Dr michelle muscat MD MRCS(Ed) MSc

C hemical pathology is a somewhat lesser known medical subspecialty. It is also known as clinical biochemistry or clinical chemistry. It comprises an array of laboratory investigations that range from simple routine tests such as renal, liver and lipid profiles to cardiac markers, endocrine investigations, therapeutic drug monitoring and many other tests within the clinical chemistry repertoire. These investigations are central to clinical pathways.

Chemical pathology also shows great promise in the research arena. There are numerous emerging new biomarkers that are finding their way into clinical use, for example, heart-type fatty acid binding protein (hFABP) which is a recent cardiac biomarker, carbohydrate-deficient transferrin (CDT) for alcohol abuse, and many more.

Chemical Pathology is currently included in the University of Malta medical course third year undergraduate pathology module. Medical and scientific advances in the field of chemical pathology impinge directly on other medical specialties, since biochemical tests are pivotal in the diagnosis and management of numerous medical conditions.

Notwithstanding the fact that the use of clinical chemistry tests is virtually ubiquitous in clinical practice, it is still somewhat one of the lesser known disciplines or ‘Cinderella specialties’ of the medical profession.