Chemical pathology is the branch of pathology concerned with detecting, measuring and interpreting non-infectious, sub-microscopic molecules. These non-infectious molecules are usually measured in bodily fluids like blood, urine and cerebrospinal fluid but chemical pathology is also responsible for measuring these substances 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, monitor and manage patients. Branches include biochemistry, endocrinology, inherited metabolic disease, serology, toxicology and molecular pathology.
Operationally, the central reference laboratory (CRL) located in Richmond Johannesburg, is divided into an automated laboratory and 4 semi-automated laboratories.
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.
Therapeutic drug monitoring (medication levels) is conducted on a separate automated analyser.
HbA1c is a molecule found in increased concentration in diabetes mellitus. 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.
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.
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 (Patua 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.
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