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General Information

Advanced Technology Laboratory, Flow Cytometry, General Information

PNH Flow Cytometry Test Results

High sensitivity flow cytometry testing for paroxysmal nocturnal hemoglobinuria (PNH) is a test done on patient’s peripheral blood to screen for the presence or absence of PNH clones and/or to follow PNH clonal populations.  The lower limit of detection of a PNH clone for the Spectrum Health laboratory has been validated as 0.01% (1:10,000) for red cells, 0.01% (1:10,000) for granulocytes and 0.1% for monocytes (1:1000).

The results from PNH flow cytometry testing can guide the clinical team in classifying a patient’s disease appropriately, analyzing the risk of disease progression, and choosing appropriate testing to monitor response to treatment. Therefore, the PNH flow cytometry test result will now include a pathologist’s interpretation based on the new recommendations given in Updated ICCS/ESCCA Consensus Guidelines for the Clinical Utility of Testing for GPI-Anchor Deficient Clones in Paroxysmal Nocturnal Hemoglobinuria (PNH) and other Bone Marrow Disorders (Accepted article by Dezern and Borowitz, doi: 10.1002/cyto.b.21608).

Referral/Sendouts, Test Utilization

Anti-Thyroglobulin Orders Received in Conjunction with Thyroglobulin Tumor Marker Orders

Effective immediately, Anti-Thyroglobulin (Anti-TgAb) requests if received in conjunction with Thyroglobulin Tumor Marker (Tg-TM) requests, will be canceled. Tg-TM tests are sent to Mayo Medical Laboratory; where both Tg-TM and Anti-TgAb are performed and resulted as part of the Tg-TM order. This is a laboratory best practice as anti-thyroglobulin autoantibodies (Anti-TgAb), which occur in 15% to 30% of thyroid cancer patients, could lead to misleading Tg results (falsely positive or falsely negative).

Questions may be directed to Dr. David Alter, using the “Contact Us” link above.

General Information

Faxing Orders to Outpatient Laboratories

Spectrum Health Regional Laboratory now has ONE centralized fax number to which you can send your lab orders! This means no more searching for the fax number for a particular draw site for your patient. We will enter the faxed orders into our system, making them available to ALL of our draw sites; so your patient will have access to their order at their favorite draw site and the added convenience of going to any draw site that they choose!

*The new fax line number is: 616-774-7696

 *If you are faxing an order for a patient that plans to go to a draw site immediately, please write “Patient En Route” on the order, so that it may be prioritized.

 * Please note: Specimen add-on orders (additional tests for specimens in-lab) are still faxed to 616-267-2751, as stated on the add-on form.

Microbiology, Test Utilization

Influenza Epidemic Testing Recommendations 2018

Influenza is currently widespread throughout the nation at epidemic proportions. During influenza epidemics, clinical assessment predicts the presence of influenza infection virtually as well as laboratory testing. Therefore, it is no longer necessary to perform viral testing on ambulatory patients who present with illness consistent with influenza before beginning antiviral treatment. Antiviral treatment for Influenza should be started as soon as possible to have a beneficial effect.

Shortages of supplies and medications frequently occur during Influenza epidemics. However, diagnosis of specific viral respiratory infection remains important for hospitalized patients.

Please follow the current recommendations:

  • Limit availability of viral transport media at ambulatory sites.
  • Emergency departments are to limit viral respiratory testing to patients expected to be admitted.
  • Do not perform testing for test of cure.

Thank you for your support during this time. Please direct any questions to Laboratory Services via the “contact us” link above.

Chemistry, Compliance & Safety, General Information

RESOLVED: Delay in TB Screen (QuantiFERON Gold) Results

As of 1/12/2018, the analyzer has been repaired and all specimens have been resulted.

The Dynex DS2 analyzer in the Chemistry department at Spectrum Health Regional Laboratory is currently down until Tuesday, January 2, 2018. Results for TB Screen (QuantiFERON Gold) on tests collected since December 21, 2017 will be delayed. Specimens are stable for 27 days, so the patient will not need to be recollected. We apologize for any inconvenience.

If you have further questions, please contact the Laboratory Call Center or use the “contact us” link above. This post will be updated when the analyzer is serviced.

Immunochemistry, Test Utilization

Test Utilization: Cardiolipin Antibody Testing

Listed below are the Cardiolipin Antibody tests available in the Spectrum Health Regional Laboratory (SHRL) catalog. Please review the tests and the recommended test utilities.

Cardiolipin IgA testing should not be ordered unless the patient is negative for IgM and IgG. It should be restricted to very specific clinical scenarios for the evaluation of patients with suspected APS (Antiphospholipid Antibody Syndrome). Cardiolipin IgA requests will be reviewed for presence or absence of IgM/IgG testing.

Questions may be directed to Dr. David Alter by using the contact us link above.