Oct 30, 2023 | Chemical Pathology
Chemical Pathology Occupational HealthThe monitoring of cholinesterase levels plays a fundamental role in assessing exposure to organophosphates and carbamate pesticides. The biological monitoring of workers exposed to organophosphate or carbamate is a legal requirement in South Africa, in terms of the “Regulations for Hazardous Chemical Substances 1995” under section 43 of the Occupational Health and Safety Act (Act No. 85 of 1993)....
Sep 12, 2023 | Virology
Rubella Antenatal ProfileRubella virus causes the classic childhood exanthem sometimes referred to as German measles. Although this vaccine-preventable illness generally causes mild symptoms, particularly in children, primary rubella during pregnancy may have devastating consequences....
Aug 29, 2023 | Haematology
Full Blood Count (FBC)In June 2023, Ampath adopted a new set of reference intervals applicable to Full Blood Counts (FBCs) performed on adults. The rationale for the change was to ensure that reference intervals are as representative as possible of our diverse South African population whilst continuing to comply with local and international standards, namely South African National Accreditation System (SANAS) and Clinical and Laboratory Standards Institute (CLSI)....
Jul 10, 2023 | Genetics
PharmacogenomicsAmpath is proud to be a leading provider of pharmacogenomic testing (PGT) in South Africa. PGT investigates the way an individual’s genetic makeup influences their response to various types of medication. Evidence supporting the clinical benefit of PGT has been growing steadily. Internationally, several professional bodies are now advocating for the implementation of PGT into primary care services. One of the largest published multicentre studies to date demonstrated a 30% reduction in clinically relevant adverse drug reactions using pre-emptive PGT within diverse healthcare settings across seven European countries....
Jun 19, 2023 | Haematology
Thrombotic Thrombocytopenic Purpura (TTP)Thrombotic thrombocytopenic purpura (TTP) is a rare disorder with high mortality. A high index of suspicion and early communication with the haematologist is pivotal to improve outcome....
Jun 15, 2023 | Genetics
Immunology Tissue typing HLA typingHLA typing is performed by sequencing the DNA. This method is robust, specific and reproducible, which, in turn, allows for accurate and higher-resolution typing between the donor and the recipient. HLA typing by next-generation sequencing (NGS) is considered to be the gold standard of tissue typing methods internationally....
Apr 26, 2023 | Immunology
Autoimmune Encephalitis EncephalitisAutoimmune encephalitis is caused by autoantibodies against intracellular, membrane or synaptic neuronal proteins.¹ The prevalence and incidence of AE is comparable to infectious encephalitis, and its detection is increasing over time. Several clinical syndromes and diagnostic variants have been described. The nomenclature may be confusing since the clinical spectrum is wide, and all presentations have underlying autoimmune insults to neurons.²...
Mar 31, 2023 | Genetics
Ampath is one of the leading providers of comprehensive genetic testing in South Africa. The Oncomine™ Precision Assay (OPANGS) is the latest in a string of state-of the-art technologies being offered that allows for the simultaneous investigation of several solid tumour malignancies using a singular approach....
Dec 08, 2022 | Genetics
GeneticsIt is well established that unique patient characteristics exist to guide therapeutic drug decision making. These assist in optimising drug response and minimising adverse drug reactions (ADRs), and include age, weight, diet, co-morbidities, liver and renal function, as well as drug-drug interactions....
Aug 16, 2022 | Genetics
Dr Janin Alant
OncologyWith the advent of next-generation sequencing (NGS) and tumour genomic profiling, it has however become apparent that significant mutational overlap exists between these disorders, and that many of them might, in fact, be viewed as different evolutionary phases of the same disease....
Aug 15, 2022 | Microbiology
Dr Marieke Brauer, Dr Sylvia van den Berg, Dr Cathy van Rooyen
COVID-19While a large component of research into the adaptive responses has focused on the humoral (antibody) component of the immune response, and particularly neutralising antibody responses, it is also crucial to understand the role of the cellular immune response to COVID-19 infection, vaccination and SARS CoV-2 variants of concern....
Dec 01, 2021 | Microbiology
Dr. Marieke Brauer, Dr Cathy van Rooyen, Dr Marcelle Myburgh
COVID-19 Infectious DiseasesSeveral developments have occurred since the authorisation and introduction of SARS-CoV-2 (COVID-19) antibody tests in South Africa in August 2020. This AmpathChat provides an update on the latest COVID-19 antibody tests available at Ampath as of November 2021 in order to guide testing....
