Module - Clinical Immunology in Histocompatibility and Immunogenetics (SLS122)

STP

Aim of this module

This module will provide the trainee with the practical application of knowledge and skills relating to a range of immunological conditions, including immunodeficiencies, hypersensitivities and allergies and haematological malignancies. This module will provide the trainee with knowledge and understanding of the scientific basis of organ transplantation. They will understand the clinical preparation of patients for organ transplantation and the principles and practice of immunogenetics. They will become familiar with methods that support transplantation and gain experience of the interpretation of patient results in a variety of clinical settings. The trainee should be based in or spend extended time in a histocompatibility and immunogenetics department.

Work-based learning outcomes


  1. Select appropriate methods for the diagnosis and management of a range of immunological conditions.
  2. Interpret and report results of clinical investigations undertaken in patients with:
    • immunodeficiency
    • hypersensitivity and allergy
    • haematological malignancies
    • a transplantation procedure
  3. Work in partnership with other clinical specialisms in the investigation and therapy for a range of immunological conditions and, where appropriate, with service users and support staff.

Work-based Competencies


Learning outcome Title Knowledge
1 1

Select the appropriate immunological assay to investigate whether the immune system of the patient is immunocompetent or immunodeficient and have the laboratory skills to undertake at least two of the following laboratory analyses:

  • assay of immunoglobulins and subclasses
  • neutrophil function tests
  • lymphocyte function tests
  • specific antibody responses to vaccine antigens
  • complement activity
  • cytokine production
  • molecular assays to define immunodeficiencies.
  • The range and appropriate selection of immunological assays used to investigate specific immunological conditions and the normal range for these.
  • Factors influencing the selection of assays.
  • The requirements of both internal and external quality control and assessment for immunodeficiency disease in an immunology laboratory.
  • How to assure the quality of personal practice.
2 2

Interpret immunological data in the light of clinical details on patients with primary immunodeficiency including:

  • deficiencies of innate immunity
  • B Lymphocyte deficiencies
  • T Lymphocyte deficiencies
  • combined T and B cell defects.
  • The correct clinical interpretation of each assay and the impact/implications of incorrect interpretation.
  • How to assure the quality of personal practice.
3 1

Select the appropriate immunological assay to investigate whether the immune system of the patient is producing an allergic response.

  • The range of immunological assays available for investigation of hypersensitivity and allergic response.
  • The selection and application of immunological assays in the investigation of hypersensitivity and allergic response.
  • How to assure the quality of personal practice.
4 2

Interpret allergy test data in the light of clinical details and on patients with a range of common allergies including:

  • food allergy
  • inhalant allergy
  • drug allergy.
  • Requirements for interpreting and reporting results with regard to correct timing of patient samples prior to and during investigation, i.e. pre and post therapy/clinical management.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
  • How to assure the quality of personal practice.
5 1

Select the appropriate immunological assay to investigate the immune system of patients with haematological malignancies such as:

  • Chronic lymphocytic leukaemia
  • Acute leukaemia
  • Lymphomas
  • Multiple myeloma
  • Waldenstrom’s macroglobulinaemia
  • Post BMT lymphocyte levels (immune reconstitution).
  • The importance of immunological data in the light of clinical details in patients with haematological malignancies prior to and during therapy.
  • The range of appropriate assays for the investigation of haematological malignancy.
  • The factors affecting the selection of appropriate immunological assay for investigation of haematological malignancies.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
  • How to assure the quality of personal practice.
6 2

Interpret data from immunological investigations, such as:

  • Flow cytometry
  • Morphological assays
  • Relevant molecular techniques
  • Electrophoresis
  • Free light chains
  • Immunoglobulin measurement.
  • The importance of correctly interpreting the data from these assays.
  • Correct interpretation of data from immunological investigations of haematological malignancy and its importance.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
  • How to assure the quality of personal practice.
7 3

Work in partnership with other clinical specialisms in the investigation of a range of immunological conditions and, where appropriate, with service users and support staff.

  • The need to build and sustain professional relationships both as an independent practitioner and collaboratively as a member of a team.
  • Methods of effective communication.
8 3

Communicate effectively with the healthcare team recognising and responding appropriately to situations where it is necessary to share information to safeguard service users or the wider public.

  • How communication skills affect assessment of, and engagement with, service users and how the means of communication should be modified to address and take account of factors such as age, capacity, learning ability and physical ability.
  • Situations where it is necessary to share information to safeguard service users or the wider public.
  • The limits of the concept of confidentiality.

Work-based assessment


Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Perform a test to measure IgE to an allergen
DOPS Perform the test to determine total IgE levels in the serum of a patient
DOPS Prepare DNA from a patient with a suspected haematological malignancy.
DOPS Perform flow cytometric immunophenotyping on a patient following bone marrow reconstitution to determine whether lymphocyte subsets are returning.
DOPS Perform analysis of a patients serum to determine levels of immunoglobulins IgG, IgM IgA
DOPS Perform the assay to determine the level of anti-tetanus Or anti-pneumococcus Or anti-Hib IgG antibodies in a patient serum sample
DOPS Perform the flow cytometric assay to determine the number of CD4 T cells
DOPS Perform the assay to determine the C3 and C4 levels in a patient sample
OCE Undertake a skin prick test on a patient and explain to the patient how it is used by the lab
OCE Observe a patch test on a patient and explain to the patient how it is used
OCE Take a patient history for a patient with a suspected allergic reaction.
OCE Attend an adult haematology clinic where haematological patients with myeloma may or may not have secondary immunodeficency and specifically note the types of laboratory assays that may be requested to assist in their management
OCE Attend a paediatric haematology clinic where haematological patients with acute leukaemias will be assessed and specifically note the types of laboratory assays that may be requested to assist in their management
OCE Take a history where the patient is suspected of having an immunodeficiency disorder
OCE Attend an outpatient clinic within any discipline gastro rheumatology, dermatology, renal etc where the patient may have an immunological dysfunction as part of their disease