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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

Related Post: Influenza Testing Reminder

Questions may be directed to Laboratory Services using the “contact us” link above.

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

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.

Main lab, Microbiology

Test Update: Group B Streptococcus PCR Shortage

Test manufacturer supply chains continue to be disrupted due to COVID-19. Currently, there is a shortage of supplies for the Group B Streptococcus PCR test. Orders for this PCR test may continue to be placed, however, the SHRL Microbiology Department will perform a culture method until PCR supplies are available with appropriate charging and a reporting comment indicating that the culture was performed. The PCR test is normally resulted within 24-48 hours of specimen receipt in lab, whereas the culture method turnaround time may be 48-72 hours. An update will be posted when these PCR supplies are received, however, there may continue to be intermittent supply issues for this test. Additional test information can be found here.

Immunochemistry

New Test: COVID-19 IgG Antibody – Serology test

Effective May 18, 2020, Spectrum Health Regional Laboratory is pleased to be offering in-house COVID-19 serology testing, with initial availability 1,000 tests per day.

 

What is Serology Testing?

•  Serology testing measures the body’s immune response to COVID-19 infection in the form of antibody production against the SARS-CoV-2 virus.

•  There is a single COVID-19 serology order available in Epic, however, the Spectrum Health laboratory performs two versions of antibody testing to increase specificity and avoid reporting false positive results. An initial screen will be used to measure total antibody (IgA, IgM, and IgG), and positives will be confirmed by a second method that is specific to IgG.

•  Specificity is critical when the expected prevalence in a community is low. This serology testing is not expected to cross-react with other circulating coronaviruses that cause the common cold.

•  A positive IgG result indicates previous infection with COVID-19, but does not indicate immunity or protection against future infection.

•  This test should not be used to detect acute COVID-19 disease. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.

•  Whether positive or negative for the presence of COVID-19 antibodies, serology testing results do not support easing of behaviors such as social distancing, wearing masks, or hand hygiene.

Continue Reading

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]