Nov 01, 2021 | Microbiology
Dr. Marieke Brauer
COVID-19 Infectious DiseasesDiagnostic testing plays a critical role in the strategy to prevent COVID-19. While nucleic acid amplification tests such as the reverse transcriptase polymerase chain reaction (RT-PCR) remains the gold standard reference method to detect SARS-CoV-2 (the virus that causes COVID-19), these assays are generally expensive and usually require laboratory facilities, mostly with longer turnaround times. There is an ever-growing need for faster and more cost effective diagnosis tests that can be performed near the individual being tested....
Jul 31, 2021 | Chemical Pathology
CardiovascularThe management of cardiovascular disease has seen unprecedented progress in previous decades. Critical advancements have been made in the recognition and treatment of major traditional risk factors, including dyslipidaemia, high blood pressure, hyperglycaemia, inflammation and unhealthy lifestyle for atherosclerotic cardiovascular disease (ASCVD)....
Apr 08, 2021 | Microbiology
Dr Marieke Brauer, Clinical Virologist
COVID-19 Infectious DiseasesThe 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....
Sep 03, 2020 | Infectious Diseases
Dr. Marieke Brauer
COVID-19Implement the most current version of regulations on health and safety measures to reduce and eliminate the escalation of Covid-19 infections in the workplace, as determined by the Department of Employment and Labour....
Aug 01, 2020 | Chemical Pathology
Dr Shaun Naicker
Chemical PathologySARS-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...
Jun 01, 2020 | Chemical Pathology
Dr Yashna Rampursat
Chemical PathologyPrimary 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”....
May 01, 2020 | Immunology
Dr Cathy van Rooyen
ImmunologyAmpath would like to inform you of the availability of a new SARS-CoV-2 antibody test. This test may be used to determine whether a patient has previously been exposed to SARS-CoV-2, the virus causing COVID-19....
May 01, 2020 | Chemical Pathology
Dr Irma Ferreira
Chemical PathologyThe 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....
Feb 01, 2020 | Chemical Pathology
Dr Henno Olivier
Chemical PathologyThe vaginal discharge syndrome may be secondary to vulvovaginitis or cervicitis. Both of these conditions have infectious and non-infectious aetiologies....
Jan 01, 2020 | Chemical Pathology
Dr Henno Olivier
Chemical PathologyWorldwide, primary lung cancer remains the most common malignancy after non-melanocytic skin cancer. The World Health Organization (WHO) estimates lung cancer to be responsible for 1.59 million deaths globally per year, with smoking playing a major contributory role in 70% of cases....
Jan 01, 2020 | Haematology
-, Dr Debbie Jafta, Dr Carla Griesel, Dr Karen van Helden, Dr Johan van Wyk
HaematologyVitamin B12 deficiency can lead to devastating disabilities, morbidity and even death if not diagnosed timeously. Prompt diagnosis and treatment of Vitamin B12 deficiency can easily reverse the wide range of debilitating neurological and hematological symptoms associated with Vitamin B12 deficiency....
Nov 01, 2019 | Immunology
Dr Sylvia van den Berg (Ampath), Dr Cathy van Rooyen, Pathologist, Immunology
ImmunologyPatients suffering from recurrent infections, autoimmunity or lymphoproliferative disease may have an underlying humoral immunodeficiency....
Oct 01, 2019 | Haematology
Dr Boitumelo Phiri-Ramongane, Chemical Pathologist
HaematologyIn 2016 the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) revised guidelines for the management of Dyslipidaemia....
Sep 01, 2019 | Haematology
Dr Pamela Moodley MBBCh, FCPath (SA) Haematology
HaematologyHaematopoietic stem cell transplantation (HSCT) is any procedure where haematopoietic stem cells of any donor and any source are given to a recipient with the intention of repopulating the haematopoietic system in total or in part....
Jun 01, 2019 | Chemical Pathology
Dr Devina Govender
Chemical PathologyHypercalcaemia is a relatively common clinical problem. Primary hyperparathyroidism and malignancy are the most common causes of hypercalcaemia...
