Chemistry

Chemical Pathology

Chemistry

Our SANAS accredited chemical pathology laboratories are in all nine provinces of South Africa and offer routine and urgent chemistry analysis in over 100 facilities. Find out more.

What is chemical pathology?

Chemical pathology is the branch of pathology concerned with detecting, measurement and interpretation of different proteins and other elements and compounds in all the body fluids such as blood, urine and cerebrospinal fluid. These substances are also measured in solids like stool, hair and tissue biopsies. As medical doctors, the pathologists in pathology laboratories provide a consultative service to our clinicians. This service aids in the interpretation of results and provides guidance on selecting the appropriate tests to confirm a diagnosis, prognosticate(Predict how the disease will progress), monitor and manage patients. Branches include biochemistry, endocrinology, inherited metabolic disease, serology, toxicology and molecular pathology.

The central reference laboratory

Operationally, the central reference laboratory (CRL) located in Richmond Johannesburg, is divided into an automated laboratory and 4 semi-automated laboratories.

The automated laboratory (Autolab)

Autolab is a fully automated laboratory within the CRL where high volume, readily automatable testing is performed. Samples are shipped and processed from throughout Africa. Autolab consists of an array of automated analysers that conduct the tests. These machines are connected by a track that moves the specimens from automated analyser to automated analyser. The tests conducted include routine chemistry and endocrinology tests. Some serology and virology tests are also performed within the CRL. The specialised endocrine testing capabilities include dynamic hormone tests such as glucose tolerance tests (checking how your body processes sugar) and growth hormone stimulation tests (for children with growth problems).

Therapeutic drug monitoring laboratory

Therapeutic drug monitoring (medication levels) is conducted on a separate automated analyser. We monitor medications like digoxin, warfarin, seizure drugs, and transplant medications because they have a narrow range between "not working" and "dangerous" - too little won't help you, too much can harm you, so regular blood tests ensure you get just the right amount for maximum benefit with minimum side effects.

HbA1c laboratory

The amount of sugar in the blood affects different parts of the body. One of those parts affected is hemoglobin. HbA1c looks at part of hemoglobin affected by the sugar. The value gives the doctor an idea of what the average sugar levels of the patient is over a 3-month period. This allows the doctor to make better decisions on how to manage sugar levels. At Lancet Laboratories, a separation method is used to isolate HbA1c from the other haemoglobins and the diagnosis and monitoring of the HbA1c is therefore possible in the context of the other haemoglobins.

Protein electrophoresis laboratory

The protein electrophoresis laboratory separates fluids into the different components to produce patterns that are interpreted by the pathologist. For example, serum protein electrophoresis separates proteins found in blood to identify proteins found in haematological malignancies. Once the diagnosis is made, these proteins are monitored as one of the proxies for the malignancy.

Prenatal genetic screening laboratory

First trimester screening and second trimester screening are performed in this laboratory. Results from multiple tests are processed by computer programs to calculate the risk of Downs syndrome (usually trisomy 21), trisomy 13 (Patau Syndrome) and trisomy 18 (Edwards syndrome). After screening as high risk, the next step is Non-invasive prenatal testing (NIPT). In NIPT, placental DNA is separated from maternal DNA in the mother’s blood to calculate a more accurate risk. Lancet Laboratories offers NIPT to reduce the number of pregnancies subjected to definitive, invasive testing. The invasive testing is either amniocentesis or chorionic villus sampling.

Lancet Laboratories’ regional reference laboratories

Also provide a broad range of specialised chemistry, endocrine, serology and allergy analysis. These centres offer consultative services by specialist pathologists including dynamic endocrine testing for patients where necessary. These regional reference laboratories are in: Durban, Kwazulu-Natal Pretoria, Northern Gauteng Cape Town, Western Cape Bloemfontein, Free State Province