Chemical Pathology

Chemical Pathology as a sub-speciality within pathology extends across most medical specialities and involves the chemical analysis of bodily fluids (blood – whole blood, serum or plasma; urine; cerebrospinal fluid; and other fluids such as effusions, seminal fluid, sweat and amniotic fluid) to assist in the diagnosis of various disease processes. Laboratory medicine in general and Chemical Pathology in particular is therefore an essential tool to assist clinicians in the diagnosis of various disorders, as well as management and follow-up of patients.

Day in the life of a Chemical Pathologist

Chemical Pathology deals with the entire range of disease and encompasses detecting changes in a number of substances in blood and body fluids (such as electrolytes, enzymes and proteins).

The Chemical Pathologist, as a medical specialist with knowledge of general medicine as well as detailed specialised knowledge of laboratory methods, has a wide variety of functions within the clinical laboratory, including:

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Providing a consultation service to clinicians to advise on the most appropriate testing within specific clinical situations

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Advice regarding the limitations of laboratory tests in specific circumstances

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Ensuring the quality of laboratory testing through internal and external quality assurance

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Training of medical students in the appropriate selection of clinical laboratory testing and the most cost effective and appropriate use of the clinical laboratory

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Interpretation of a wide variety of clinical laboratory tests

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Advice on the influence of “pre-analytical” factors, medications and other factors on laboratory tests which may influence clinical decision making

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Introduction of new tests, since medicine and clinical testing is a rapidly evolving science and new tests are developed continuously

The clinical laboratory is an extremely useful tool in the diagnosis, management and follow up of a wide range of conditions. Despite the sophisticated nature of modern laboratory testing, the importance of strict adherence to basic guidelines cannot be overstated. As such, the patient can play an important role in ensuring the quality and therefore the cost effectiveness and value of the laboratory testing process by paying particular attention to the following aspects:

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Understanding the “pre-analytical” requirements of the tests being performed – an example would be a lipogram or glucose which should generally be performed when the patient is fasting

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Understanding why a specific test is being performed

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Understanding the effect of possible medications on the specific test being requested

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Understanding procedures such as 24 hour urine collection where procedure followed incorrectly could lead to falsely abnormal test results

The golden rule to maximise the value of laboratory testing from the patient’s point of view, is for the patient to seek advice from the laboratory whenever there is uncertainty regarding the procedure to be followed in preparation for a specific laboratory test.

Examples of analyses performed within the Chemical Pathology laboratory:

  • Water and electrolyte balance and kidney function
  • Acid base balance
  • Liver function
  • Minerals such as calcium, magnesium and phosphate
  • Proteins and enzymes
  • Lipids such as cholesterol and triglycerides and risk factors for heart disease
  • Diagnosis of diabetes mellitus and it’s complications
  • Cardiac markers for detection of cardiac damage
  • Iron and porphyrins
  • Endocrinology, including:
    • Pituitary function
    • Sex hormones
    • Thyroid function
    • Adrenal hormones
  • Tumour markers such as Prostate specific antigen (PSA) and various other markers used in the detection and management of cancer patients
  • Inherited metabolic diseases
  • Therapeutic Drug Monitoring (TDM)
  • Drugs of abuse testing
  • Allergy testing

In addition, the Chemical Pathology laboratory performs specialised testing including:

  • Occupational Health testing (monitoring of exposed workers)
  • Insurance testing
  • Environmental testing (water analysis, etc.)

Our team of professionals with expertise in this field:

Dr Marita Van Leeuwen
Chemical Pathologist
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Dr Mariza Hoffmann
Chemical Pathologist
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Dr Pierre Schoeman
Clinical Pathologist
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Dr Wessel Meyer
Chemical Pathologist
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Dr Younus Essack
Chemical Pathologist
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