Jun 01, 2019 | Chemical Pathology
Sarah Walters (MSc (Med) Genetic Counselling) Ampa
Chemical PathologyCystic fibrosis (CF) is one of the most common life-limiting autosomal recessive conditions in South Africa. CF is increasingly being recognised in all of South Africa....
Apr 01, 2019 | Chemical Pathology
Dr Petri Swanepoel
Chemical PathologyAmpath Immunology is proud to announce the introduction of HLA tissue typing and antibody screening using Luminex PCR-based multiplex technology....
Apr 01, 2019 | Infectious Diseases
Dr Ebrahim Hoosien
Infectious DiseasesHelicobacter pylori is a highly prevalent curved gram-negative bacterium. Seropositivity rates in South-Africa range between 60% and 100%. It causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers. Atrophic gastritis due to H. pylori can lead to gastric cancer....
Apr 01, 2019 | Histopathology
Dr Robert M. Maritz & Dr Jaysen Knezovich
HistopathologyColorectal carcinomas arise from colorectal epithelium, which has undergone a series of molecular changes, referred to as the adenoma-carcinoma progression sequence. With increasing genetic mutations, progression from normal epithelium to adenomas with dysplasia occurs. Eventually, adenomas that show high-grade dysplasia give rise to invasive colorectal carcinomas....
Jan 01, 2019 | Histopathology
Dr Carolyn Fedler & Dr Piet Swanepoel
HistopathologyAll individuals with a positive family history of breast or ovarian cancer are not equally at risk. The likelihood that BRCA testing will be informative should be assessed prior to testing....
Dec 01, 2018 | Immunology
Dr Louise Murray & Dr Cathy van Rooyen
ImmunologyPenicillin allergy is the most commonly reported antibiotic allergy. However, very few patients ever have their penicillin allergy confirmed. Furthermore, less than 20% of patients who report a positive history of a prior reaction to penicillin are found to be allergic to penicillin upon skin prick testing. Avoidance of penicillin based on self-reported allergic history alone often leads to the use of an alternate antibiotic with greater cost or side effect profile....
Dec 01, 2018 | Infectious Diseases
Dr Kathy-Anne Strydom & Dr Marcelle Myburgh
Infectious DiseasesPertussis, also known as whooping cough, is a highly infectious disease of the respiratory tract. Bordetella pertussis is classically regarded as the sole agent of pertussis. However, infection with other Bordetella species, such as B. parapertussis and B. holmesii, can cause a similar, though typically milder, clinical picture....
Sep 01, 2018 | Chemical Pathology
Dr Marita du Plessis
Chemical PathologyThe 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....
Jul 01, 2018 | Genetics
Dr Jaysen Knezovich
GeneticsAmpath Genetics is excited to announce the introduction of products of conception (POCs) testing using next generation sequencing (NGS) technology. NGS allows analysis of all chromosomes (1-22, X and Y), resulting in significantly increased pick-up rates of chromosomal abnormalities when compared to conventional testing approaches....
Jun 01, 2018 | Infectious Diseases
Dr C Kingsburgh
Infectious DiseasesClinicians are faced with a growing population of immuno-compromised patients who are at risk of systemic infections. The diagnosis of bacterial septicaemia is unfortunately not straightforward. Positive blood cultures remain the gold standard....
Jan 31, 2018 | Chemical Pathology
Dr Marita du Plessis
Chemical PathologyFasting 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,...
Jun 02, 2017 | Chemical Pathology
Dr Marita du Plessis
Chemical PathologyAfter 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....
Jun 01, 2017 | Haematology
Dr Rita Govender
HaematologyThe extent of evaluation and the nature of intervention depends on duration, severity and clinical findings. The normal absolute neutrophil count (ANC) in adults is 1.5 to 7 x 10/9 per l. The following grading evolved from clinical experience with patients on cancer chemotherapy....
Feb 28, 2017 | Infectious Diseases
Dr Jackie Chokoe- Maluleke
Infectious DiseasesThe frozen section technique has evolved and has improved immensely from 1818, when Dutch anatomist Pieter de Reimer utilised cold brine (salt water) to harden tissues, until 1895, when Thomas Cullen, MD, published the first written frozen section technique from Johns Hopkins....
Feb 28, 2017 | Chemical Pathology
Dr N. Lutchman & Dr M. du Plessis
Chemical PathologyDrugs 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....
