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Main lab, Microbiology, Referral/Sendouts

Measles Ordering and Collecting Specimens

With several suspected cases of measles within Michigan, we thought it would be an excellent time to highlight Corewell Health West’s guidance on testing suspected patients. Specimens are sent to a reference lab for testing, which must be coordinated with local public health departments. Typically an upper-respiratory swab (throat or nasopharyngeal)  is collected for PCR testing in addition to a serum for measles IgM if collection is possible.

  • Patients should not be directed to a Corewell Health Laboratory or other healthcare facility for serum collection if patient is within 4 days after the onset of rash (with onset of rash considered to be Day 0). If Day 5 of rash or later, immunocompetent patients are no longer considered contagious and may be sent to a laboratory for a serum draw.
  • Corewell Health Providers:
    • Please reach out to Corewell Health Infection Prevention (IP) via Perfect Serve to make them aware of the situation.
    • Corewell Health Infection Prevention will contact the appropriate county.
  • Non-Corewell Health Facilities:
    • The provider’s office must coordinate with the county health department that the patient lives in to obtain permission to send measles testing.
    • Visit the following link for county health department contact information: Slide 1 (michigan.gov)
      • The county will coordinate with MDHHS for testing permission.

The preferred testing specimen is a throat or nasopharyngeal swab collected in office. Corewell Health Laboratories do not collect swabs.

For further collection and ordering instructions, please visit: Measles PCR – Laboratory Test Catalog | West

Any additional questions or concerns, please use the contact us link above or reach out to your local health department.

Immunochemistry

Aldosterone Testing Cancellations and Delays

Update 4/11/2024: The supplier shortage is ongoing. For patient health, we will now be sending these specimens to Mayo Clinic Laboratories, please note that this will impact trending charts in Corewell Health Epic. Please continue to order Aldosterone LAB1230656 and Direct Renin LAB1230657 separately.

Original Post: Due to a supplier shortage of Aldosterone reagent, Aldosterone (LAB 1230656 and LAB1230661) testing will be temporarily unavailable at Corewell Health Laboratories West. Continue Reading

Chemistry, Referral/Sendouts

Hepatitis A IgG Antibody Discontinued

Effective Thursday, April 18, 2024, Corewell Health Laboratory will discontinue the send out test Hepatitis A IgG Antibody, Serum (Mayo Test ID: HAIGG). This test has been made obsolete by Mayo Clinic Laboratories. We recommend to our healthcare providers the following in-house testing:

1.Hepatitis A Total Antibody (LAB1230596): intended for the clinical laboratory diagnosis of acute or past hepatitis A virus infection in persons with signs or symptoms of hepatitis and in persons at increased risk for hepatitis A infection, to identify HAV susceptible individuals and to determine the presence of an antibody response to HAV in vaccine recipients.

2.Hepatitis A Antibody, IgM (LAB7980): intended for use as an aid in the laboratory diagnosis of an acute or recently acquired hepatitis A virus infection.

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Compliance & Safety, Cytology, General Information

Resolved: HPV Error 3/17/2024

This issue is resolved. It was identified as an issue within Corewell Health Epic Preference Lists. If you are still encountering issues, please reach out to Service Now. This post will be archived in 7 days.

Due to an error from our system changes that happened on Sunday, March 17, 2024, the HPV reflex on the Pap testing orderable is not reflexing appropriately based on ASCCP Guidelines.

The Cytology Laboratory (Corewell Health Reference Laboratory West) and our Digital Services teams are aware of the error and working on a solution to correct the missed HPVs that were processed this week.  As the correction may cause a slight delay in HPV results, please hold add-on requests for HPV until Friday (3/29).  If you are concerned about an HPV being missed after this date (3/29/24), please fill out an Add-On form and fax to the number on the form (Note: Pap Specimens are held for 30 days).

We apologize for any inconvenience and confusion. If you have any further questions or concerns, please use the contact us link above.

Chemistry

Anion Gap Reference Range Update

Effective February 7, 2024, at 7:30 AM, Corewell Health West Laboratories will go live with a new reference range for the calculated Anion Gap (AG). The AG reference range will be adjusted to align with recent reference range studies.

The following will be the new normal reference ranges for AG:

Anion Gap: 5 – 14 mmol/L

 

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Immunochemistry, Main lab

Update in Testing Platform – Immunochemistry

As of January 26, 2024, for the following tests, the testing platform has changed from EliA Fluorescence Enzyme Immunoassay (FEIA) from Thermofisher to Multiplex Flow Immunoassay from Biorad. Please review the lab catalog for any changes to collection information or reference ranges.

• Anti-dsDNA Antibody
• Cyclic Citrullinated Peptide (CCP) Antibody
• Celiac Antibody Cascade
• Tissue Transglutaminase Antibody
• Gliadin Antibodies Continue Reading

Toxicology

Discontinuation Pyruvic Acid

Effective Wednesday, November 29, 2023, the in-house test, Pyruvic Acid, will be made inactive. Recommended alternative testing is Pyruvic Acid, Blood [LAB1231461] which is referred to Mayo Clinic Laboratories. Please review the lab catalog for information on new specimen requirements and updated reference range information. Due to the update in reference ranges, this may disrupt trending data.

The test Lactate/Pyruvate Ratio will also be inactivated with no alternative testing. If you require assistance with obtaining the ratio, please Contact Us. Continue Reading