Laboratory Medicine is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of blood, cerebrospinal fluid, urine and other body fluids, as well as tissue, using the tools of chemistry, microbiology, hematology and molecular pathology. Clinical pathologists and board-certified doctoral scientists work in close collaboration with medical technologists and referring physicians to ensure the accuracy and integrity of diagnostic testing, ease of reporting, as well as stewardship of laboratory resources.
Outpatient Laboratories – The Outpatient Laboratories at Texas Children’s Hospital provide specimen collection services for patients at the Medical Center, West, and Woodlands campuses. These services are provided to registered patients of Texas Children’s Hospital.
The TCH Clinical Chemistry Laboratory provides STAT and routine laboratory test analysis in an automated, 24/7 laboratory. Testing is performed on serum, plasma, whole blood, urine, CSF and other body fluids. For more information, visit our Pathology Online Catalog.
Routine Services
Highlights of our comprehensive menu of testing services include:
Routine chemistry, using highly automated random access analyzers relying on multiple methodologies, include basic and comprehensive metabolic panels, lipid panels, liver, renal, cardiac panels
Bilirubin quantification including total, direct measurement of unconjugated and conjugated bilirubin
Therapeutic drug monitoring including immunosuppressant levels and other drugs
Testing for Immunoglobulins with a lower limit of quantification for pediatric patients, as well as immunoglobulin subclasses, measurements of complement C3 andC4
Hemoglobin Fractionation and Quantitation of major variant hemoglobins (Hgb S, Hgb C, Hgb F, Hgb A, Hgb A2) and unique identification of rare variants by high performance liquid chromatography (HPLC) as well as quantitation of plasma hemoglobin
Sweat Chloride – Quantification of sweat chloride by chloridometry, a reference method recommended by the Cystic Fibrosis Foundation
CSF Oligoclonal banding and identification of beta-2-transferrin in fluids by isoelectric focusing and electrophoresis with immunofixation
Blood Gas and Metabolite Analysis using the Radiometer ABL, 24/7
Alpha 1 Antitrypsin phenotyping for for Alpha 1 Antitrypsin deficiency by isoelectric focusing
Specialized tests such as busulfan pharmacokinetics, mycophenolic acids, anti-epileptic drugs are also offered
Clinical Metabolomics – Tests on the tandem LC-MS/MS, including antifungals, immunosuppressants, and important screening tests for congenital adrenal hyperplasia
Test for vitamin D for deficiency as well as status
Tests of sepsis, including procalcitonin, etc.
Send out tests – Those tests not on our menu can be sent out to reference labs as needed
Consultative
In order to ensure proper ordering or interpretation of our testing, professional staff in Chemistry, as well as clinical chemistry fellows, are always available via an on-call schedule to provide consultation. This is an added value service, performed at no charge. Please contact the Laboratory at 832-824-5152 for further assistance. For Chemistry supervisor, please call 832-824-5130 or for faculty, please call 832-826-1717. Clinical chemists review and interpret all hemoglobins, alpha 1 antitrypsin phenotyping, sweat testing, oligoclonal banding and transferrin immunofixation tests.
Clinical Chemistry Laboratory
Phone: 832-824-5152
Manager
Phone: 832-824-5143
Hematopathology is the study of diseases of blood cells (white blood cells, red blood cells, platelets) and cells/tissues/organs comprising the hematopoietic system (bone marrow, lymph nodes, spleen, thymus).
The hematopathologist works closely with hematologists and hematologist/oncologists to provide a comprehensive diagnosis incorporating all the relevant clinical, laboratory, and pathologic data in order to help make a decision about the best course of action for patients. Our team participates in education and training of medical students, residents, and fellows as well as in collaborative research projects. A hematopathologist is always on call for urgent scientific and medical problems which require a high level of expertise.
Our Services
Complete blood counts and review of peripheral blood smears
Urinalysis
Body fluid cell counts & differentials
Malaria smears, sickle cell screens, and sed rates (erythrocyte sedimentation rates or ESR)
Cytology of cerebrospinal fluid samples for patients with malignancies
Examination of bone marrow aspirate smears and biopsies
Flow cytometric immunophenotyping for the diagnosis of hematologic malignancies and in the diagnosis of paroxysmal nocturnal hemoglobinuria
Diagnosis of hemoglobinopathies
Review of specimens from outside hospitals for patients referred to TCH for management, as well as from other pathologists for second opinions. For more information, see Anatomic and Hematopathology Consults
Medical Microbiology
The Medical Microbiology laboratory strives to apply the science of Microbiology to the diagnosis and management of children with infections. Our goals are to improve the health of our patients by offering quality laboratory diagnostic services to clinicians, to enhance patient safety through best practices and continuous education, and to share our knowledge and expertise through training and education of medical students, residents, fellows and other trainees.
