Chemical Pathology Articles

AmpathChat #75 Residual Cardiovascular Risk Factors

The management of cardiovascular disease has seen unprecedented progress in previous decades.


The repertoire of laboratory tests related to COVID-19 has expanded since the first appearance of SARS-CoV-2 in December 2019. This guide provides an update on the latest Ampath COVID-19 tests (as of March 2021), including the appropriate indications for use.

AmpathChat #73 The new South African variant SARS CoV-2

Viruses mutate – this is the reality we face with any virus, and we need to be alert to the possibility that these mutations may change the way the virus behaves in the population, and the way the population is able to respond to the virus. Mutations raise concerns about changes in the virulence, or transmissibility of the virus.

AmpathChat #73 Familial hypercholesterolaemia detection using NGS

Familial hypercholesterolaemia (FH) is the most common autosomal-dominant inherited disorder of lipid metabolism.

AmpathChat #72 NPG COVID-19 Antigen test guideline

The current recommended method for the detection of SARS-CoV-2, the virus that causes COVID-19, is the reverse transcriptase polymerase chain reaction (RT-PCR) test, which is a type of nucleic acid amplification test (NAAT). While this method is more sensitive than other test modalities for the detection of SARS-CoV-2, even RT-PCR tests may produce false negative results in infected individuals

AmpathChat #72 - Non-invasive prenatal testing: Introducing VERACITY

Non-invasive prenatal testing (NIPT) is a prenatal screening test that calculates the risk of a fetus being affected with a chromosome abnormality. The test utilises cell-free DNA released from the placenta into the maternal bloodstream during pregnancy. NIPT is the most sensitive and specific screening test for the common fetal aneuploidies and reduces the need for invasive prenatal testing, with its associated risks.

AmpathChat #70 Cutaneous Manifestations of Covid-19

SARS-CoV2, the cause of COVID-19, was identified in Wuhan, Hubei, China, in December 2019. Its unrepentant worldwide spread led to the World Health Organisation (WHO) declaring a worldwide pandemic in early March 2020

AmpathChat #69 - Primary Hyperparathyroidism

Primary hyperparathyroidism (PHPT) is a disorder of mineral metabolism characterised by incompletely (PTH) regulated, excessive secretion of parathyroid hormone (PTH) from one or more of the four parathyroid glands. It is usually first suspected on the basis of an elevated serum calcium concentration (corrected for the albumin level), or symptoms thereof – the so called “bones, stones, moans and groans syndrome” (Table 1).

AmpathChat #67 - Update on Paternity Testing

The term paternity testing, parental testing and human identity testing are interchangeable. Paternity testing refers to the use of genetic fingerprinting to determine a biological parent-child relationship.

AmpathChat #66 - The aetiology, diagnosis and management of the vaginal discharge syndrome

The vaginal discharge syndrome may be secondary to vulvovaginitis or cervicitis. Both of these conditions have infectious and non-infectious aetiologies.

AmpathChat #57 Hypercalcaemia a Diagnostic Approach

Hypercalcaemia is a relatively common clinical problem. Primary hyperparathyroidism and malignancy are the most common causes of hypercalcaemia

AmpathChat #49 - Cystatin C

The prevalence of chronic kidney disease (CKD) and end- stage renal disease is increasing worldwide. Initial diagnosis relies on estimation of the glomerular filtration rate (GFR), and examination of urinary sediment and protein-excretion to establish the presence of kidney damage.

AmpathChat #46 - Screening and Diagnosis of Diabetes

Fasting glucose levels are affected by the duration of fasting and the effect of circadian rythmicity, the latter being the predominant factor. Both glucose and insulin levels are highest in the early morning,

AmpathChat #44 - Vitamin D Overview

After much consideration about the most appropriate cutoffs to define adequate vitamin D status, Ampath has decided to lower the currently reported cutoffs to those proposed by the Institute of Medicine, and recently endorsed by the National Osteoporosis Foundation of South Africa. According to these guidelines, a 25-hydroxyvitamin D level < 12 ng/ml is regarded as vitamin D deficient, with levels between 12 and 19 regarded as insufficient and levels of 20 ng/ml or above as sufficient.

AmpathChat #41 - Drugs of Abuse Screening

Drugs of abuse screening (DOAS) is well established in the workplace and in professional sports. It is increasingly being used in casualties and/or emergency departments for the medical management of patients with an altered mental state and in trauma patients.

AmpathChat #34 - Hypogonadism in the Elderly Male

Testosterone is the principal male sex hormone, and is secreted primarily by the Leydig cells of the testicles in the presence of luteinizing hormone (LH). Small amounts are also secreted by the adrenal glands. Testosterone plays a key role in the development of male reproductive tissues (testis and prostate),

AmpathChat #28 - Anti-Mullerian Hormone (AMH) Physiology and Clinical Utility

Anti-Müllerian hormone (AMH), previously termed Müllerian- inhibiting substance, is a 140 kDa dimeric glycoprotein belonging to the TGF-β (transforming growth factor beta) superfamily.

AmpathChat #27 - Diagnosis and Investigation of Occupational Exposure to Metals - A General Review

Exposure to metals in the workplace presents serious and significant health risks. The hazards that metals present are a function of the toxic properties of metals and include the duration, dose and route of exposure, and health history of the individuals exposed to them. Controlling and preventing metal exposures often involves a multidisciplinary team, usually beginning with the primary healthcare provider.

AmpathChat #24 - Laboratory Markers for Alcohol Use

Alcohol use disorders (AUD) were reclassified by the DSM-5i in 2013. The DSM-5 replaced the DSM-IV, which differentiated alcohol abuse (problem drinking without compulsive use) from alcohol dependence (compulsive drinking).

AmpathChat #18 - Chronic Kidney Disease - Updated Recommendations on Definition and Classification

Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for longer than three months, with implications for health.

AmpathChat #15 - Screening and Diagnosing Diabetes Mellitus During Pregnancy (Revised Criteria)

Gestational diabetes mellitus (GDM) has traditionally been defined as any degree of hyperglycaemia in pregnancy, including overt diabetes mellitus (DM), impaired glucose tolerance and impaired fasting glycaemia (as defined in the criteria for non-pregnant adults). The GDM guidelines had mainly focused on the increased risk of future maternal DM.

AmpathChat #06 - The Case of Newborn Screening in South Africa - A Personal Perspective

Newborn screening (NBS) is a public health measure that is recognised worldwide. It is aimed at the early screening, diagnosis and management of selected, inherited diseases. Such diseases are selected based on the current ability to detect and treat them, and the demonstration of the positive economic impact of such interventions.

AmpathChat #01 - A Practical Approach to the Biochemical Assessment of Osteoporosis

Recognising the risk of osteoporosis and starting preventative action timeously has become increasingly important. Annually, osteoporosis is responsible for around 9 million fractures worldwide. The lifetime risk of sustaining an osteoporotic fracture above the age of 50 years is up to 40% in women and 20% for men.