Feb 28, 2017 | Infectious Diseases
Dr Pieter Ekermans & Dr Xoliswa Poswa
Infectious DiseasesThe urine lipoarabinomannan test (U-lam) has been marketed as an adjunct diagnostic modality in HIV-infected patients with severe immunosuppression. The test detects a cell wall component of the Mycobacterium tuberculosis bacterium that is excreted in urine. The lateral flow test format of the test (Determine TM TB-LAM Ag test) is rapid and can be performed directly on urine....
Feb 28, 2017 | Haematology
Dr Ingrid Aronson
HaematologyAnaemia of chronic disease (ACD)/inflammation is the leading cause of anaemia in hospitalised patients and the second-most common cause of anaemia after iron deficiency. The main aetiologies are infection, autoimmune disorders and malignancies....
Feb 28, 2017 | Immunology
Dr Cathy van Rooyen
ImmunologyPrimary immunodeficiencies (PID) are a diverse group of inborn errors in immunity. PID can present at any age, with the more severe forms presenting in infancy. Due to the heterogeneity of presentation and age of onset, the diagnosis of PID is often delayed or missed. There are at least 300 known genetic defects resulting in PID....
Feb 28, 2017 | Infectious Diseases
Dr Jennifer Coetzee
Infectious DiseasesDr Tom Frieden, Director of the US Centres for Disease Control and Prevention, has called carbapenem-resistant Enterobacteriaceae (CRE) “nightmare bacteria”. CRE emerged in South Africa in 2011 when the first cases of Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM) were described....
Feb 28, 2017 | Chemical Pathology
Dr David Haarburger
Chemical PathologyTestosterone 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),...
Feb 28, 2017 | Genetics
Dr Lerato Nokoane
GeneticsBreast cancer is the most common cancer among women worldwide, with approximately 1.7 million cases diagnosed annually. In South Africa, the incidence is 40 new cases per 100 000 persons per year. The incidence of breast cancer varies across the world between races and regions....
Feb 28, 2017 | Immunology
Dr Cathy van Rooyen
ImmunologyAllergic rhinitis and inhalant allergy are common problems in primary care. Their diagnosis and subsequent management are often suboptimal. This may impact on a patient’s quality of life, asthma control and exacerbations....
Feb 28, 2017 | Infectious Diseases
Dr Marcelle Myburgh
Infectious DiseasesIt is important that healthcare workers (HCWs) know the steps to follow when an accidental exposure to infectious bodily fluids occurs. Viruses that can be transmitted after occupational exposure to potentially infectious bodily fluids include HIV....
Feb 28, 2017 | Chemical Pathology
Dr Marita du Plessis
Chemical PathologyAnti-Müllerian hormone (AMH), previously termed Müllerian- inhibiting substance, is a 140 kDa dimeric glycoprotein belonging to the TGF-β (transforming growth factor beta) superfamily....
Feb 28, 2017 | Chemical Pathology
Dr Nereshni Lutchman
Chemical PathologyExposure 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....
Feb 28, 2017 | Infectious Diseases
Dr Adrian J Brink
Infectious DiseasesThe majority of antibiotic prescriptions for systemic use are prescribed in the outpatient setting with acute respiratory tract infections (ARTIs) being the most common indication, followed by urinary tract infections (UTIs). In fact, general practitioners (GPs) prescribe approximately 80% of all antibiotics,...
Feb 28, 2017 | Chemical Pathology
-, Dr René van der Watt
Chemical PathologyAlcohol 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)....
Feb 28, 2017 | Haematology
Dr Rita Govender
HaematologyA standard incision is made on the volar surface of the forearm with the application of 40 mmHg pressure to the upper arm. Time to cessation of bleeding is recorded....
Feb 28, 2017 | Haematology
Author: Kim Alexander - Editor: Dr Bennie Vorster
HaematologyMost patients who receive unfractionated heparin experience a small, quick drop in their platelet count. This is called Type 1 HIT and is clinically insignificant....
Feb 28, 2017 | Haematology
Dr Pamela Moodley
HaematologyUpon presentation, all patients should be carefully evaluated for clinical pretest probability of VTE using a validated clinical prediction rule (CPR) and then stratified into clinical probability groups: low, intermediate and high. The Wells prediction rules for DVT and for pulmonary embolism have been validated and are frequently used to estimate the probability of VTE before performing more definitive testing on patients....
