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Immunology / Serology / STD / Allergy

Introduction

The Immunology & Serology section provides services for Autoimmune serology, Allergen-Specific IgE serology, Infectious Diseases serology (excludes viral serology) and Sexually Transmitted Diseases (STD) serology.

For serological tests for toxoplasmosis and legionellosis, paired sera (acute and convalescent; at least two weeks apart) should be sent. However, antibodies to some infections may take a longer time to develop (e.g. Legionella infections), such specimens should be taken a month to 6 weeks apart. Results for the first (acute) specimen are always despatched when ready, and this specimen is kept so that it can be run in parallel with the second (convalescent) specimen when it arrives. Interpretation for single specimens are inconclusive and do not carry the same weight as a rise in titre between the two specimens.

The assays used for clinical reporting have undergone robust in-house optimization and/or validation and are used with appropriate quality assurance and quality control measures in line with laboratory best practice and accreditation. Most are registered for in-vitro diagnostic use ( IVD); a small minority may not be formally registered or used off-label.

For further inquiries on tests and interpretation of results, laboratory users may call the laboratory at 63214922 or 63214960.

Turnaround time is based on the number of working days.


Specimens for Tests that Require Special Handling

I.  T-SPOT.TB
  1. Send blood specimens in Lithium Heparin tubes (green cap) to the Immunology & Serology Lab. Testing is by appointment only. Please call 6321 4960/4922 for appointment.

  2. Obtain samples in the morning, dispatch immediately to the laboratory, reaching the laboratory no later than 12 noon the same day. 
     
  3. Testing is available only on Mondays to Thursdays. Testing is not available on Public holidays and eves of public holidays. Urgent test requests are not indicated nor available.
     
  4. Adults: 10 mL blood (3 tubes required), Children: 4 mL blood (1 tube required), Neutropenia: at least 20 mL blood (5 tubes required).  
       
                                                 
  5. Invert tube contents 8 to 10 times to ensure the whole blood is mixed thoroughly with the anticoagulant.
     
  6. Do NOT refrigerate at any time. Store and transport only at room temperature (18 to 25oC), otherwise the WBCs will not be viable. 
     
  7. Please deliver samples to Client and Specimen Management (CSM), Level 8, Diagnostics Tower, The Academia, 20 College Road, Singapore General Hospital. For SGH cases, please deliver samples by pneumatic tube to station 901.

 

II. Clostridioides (Clostridium) difficile Toxins A & B

Only unformed stool that takes the shape of the container will be accepted.

Send fresh stool (one teaspoon or about 10 mm3 of stool) in a clean leak-proof container with a tight-fitting lid. If it is not possible to despatch the stool sample to the laboratory within the same day, the sample should be kept at 2 – 8oC in the refrigerator.

Please note: Stool specimens sent in transport media, on swabs, mixed in urine or preservatives, are not appropriate for testing and will have to be rejected.

 

III. Helicobacter pylori Stool Antigen

Send fresh stool (one teaspoon or about 10 mm3 of stool) in a clean leak-proof container with a tight-fitting lid. If it is not possible to despatch the stool sample to the laboratory within the same day, the sample should be kept at 2 – 8oC in the refrigerator.

Stool specimens should be sent 4 weeks after discontinuation of antibiotics, and 2 weeks after discontinuation of proton pump inhibitors and bismuth preparations, as these are known to cause false-negative results if ingested  prior to stool testing.

Stool specimens sent in transport media, on swabs, mixed in urine or preservatives, are not appropriate for testing and will have to be rejected.

 

IV. Stool Calprotectin

Please send first morning stool. Stool samples should be collected after stopping medications belonging to proton-pump inhibitors for 2 weeks before test.

Send fresh stool (one teaspoon or about 10 mm3 of stool) in a clean leak-proof container with a tight-fitting lid. If it is not possible to despatch the stool sample to the laboratory within the same day, the sample should be kept at 2-8oC in the refrigerator.

Stool mixed with transport media, preservative or urine is unsuitable for testing.

 

V. Aspergillus Galactomannan Antigen Test (Blood, BAL or CSF samples)

Please send sample in a separate container; sample is not to be shared with other test requests to avoid contamination.



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