The Medical Microbiology laboratory is staffed by trained Medical Laboratory Scientists with a broad base of experience areas of bacteriology, antibiotic susceptibility testing, mycology, mycobacteriology and infectious disease serology. We partner closely with our Molecular Microbiology lab for additional tools including PCR based identification of bacterial resistance genes, and 16S gene sequencing for bacterial identification. Our medical director is readily available to consult and advise treating physicians, fellows and residents on the tests that we offer and discuss the implications of test results.
Medical Microbiology Laboratory
Phone: 832-824-2221
Manager
Phone: 832-824-2220
Timely Results:
We pride ourselves in delivering results in a timely manner. Turnaround times vary by test from a few hours to several days for particularly complex tests or slow-growing organisms.
MALDI-TOF mass spectrometry for organism identification
On-demand molecular testing for detection of C. difficile toxin and identification of organisms directly from blood culture bottles
Rotavirus (January through May)
Specimen Integrity:
Proper collection of a specimen for culture is the most important step in the recovery of pathogenic organisms responsible for infectious disease. A poorly collected specimen may yield false negative results and/or result in the recovery of contaminating organisms. Therefore, it is important to submit specimens that meet the specified requirements in both volume and integrity to ensure patient safety with accurate results leading to better patient outcomes (please see the TCH pathology online catalog for specifics regarding specimen collection requirements).
Virology
The Virology laboratory applies both traditional and advanced techniques to the science of clinical virology to aid in the diagnosis and management of children with viral infections. Our goals are to improve the health of our patients by offering quality laboratory diagnostic services to clinicians, to enhance patient safety by offering up to date viral epidemiology reports throughout the year, and to aid in continuous education of our medical students, residents, fellows and other trainees.
Virology Laboratory
Phone: 832-824-2280, Fax: 832-825-2283
Viral Culture:
Herpes Simplex Virus, Cytomegalovirus, Varicella, Zoster Virus, Picornaviruses (Enteroviruses and Rhinovirus), Influenza, RSV, Parainfluenza, and Adenovirus.
On-demand Rapid Molecular Testing:
Influenza A, Influenza B, Respiratory Syncytial Virus, and Enterovirus
Direct and Indirect Fluorescent Assays:
Herpes Simplex Virus, Varicella Zoster Virus
Viral Epidemiology Snapshot:
The combined report of all viruses detected at TCH by both virology and molecular microbiology can be found in our weekly and monthly publication “Viral Epidemiology Snapshot,” available on the TCH Pathology Online Catalog. The Snapshot application provides both a monthly and weekly surveillance report of the currently circulating viral pathogens at TCH; lookback at data for prior weeks or months is also supported. Reports generated by the application can be printed using instructions available via a hyperlink in the report.
Information available via the application includes:
Overall prevalence of currently circulating viruses as detected by culture and molecular methods
The distribution of influenza A sub-types currently circulating in the TCH patient population
Yearly trends for positivity of RSV, Influenza A, and Influenza B
Molecular Microbiology
The Molecular Microbiology laboratory employs state-of-the-art techniques and instrumentation that utilize nucleic acid amplification for rapid, accurate, and sensitive identification of bacteria and viruses. Our primary goal is to aid the physicians in the diagnosis and treatment of infections thus enabling the highest standard of patient care available in the industry today.
Viral load testing for CMV, EBV, Adenovirus, HHV-6, BK virus
Bartonella spp.
Bacterial identification by DNA pyrosequencing
Bacterial strain typing
Molecular Microbiology Laboratory
Phone: 832-824-5179
Manager
Phone: 832-824-5032
Point of Care Testing (POCT) is laboratory testing that takes place at or near the site where the patient is located. Decentralized patient care, including POCT, is a growing trend and decreases turnaround time as well as makes testing more accessible and affordable. POCT is a discipline where the laboratory and clinical areas overlap and allows not only technical administration of POCT devices or kits but also acts as a bridge between direct care providers performing POCT and the laboratory. Such relationships increase understanding about laboratory testing and promote excellence in patient care.
The TCH POCT division offers point of care training and competency as well as overall maintenance and functioning of POCT instruments for inpatient and outpatient areas of the hospital, including critical units and operating rooms. POCT also oversees TCH Health Centers (Clear Lake, Cy-Fair, Sugar Land, Bellaire, Kingwood) and acts in a consultative role for West and Woodlands Campus POCT and The Center for Women and Children. POCT also provide online competency modules for physicians performing provider performed tests.