Feb 28, 2017 | Haematology
Author: Kim Alexander - Editor: Dr Bennie Vorster
HaematologyWith the exception of pregnant women and neonates, the presence of immature granulocytes (IG) in the blood indicates a response to infection, inflammation or other stimuli of the bone marrow. Having a six-part differential count facilitates new diagnostic possibilities. The IG count includes stab cells, metamyelocytes and myelocytes, and requires a specific Sysmex analyser (XE-2100) for determination....
Feb 28, 2017 | Infectious Diseases
Dr Marita du Plessis
Infectious DiseasesChronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for longer than three months, with implications for health....
Feb 28, 2017 | Haematology
Author: Kim Alexander - Editor: Dr Bennie Vorster
HaematologyHaemostasis is the delicate balance between the naturally occurring procoagulant and anticoagulant mechanisms found in the body. Any shift in this balance or interference in the control mechanisms results in either a bleeding or a thrombotic tendency....
Feb 28, 2017 | Chemical Pathology
Dr Jessica Trusler, Dr Marietjie Meyer, Dr Carolyn, Dr Marita du Plessis
Chemical PathologyGestational 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....
Feb 28, 2017 | Haematology
Dr Pamela Moodley
HaematologyAcquired Haemophilia A is a rare bleeding disorder caused by an autoantibody to factor VIII. The condition is often mistaken for other acquired bleeding disorders, such as disseminated intravascular coagulation (DIC). This may lead to delayed or suboptimal treatment. There is a poor correlation between measurable factor VIII or strength of the inhibitor and severity of bleeding....
Feb 28, 2017 | Immunology
Dr Mark Cruz da Silva
ImmunologyEncephalitis (inflammation of the brain) is a pathological diagnosis, yet the diagnosis is made clinically. Diagnosis is made through the observation of neurologic dysfunction (e.g. depressed level of consciousness, seizures etc.) combined with corroborating findings of a cerebrospinal fluid (CSF) tap, EEG and neuroimaging studies....
Feb 28, 2017 | Haematology
Dr Carol Moore
HaematologyA pseudo (false) thrombocytopenia, due to either a difficult bleed or ethylenediamine- tetraacetic acid (EDTA)-related platelet clumping, should be excluded by examining a peripheral blood (PB) slide or repeating the platelet count using a sodium citrate tube....
Feb 28, 2017 | Haematology
Dr Carol Moore
HaematologyThere are three main possibilities for a microcytic anaemia, namely iron deficiency, thalassaemia and anaemia of chronic disease (ACD). Since iron deficiency is the most common cause of a microcytic anaemia, a ferritin level is recommended as an initial investigation. A low ferritin level confirms iron deficiency. A normal or raised ferritin level suggests possible thalassaemia or ACD....
Feb 28, 2017 | Haematology
Dr Ingrid Aronson
HaematologyThe myelodysplastic syndromes (MDS) are a group of clonal haematopoietic disorders characterised by progressive bone marrow failure due to ineffective haematopoiesis. There are progressive cytopenias involving one or more of the myeloid cell lines, with a variable increased risk of development of acute leukaemia....
Feb 28, 2017 | Haematology
Dr Rita Govender, Haematologist
HaematologyThe decision to transfuse a blood product by the clinician requires an evaluation of the risk benefit ratio for the individual patient and documented informed consent....
Feb 28, 2017 | Chemical Pathology
Dr Chris Vorster
Chemical PathologyNewborn 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....
Feb 28, 2017 | Immunology
Dr Cathy van Rooyen
ImmunologyScreening for severe primary immunodefi- ciencies involving the cellular and humoral immune system allows early detection and treatment, potentially saving the lives of babies affected by the disease....
Feb 28, 2017 | Immunology
Dr Sylvia van den Berg and Dr Cathy van Rooyen
ImmunologyPrimary immunodeficiencies are a group of heterogenous genetic disorders that cause an enhanced susceptibility to recurrent and severe infections....
Feb 28, 2017 | Immunology
Dr Sylvia van den Berg (Ampath)
ImmunologyCoeliac disease used to be a disease of infancy, with children presenting with life-threatening malabsorbtion. Currently and more commonly, the disease presents between the ages of 10 and 40 with milder manifestations....
Feb 26, 2017 | Chemical Pathology
Dr Elza Coetzee
Chemical PathologyRecognising 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....