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General Information

General Information, Immunochemistry, Main lab, Referral/Sendouts

Resolved: Change in testing for Lyme Total Antibody

As of February 11, 2021, this has been resolved. Testing has resumed at Spectrum Health Regional Laboratory Immunochemistry Department.

Starting November 1, 2020, the Lyme Total Antibody test will temporarily not be performed in-house and will be sent out to the Mayo Clinic Laboratories using the Lyme Disease Serology, Serum.  This is due to the backorder of reagents from the vendor until approximately January 2021.

Lyme Disease Serology, Serum is available to order in Epic. Lyme Total Antibody will still be available to order, however, when the specimen arrives to the laboratory the order will be switched to the Lyme Disease Serology, Serum.

Similarly, to the current in-house test, the Mayo assay is also a Lyme total antibody assay, detecting both IgG and IgM antibodies, with the same specimen type as the in-house test.  However, test turn-around-times may be increased.

Lastly, this change will have no effect on the reflexing of positive samples to the confirmatory Lyme Disease Antibody, Immunoblot, Serum. Continue Reading

General Information, Microbiology, Referral/Sendouts, Test Utilization

Obsoletion of Mayo Send-Out Test Influenza Virus A/B Antibodies, IgG and IgM

As of October 29, 2020, the following send-out tests will be will become obsoleted due to lack of clinical utility:

SFLA Influenza Virus A Antibodies, IgG and IgM (Separate Determinations), Serum [LAB802]

SFLB Influenza Virus B Antibodies, IgG and IgM (Separate Determinations), Serum [LAB803]

For diagnosis of acute Influenza infection the following molecular tests are recommended:

Influenza A/B PCR [LAB3255]

Influenza A/B Rapid [LAB9240]**

Influenza A/B Rapid, Influenza A/B PCR if Negative [LAB2111530]**

**Available only at regionals and during times of high flu incidence Continue Reading

Compliance & Safety, General Information, Immunochemistry, Main lab

Serum Kappa/Lambda Free Light Chain Assay Update

Effective September 28th, 2020, a new generation of the serum kappa/lambda free light chain assay has been implemented.

With the implementation of the new generation of the assay there is an approximately 20% negative bias for kappa free light chains in serum containing >20 mg/dL kappa free light chain.  This may affect the trending for patient who are serially monitored by this assay. Continue Reading

General Information, Immunochemistry, Test Utilization

Protein Electrophoresis Orderable Changes

As of August 26, 2020, the following tests will be obsoleted or made as lab orderables only.  This was implemented to streamline protein electrophoresis orders and ensure that patients receive the recommended testing for the assessment of plasma cell proliferative diseases.

In addition to streamlining protein electrophoresis orders, order questions have been implemented to the available tests to access the reason for ordering to ensure that the proper reflex testing is applied.

For more information, see the lab test directory under the available tests for a protein electrophoresis orders tip sheet entitled “Orders- Protein Orderable ChangesContinue Reading

Compliance & Safety, Education & Training, General Information

Leaky Specimen Containers

Leaky specimen containers may cause compromised test results and it is also a hazard to lab couriers and registration personnel. Leaky specimen containers are not acceptable and may be rejected.

In order to prevent leaky containers, please be sure to:

  • Pay close attention to the lid, making sure the screw-cap lids are fastened evenly and securely, with the threads aligned. If a patient has challenges with tightening the lid, please have them notify lab staff when they return to drop off their container.
  • Containers should be upright at all times, with lid on the top during transport. If container is placed in a biohazard bag, please maintain in the upright position by gripping the cup or the handle and not by the top of the bag.

The Laboratory provides a brochure “Laboratory Specimen Home Collection” for patient collection instructions. Internal offices (i.e. SHMG) may order these from Document Services using the order number X17776 (X19611 for the Spanish version). External offices may order these from Laboratory Courier Services using the Supply Order Form.

Hemostasis/Coagulation, Test Spotlight

New Reference Range: APTT and APTT Assay

Beginning September 8, at approximately 2PM, Spectrum Health Laboratories will go live with their new lot of APTT reagent.  This lot change triggered a new therapeutic curve resulting in new heparin nomograms for the system.  The standard heparin therapeutic range will change from the current 45-65 seconds to a new range of 37-52 seconds based off the new curve.  Reference ranges for the APTT assay will also be updated.  Grand Rapids APTT reference range will be 21-27 seconds and the Regional Hospitals will be 21-31 seconds.

APTT specimens that are unable to reach an endpoint (no clot is detected), will reflex to the Unfractionated Heparin (UFH) (Test Code LAB3389) anti-Xa assay.  To accommodate this change, UFH values have been added to heparin nomograms. The UFH anti-Xa assay is currently only performed in the Grand Rapids labs and valid only for unfractionated heparin.  Any questions concerning these changes may be directed to the Spectrum Health Regional Laboratory Coagulation department at 616-267-2740.

General Information, Hemostasis/Coagulation

Test Update: D-Dimer

Effective April 30, 2020, Spectrum Health Laboratories will no longer be performing the D-Dimer Semi-Quantitative assay. D-Dimer (quantitative) will be the only orderable for the D-Dimer assay. This D-Dimer will be reportable up to 35,000 ng/mL FEU. The cut-off value used in the diagnosis of venous thromboembolism (VTE), deep vein thrombosis (DVT), or pulmonary embolism (PE) remains at 500 ng/mL FEU. It is important to note inpatients can be (falsely) elevated in many underlying non-thrombotic conditions common in hospitalized patients.

Questions and inquiries regarding this change may be sent to the Coagulation Department using the “Contact Us” link above.

 

TEST INFORMATION

D-Dimer – [Epic Code: LAB313, Interface Code: 10123, CPT 85379]

Discontinued: D-Dimer Semiquantitative for DIC [Epic Code: LAB760, Interface Code: 10122, CPT: 85378]