40 years of paediatric chemical pathology – a personal view

Abstract

My career in paediatric Chemical Pathology began in the early 1970s at the Royal Children's Hospital, Melbourne, and I retired from the Children's Hospital at Westmead in 2014. During that time, I have witnessed many advances in the field. Firstly, instrumentation has improved considerably, so that sample volumes have become much smaller. Centrifugal analysers were introduced in the 1970s, followed soon after in the 1980s by dry chemistry, which was particularly useful in paediatrics. In the 1990s, mass spectrometry became a powerful tool in paediatric biochemistry, especially in the diagnosis of inborn errors of metabolism. Specific methods have also improved, particularly with the almost universal use of enzymatic methods for creatinine measurement. Perhaps the greatest advances in paediatric biochemistry over the last 40 years have been in newborn screening, associated with the introduction of tandem mass spectrometry. Point of care testing has also shown great improvements, and more accurate paediatric reference intervals are now available. Blood collecting has shown advances over time, but the trauma of blood collection in babies remains. To maintain excellence in paediatric Chemical Pathology, pathologists in training should be encouraged to enter this field. My career in paediatric Chemical Pathology began in the early 1970s at the Royal Children's Hospital, Melbourne, and I retired from the Children's Hospital at Westmead in 2014. During that time, I have witnessed many advances in the field. Firstly, instrumentation has improved considerably, so that sample volumes have become much smaller. Centrifugal analysers were introduced in the 1970s, followed soon after in the 1980s by dry chemistry, which was particularly useful in paediatrics. In the 1990s, mass spectrometry became a powerful tool in paediatric biochemistry, especially in the diagnosis of inborn errors of metabolism. Specific methods have also improved, particularly with the almost universal use of enzymatic methods for creatinine measurement. Perhaps the greatest advances in paediatric biochemistry over the last 40 years have been in newborn screening, associated with the introduction of tandem mass spectrometry. Point of care testing has also shown great improvements, and more accurate paediatric reference intervals are now available. Blood collecting has shown advances over time, but the trauma of blood collection in babies remains. To maintain excellence in paediatric Chemical Pathology, pathologists in training should be encouraged to enter this field.