Here is an A-Z list of clinical conditions covered by Greater Manchester Immunology Service, together with the relevant immunological tests for each condition.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Acute leukaemia	Acute Leukaemia panel CD2, CD10, CD13, CD14, CD19, CD33, CD34, CD79a, CD117, TdT and MPO
Adrenal failure	Adrenal antibody, Ovary antibodies, Testis antibodies
Anaphylactoid reactions to drugs, etc	Refer patients to the combined Immunology/Anaesthetic clinic
Anaphylaxis	IgE (Total), Mast Cell Tryptase
Angioedema (Hereditary)	C1 esterase inhibitor, C1 esterase inhibitor functional test
Asthma	IgE (Total), Allergen specific IgE (ImmunoCAP)
Atopic Eczema	IgE (Total), Allergen specific IgE (ImmunoCAP)

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B

B cell enumeration	Immunodeficiency (T&B Lymphocyte Subsets)
Bernard-Soulier Syndrome	Platelet glycoprotein expression
Bird Fancier’s Disease	Avian precipitins
Bronchopulmonary Aspergillosis	Aspergillus fumigatus precipitins

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C

C1 esterase inhibitor deficiency (acquired)	C1 esterase inhibitor, C1q, Complement C3, Complement C4
Chronic lymphocytic malignancies/ lymphoma	Chronic lymphocytic/lymphoma panel: CD3, CD5, CD19, CD23, CD79b, Kappa chains, Lambda chains, FMC7, CD38
Coeliac Disease	Coeliac Disease Antibodies
Conjunctivitis	Allergen specific IgE (ImmunoCAP)
Cryoglobulinaemia (mixed)	Cryoglobulins

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D

Dermatitis herpetiformis	Coeliac Disease Antibodies
Dressler’s syndrome	Cardiac muscle antibodies

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F

Farmer’s Lung

Farmer’s lung precipitins (Micropolysporium faeni and T vulgaris)

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G

Glanzmann’s thrombasthenia	Platelet glycoprotein expression
Gonadal Failure	Ovary antibodies, Testis antibodies, Adrenal antibody
Goodpasture’s syndrome	Glomerular basement membrane antibodies

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H

Hereditary Spherocytosis (HS)

EMA Binding Assay (HS Screen)

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I

IgA nephropathies	Raised Immunoglobulins (IgG, IgA, IgM)
Immunodeficiency (Primary)	Immunodeficiency (T&B Lymphocyte Subsets)
Immunodeficiency (Secondary), HIV	Immunoglobulins (IgG, IgA, IgM), electrophoresis; CD4 count (T cell count) for patients with known HIV serology

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L

Lymphoproliferative disorders	Immunophenotyping for lymphoid (Chronic lymphocytic/lymphoma panel) and myeloid malignancies (Acute Leukaemia panel) (full clinical information required)
Liver autoimmunity	Smooth muscle mitochondrial antibodies; Liver kidney microsomal (LKM), Immunoglobulins (IgG, IgA, IgM)
Lymphoid/myeloid malignancies	Cell surface markers appropriate to diagnostic information provided

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M

Mixed connective tissue disease	ENA antibodies, particularly RNP Ab to ENA including Sm, Sm/RNP, RNP(RNP A, RNP68), Ro(SS-A52 SSA60), La(SS-B), Ribo P, Scl-70, Jo-1 and Chromatin
Motor neuropathy	Ganglioside Antibodies GM1
Myasthenia gravis	Acetyl Choline Receptor Antibodies

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N

Necrotising crescentic glomerulonephritis	Myeloperoxidase (MPO) antibodies (p-ANCA)
Nephrotic syndrome	Immunoglobulins (IgG, IgA, IgM)

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P

Paraproteinaemia, Myeloma	Immunoglobulins (IgG, IgA, IgM) (including immunofixation), Free Light Chains, Bence Jones protein (Urinary light chains) Urine immunofixation: β2 Microglobulin
Pemphigus/ Pemphigoid	Skin antibodies, Immunohistology
Polyendocrine Autoimmunity	Adrenal antibody, Ovary antibodies, Testis antibodies, Islet Cell Antibodies, Ab to gastric parietal cells. Additional: Antinuclear antibody (ANA), includes anticentromere, Smooth muscle mitochondrial antibodies, Acetyl Choline Receptor Antibodies (if indicated)
Polymyositis/ Dermatomyositis	Antinuclear antibody (ANA), includes anticentromere, antibodies to Jo-1 ENA includes: Sm, Sm/RNP, RNP(RNP A, RNP68), Ro(SS-A52 SSA60), La(SS-B), Ribo P, Scl-70, Jo-1 and Chromatin
Primary anti-phospholipid antibody syndrome	Anti-phospholipid antibodies, Cardiolipin (IgG and IgM) antibodies

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R

Recurrent foetal loss	Ab to phospholipids, Cardiolipin (IgG and IgM) antibodies
Rhinitis	IgE (Total), Allergen specific IgE (ImmunoCAP)

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S

Scleroderma/ systemic sclerosis	Antinuclear antibody (ANA), includes anticentromere (CREST). Antibodies to Scl-70. ENA  includes: Sm, Sm/RNP, RNP(RNP A, RNP68), Ro(SS-A52 SS-A60), La(SS-B), Ribo P, Scl-70, Jo-1 and Chromatin
Sjögren’s syndrome	Antinuclear antibody (ANA), includes anticentromere, antibodies to extractable nuclear antigens (ENA ) includes Ro, La
SLE	Antinuclear antibody (ANA), includes anticentromere (includes anticentromere), Double stranded DNA antibodies (IgG), Ab to ENA  includes: Sm, Sm/RNP, RNP(RNP A, RNP68), Ro(SS-A52 SSA60), La(SS-B), Ribo P, Scl-70, Jo-1 and Chromatin Other indicators include: Raised IgG Immunoglobulins (IgG, IgA, IgM), electrophoresis, Low Complement C3, Complement C4
Systemic Autoimmune Disease	Antinuclear antibody (ANA), includes anticentromere (includes anticentromere), Rheumatoid factor, Immunoglobulins (IgG, IgA, IgM)

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T

TB (latent)	Gamma Interferon (Quantiferon)
Thyroid Disease	Thyroid peroxidase (TPO) antibodies

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U

Urticaria (Acute)

IgE (Total), Allergen specific IgE (ImmunoCAP)

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V

Vasculitis (Primary systemic)	Wegener’s, Churg-Strauss, Microscopic polyarteritis, Henoch-Schönlein Purpura, Kawasaki’s Syndrome – Antinuclear antibody (ANA), includes anticentromere (includes anticentromere), Myeloperoxidase (MPO) antibodies (p-ANCA), PR3 autoantibodies (cANCA), Immunoglobulins (IgG, IgA, IgM)electrophoresis, IgE (Total), CRP (Biochemistry)
Vasculitis (small vessel hypersensitivity)	Antinuclear antibody (ANA), includes anticentromere, Rheumatoid factor, Complement C3, Complement C4, Cryoglobulins, Immunoglobulins (IgG, IgA, IgM), electrophoresis, Anti-neutrophil cytoplasmic antibody (ANCA)

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(Last reviewed September 2024)