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Immunochemistry

General Information, Immunochemistry, Main lab, Referral/Sendouts

Change in testing for Lyme Total Antibody

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

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

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, Immunochemistry

Immunochemistry ANA (Antinuclear Antibodies) Testing Name Update

Effective April 22nd, 2020, the following ANA (Antinuclear Antibodies) Tests’ name will be updated.  The change in naming convention comes in hopes of enhancing proper test utilization.  This update includes only the name change with no changes in laboratory testing workflow.

Old Test Name New Test Name Test Code Clinical Utility
ANA (Antinuclear Antibodies) Screen, Double Reflex to ANA IFA Hep2 Titer and Pattern, and if positive to ANA antibodies ANA screen LAB1230491 Preferred initial ANA screen for autoimmune connective tissue diseases.
ANA (Antinuclear Antibodies), Hep2 Substrate IFA with reflex to Titer and Pattern if positive IFA ANA (Rheumatology)

 

LAB3540 Preferred confirmatory ANA test for autoimmune connective tissue diseases.  With ordering recommendations for rheumatology only.
General Information, Immunochemistry

Immunochemistry Methodology Update

Effective December 11th, 2019, Spectrum Health Regional Laboratory’s Immunochemistry laboratory will be upgrading the following tests from the Immunoassay Vidas platform to the Multiplex flow immunoassay Bioplex 2200 platform.

Cytomegalovirus IgG Antibody

Cytomegalovirus IgM Antibody

Toxoplasma IgG Antibody

Toxoplasma IgM Antibody

Lyme Total Antibody

All tests will continue to have the same collection instructions, processing instructions, rejection criteria, specimen stability, turn-around-time, and qualitative reference ranges of negative. Continue Reading

General Information, Immunochemistry, Main lab, Test Utilization

Protein Electrophoresis Testing Update

In December, serum and urine protein electrophoresis testing will be simplified and standardized.  The only testing available will be:

Protein electrophoresis, serum, IFE if indicated 

Protein electrophoresis, random urine, do IFE if indicated 

Protein electrophoresis, 24 hour urine, do IFE if indicated 

In addition, on December 5, 2019, a new panel will be added which reflects expert recommendations for first line testing for monoclonal gammopathy, including plasma cell myeloma and most cases of amyloidosis, called “Monoclonal Gammopathy Screen

Protein electrophoresis, serum, IFE if indicated 

Kappa and lambda free light chains  Continue Reading