June 18th 2015
Immunology Laboratory
The Churchill Hospital
Old Rd
Headington
Oxford
OX3 7 LJ
Tel: 01865 225983
Fax: 01865 225990
Email: Berne.Ferry@ouh.nhs.uk
Web site : ouh.nhs.uk/immunology
Dear Colleagues,
Re: ChangingoftechniqueforthemeasurementofIntrinsicFactorANDnewGuidelines
Aspartoftheimplementationofchangefollowingtherecentre‐procurementprocessattheOUHTrust,
themethodcurrentlyusedinImmunologytomeasureIntrinsicFactorantibodiesisabouttochange.
FromJune 2015wewillbeusingtheQuantaliteIntrinsicFactorassaysuppliedbyInova.Previouslywe
usedanAlphadiaELISA,suppliedbyAlphadiaLtd.
Verificationofthisnewassayhasbeencarriedbythelaboratoryaccordingtothestandardsoutlinedin
ISOstandard15189fordiagnosticlaboratories. Thishasincludedverifyinginternalandexternalquality
controls,levelsofuncertainty,precisionandreproducibility.Theconcordancebetweenourpreviousand
ournewassaysisexcellent.Resultswillcontinuetobereportedaspositiveandnegative.
Wehopethatthischangewillcauseminimumdisruptiontoyourclinicalwork.Pleasedonothesitateto
contactmeifyouhaveanyqueries
Re:
NEWGUIDELINEforrequestingIntrinsicFactors
Guidelines for the diagnosis and treatment of cobalamin and folate disorders
Vinod Devalia, Malcolm S. Hamilton, and Anne M. Molloy on behalf of the British Committee for
Standards in Haematology. British Journal of Haematology, 2014, 166, 496–513
Intheaboveguideline,thefollowingrecommendationsaremade:
1 Allpatientswithanaemia,neuropathyorglossitis,andsuspectedofhavingperniciousanaemia,should
betestedforanti‐IFABregardlessofcobalaminlevels(Grade1A).
2 Patientsfoundtohavealowserumcobalaminlevelintheabsenceofanaemiaandwhodonothavefood
malabsorptionorothercausesofdeficiency,shouldbetestedforIFABtoclarifywhethertheyhavean
early/latentpresentationofperniciousanaemia(Grade2A).
3 Anti‐GPCantibodytestingfordiagnosingperniciousanaemiaisnotrecommended(Grade1A).
Inthelightofthesenewrecommendations,theImmunologyDepartmentwillbehappytoperformIFAB
assaysasaninitialscreen.Tillnow,whentheImmunologydepartmentreceivedarequestforatestfor
perniciousanaemia,theprimaryassaywouldhavebeenAnti‐GPCantibodytest,wewillnowchangethe
primarytestforperniciousanaemiatoanIFABtesttocomplywiththesenewguidelines.Thefacilityto
requestIFABisonICEandshouldalsobeonEPRforourhospitalcolleagues.
Onceagain,pleasedonothesitatetocontactmeifyouhaveanyqueries
Yours sincerely
Professor BL Ferry