTA (paediatric)

Discuss with haematology laboratory.

Turnaround time: 2 weeks

Reference range:

11 - 19 IU/g Hb

Red cell mass/plasma volume estimation

Done at RSCH

Available only after discussion with consultant haematologist.

Red cell osmotic fragility

No longer available - please see EMA test for red cell membrane studies.

Reticulocytes

4 mL EDTA blood (can use FBC sample)

Turnaround time: 1 working day

Reference range:

Adult: 0.2 - 2.0%, 50 -100 x10⁹/L

Infant: 2.0 - 6.0%, 74 -390 x10⁹/L

Schilling Test

Available only after discussion with consultant haematologist. .

Sickle Cell screen

4 mL EDTA blood

Turnaround time: 1 working day

T lymphocyte subsets

Immunohaematology test - click here

Thalassaemia screen

see see Haemoglobinopathy screen

Therapeutic Heparin Ratio

see APTT ratio - Therapeutic Heparin Ratio

Thrombin time

1.8 mL Na-citrate blood

Take with minimal stasis, must be filled to the line.

Turnaround time: 1 working day

Reference range:

12 - 16.6 seconds

Thrombophilia screen

General screen: 4 x 1.8 mL Na- citrate blood taken with minimal stasis, filled to the line.

Best done 4 weeks after stopping warfarin, not at presentation or in non-steady state. BSUH guidelines suggest screen including FBC, coagulation screen,  thrombophilia screen including Factor V Leiden and prothrombin gene mutation, cardiolipin antibody & antinuclear antibody is carried out on patients less than 45 years of age who have an episode of venous thromboembolism.

Requests for individual tests (i.e. not as part of screen) should be discussed with the laboratory before submitting sample.

Turnaround time: 1 month

Factor V Leiden and Prothrombin gene mutation

May be available after discussion with a consultant haematologist.

4 mL EDTA blood

Turnaround time: 1 month

von Willebrand screening

2 x 1.8 mL Na-citrate blood, take with minimal stasis, must be filled to the line.

Available only after discussion with consultant haematologist.

	Reference range: (from 23/12/11)
Factor VIIIc	50 - 150 u/dL
VW activity	Blood group O: 40 - 126% Blood groups A, B, AB: 49 - 163 %
VW antigen	Blood group O: 42 - 141% Blood groups A, B, AB: 66 - 176 %

Turnaround time: 1 month

See report.

White Cell Enzymes

Now being handled by Biochemistry - click here.