Clinical Laboratory

The high complexity clinical laboratory is one of essential diagnostic entities of the Institute for Specialized Medicine.

Our laboratory performs in-house immunologic, biochemical and hematologic testing focused on establishment of an accurate diagnosis, prediction of diseases’ progression, monitoring of therapy and prevention of serious drug reactions.

The list of tests commonly utilized in our clinic includes:

CBC	-cell blood count is used as a screening test to check for such disorders as anemia, infection, and many other diseases. It is actually a panel of tests that examines different parts of the blood and includes the following: White blood cell (WBC) count White blood cell differential looks at the types of white blood cells present. Red blood cell (RBC) count is a count of the actual number of red blood cells per volume of blood. Hemoglobin measures the amount of oxygen-carrying protein in the blood. Hematocrit measures the percentage of red blood cells in a given volume of whole blood. The platelet count is the number of platelets in a given volume of blood.. Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a red cell. Red cell distribution width (RDW) is a calculation of the variation in the size of your RBCs.
ESR	– erythrocyte sedimentation rate is an indirect evaluation of the degree of inflammation present in the body. ESR measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a special tube of blood.
CMP	- comprehensive metabolic panel is a frequently ordered panel of tests that provides information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. The CMP includes: Glucose Calcium Proteins Albumin Total Protein Electrolytes Sodium Potassium CO2 (carbon dioxide, bicarbonate) Chloride Kidney Tests BUN (blood urea nitrogen) Creatinine Liver Tests ALP (alkaline phosphatase) ALT (alanine amino transferase, also called SGPT) AST (aspartate amino transferase, also called SGOT) Bilirubin
CRP	- C-reactive protein is an acute phase reactant, a protein produced by the liver and secreted into the bloodstream within a few hours after the start of an infection or inflammation. Its rise in the blood can also precede pain, fever, or other clinical symptoms. The level of CRP can be valuable in monitoring disease activity.
TSH	- is a thyroid-stimulating hormone which is produced by the pituitary gland, a small organ located below the brain and behind the sinus cavities. TSH is part of the body’s regulatory system to maintain stable amounts of the thyroid hormones in the blood. Low levels of TSH are associated with increased function of the thyroid gland while TSH elevation is indicative for abnormally low thyroid function.
Lipid profile	- is a group of tests that are often ordered together to determine risk of coronary heart disease. They are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (atherosclerois). The lipid profile typically includes: Total cholesterol High density lipoprotein cholesterol (HDL-C) — often called good cholesterol Low density lipoprotein cholesterol (LDL-C) —often called bad cholesterol Triglycerides
Uric acid	- is the final breakdown product of purine (component of nucleic acids) metabolism which is produced in the liver by the enzyme xanthine oxidase. Elevated levels of uric acid are associated with gout and metabolic syndrome.
CPK or CK	- Creatine kinase is an enzyme found in the skeletal muscle as well as in the heart, brain, and other tissues. Elevation of CPK is typically observed in patients with damaged or inflamed muscles. Low levels of CPK do occur in patients with muscle atrophy or in association with muscle damage by corticosteroid hormones such as the prednisone.
PTH	- is a parathyroid hormone that produced by four parathyroid glands and helps the body maintain stable levels of calcium in the blood. PTH is part of a regulatory loop that includes calcium, vitamin D, and, to some extent, phosphorous (phosphate) and magnesium.
SPEP UPEP	proteins, to identify the absence of normal proteins, and to determine when different groups of proteins are increased or decreased in serum (SPEP) or urine (UPEP).
Vitamin D	- is a measurement of a total 25-hydroxyvitamin D concentration in the blood. Vitamin D is a regulator of calcium absorption and metabolism. Vitamin D is frequently utilized as a marker of malabsoption of lipid soluble vitamins.
Beta-2-microglobulin	- is a component of Major Histocompatibility (MHC) class I molecules. Elevated levels of beta-2-microglobulin in the blood are observed in patients with Sjogren’syndrome, lupus and various lymphoproliferative malignancies. Typically, beta-2-microglobulin is used to monitor patient’s response to the drug therapy and to assess the disease activity.
