IMMUNOLOGY

Clinical microbiology and immunology



Clinical microbiology and immunology

Introduction to the study

The field of immunology has progressed rapidly over the last 30 years. Advances in the understanding of the basic mechanisms of the immune response as well as the clinical application of these mechanisms on a practical level have also progressed. This article will summarize briefly the progress of clinical immunology, particularly as it refers to the laboratory, and then discuss the different components of the clinical immunology laboratory as it exists today. It will deal with various issues that affect the day to day operation of such a laboratory, including regulatory matters, quality control and proficiency testing.

It will also deal with the application of the various testing modalities for diagnosis of various immunological, oncological. and infectious diseases. Last, will review reimbursement issues, indicating the limitations and the impact and constraints for utilizing various procedures to diagnose various disease states. Many and varied laboratory procedures involving immunological techniques designed to evaluate various components of the immune system have now become available, and clinical laboratories are faced with the problems of providing service in many or all of the areas mentioned above.

Recent legislative changes such as the Clinical Laboratory Improvement Act of 1988 (known as CLIA '88). as well as the concept of diagnosis-related groupings and application to the CPT codes, have made it necessary that these services be provided in an efficient and cost-effective fashion. In the past and to some degree even now, different immunological test procedures have been carried out in different clinical laboratories, such as those involved in immunology, serology, and blood banking. Today, there is a trend among large medical centers and service laboratories to crate a specific well-defined clinical immunology laboratory so that appropriate service to the various clinical departments can be provided in a well coordinated fashion.

Patient Profile

Mrs Moon a 24 year old administration support worker diagnosed as hepatitis carrier. Mrs Moon originally come from Iran and has been living in the UK with her husband the last five years, her husband is also from Iran but has been living the UK longer “10 years”. At the time of this diagnoses, Mrs B was 16 weeks pregnant.

Mrs Moon's condition was found through a routine blood screening at the antenatal clinic. Further investigation confirmed that Mrs Moon has taken the Hepatitis A vaccine six month earlier during a holiday trip back to the native country and therefore was finding it difficult to accept the diagnoses suggesting that there may have been a mistake. As faras as she was concerned, the Hepatitis A vaccine should provide her with the protection against all hepatitis viral infections including the Hep B.

Case Management

When a pregnant woman is infected with hepatitis virus, there is a chance she will infect her fetus. Whether the baby will get the virus depends on when infection occurred. If it was early in pregnancy, the chances are less than 10% that the baby will get the ...