Browsing Tag

David Alter

Chemistry, Compliance & Safety, General Information

Reference Range Update: Anti-Thyroid Peroxidase Antibody

As of October 1, 2018, the reference interval for Anti-Thyroid Peroxidase Antibody levels has been updated to 0.0 to 34.9 IU/mL from 0.0 to 8.9 IU/mL. This change is due in part to client feedback resulting in an audit of the existing range and leading to discovery that it had not  been updated when the instrument had been changed.

We appreciate and welcome any and all client feedback; if you identify what may appear to be an incorrect reference interval, please notify us immediately using the “Contact Us” link above.

Chemistry, General Information

Fasting Lipid Test Update

Effective August 8th, Spectrum Health Laboratory will ask all patients to indicate how long they have been fasting (regardless of whether they were fasting or not) when they present for Lipid testing. In light of recent discussions in the literature that debate the utility of fasting prior to lipid testing; we recognize that some clinicians may now not require their patients to be fasting and hope that reporting out length of fasting (hours) with each lipid result will allow all clinicians to better interpret their patient’s lipid results. If fasting is desired; Spectrum Health Laboratory recommends no caloric or caffeine intake for at least 8 hours. The patient is not to drink (other than water), eat, smoke, chew gum, candy, cough drops, etc. for at least 8 hours prior to their blood tests. Prescribed medications are allowed. Continue Reading

Compliance & Safety

Biotin Alert

Biotin is widely used in immunoassay type laboratory methods over a wide range of instruments at numerous clinical laboratories throughout the world (including Spectrum Health).

With the expansion of biotin – also known as vitamin B7 – supplementation and treatments (“over the counter” and prescription, respectively); an associated interference with many clinical laboratory tests has been identified, confirmed and documented. Unfortunately, magnitude and type (falsely increased/decreased) of interference varies with dose and assay; however, it has been confirmed that as dose increases so does the magnitude of the response. In late November 2017, the Food and Drug Administration (FDA) published a safety alert warning that biotin can interfere with certain lab tests and cause incorrect test results. Continue Reading

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.

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.