C3 C4	- are components of the complement system which are circulating blood that work together to promote immune and inflammatory respproteinsonses. Their principal role is to destroy foreign substances like bacteria and viruses. Low levels of complement components are frequently detected in patients with autoimmune diseases including lupus.
IgM IgG IgA	- are immunoglobulins, a group of gamma globulin proteins that are found in blood or other bodily fluids, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses.
HLA typing	- HLA are human leukocyte antigens. The major HLA antigens are essential elements in immune function. Certain HLA antigens may mediate autoimmune diseases including ankylosing spondylitis, rheumatoid arthritis, celiac disease and others, and therefore can be used as diagnostic markers.
ANA	- anti-nuclear antibodies are antibodies directed against contents of the cell nucleus. They are present in higher than normal numbers in autoimmune disease. The ANA test measures the pattern and amount of autoantibody which can attack the body's tissues as if they were foreign material. ANA are present in low titers in the general population, but in about 5% of the population, their concentration is increased, and about half of this 5% have an autoimmune disease.
Anti-dsDNA	- are antibodies against double-stranded DNA. Anti-dsDNA antibodies are associated with lupus nephritis and frequently used as markers of disease activity and therapeutic responses.
ENA	- extractable nuclear antigens are soluble cytoplasmic and nuclear components that are antibody targets with over 100 different antigens described. Antibodies to these antigens have particular associations with various connective tissue disorders. The main 6 ENA used in the diagnosis of autoimmune disease are: SSA/Ro – associated with Sjogren’s syndrome SSB/La – associated with Sjogren’s syndrome Sm – associated with lupus RNP – associated with mixed connective tissue disease Scl-70 – associated with systemic sclerosis Jo1 – associated with inflammatory muscle disease
ACL	- are anti-cardiolipin antibodies that often directed against cardiolipin and found in several diseases including antiphospholipid syndrome, vasculitis, Behçet's syndrome, idiopathic spontaneous abortions and systemic lupus erythematosus.
RF	- rheumatoid factor is an autoantibody against the Fc portion of immunoglobulin G. RF and Immunoglobulin G join to form immune complexes which contribute to the disease process. The RF test is sensitive but nonspecific. It is most closely associated with rheumatoid arthritis (RA) but may also be present in a variety of other autoimmune disorders, such as Sjögren’s syndrome, in some persistent bacterial and viral infections, and it can be found in a small percentage of healthy people. The higher the levels of RF the higher the possibility of a more destructive joint disease.
Anti-CCP	- are antibodies against cyclic citrullinated peptide antibody. These antibodies are used to support the diagnosis of rheumatoid arthritis. Anti-CCP antibodies have a sensitivity and specificity that is equal to or better than rheumatoid factor and are more likely to be positive with early RA.
Anti-gliadin	- are anti-gliadin antibodies that produced in response to gliadin, a protein found in the wheat. Positive anti-gliadin antibodies in blood and saliva are associated with gluten-intolerance and celiac disease.
Anti-TTG	- are anti-tissue transglutaminase antibodies that frequently found in patients with celiac disease.
Anti-TPO	- are antibodies against thyroid peroxidase. Elevated levels of anti-TPO antibodies are found in patients with autoimmune thyroid diseases including Hashimoto thyroiditis.
ANCA	- are anti-neutrophil cytoplasmic antibodies that directed against antigens in the cytoplasm of neutrophil granulocytes (the most common type of white blood cell) and monocytes. They are detected as a blood test in a number of autoimmune disorders, but are particularly associated with systemic vasculitis.
ASO	- anti-streptolysin O test measures the amount of antibody produced in response to a recent or persistent streptococcal infection. Streptolysin O is a toxin made by the live Group A streptococcus bacteria (Streptococcus pyogenes). Antibodies made against this foreign toxin reflect the presence of live streptococcus group A in the body. The level of ASO is commonly used for monitoring the efficacy of antibiotic therapy in patients with rheumatic fever and streptococcal reactive arthritis.