The Clinical Immunology Laboratory offers a full range of clinical diagnostic services, including agarose gel electrophoresis, immunoelectrophoresis and immunofixation to detect monoclonal proteins in serum, urine and cerebrospinal fluid. Other tests include indirect immunofluorescence, assay for detection of antinuclear antibodies, anti-native DNA antibodies, identification and characterization of cryoglobulins, detection of precipitin antibodies for hypersensitivity pneumonitis. Utilizing ELISA assays the laboratory performs assays for SS-A, SS-B, Sm, RNP, anti-Scl-70 and Jo-1, anti-CCP, a full panel of tTG IgA and IgG antibodies for celiac disease, and H. pylori. Utilizing rate nephelometry quantitation of serum and urine free light chains are performed and data coupled to interpretations of serum and urine electrophoresis and immunofixation analyses. Both IgA and IgM Heavy-Lit quantitative assays are performed to monitor IgA and IgM monoclonal gammopathies that preclude precise quantitation by immunofixation. Serum IgG subclasses are measured by nephelometry. Evaluation of complement proteins, complement activation, determination of serum viscosity and analyses of joint fluid crystals are also performed. Quantitation of 24-hour urine for Bence-Jones proteins and Heavy-Lit assays are performed to meet requirements of clinical trials in multiple myeloma.
The application and clinical value of these tests are highlighted in laboratory teaching sessions for residents and fellows in various fields of medicine by the Director during daily reporting and resulting sign-out sessions.