After consultation with our clinical partners, Spectrum Health West Michigan Laboratory will be adjusting the pediatric reference ranges for our new ALT and AST reagents in an effort to better serve our population. Numerous academic studies were reviewed, and the values listed below were adopted on August 3, 2022:
Family Medicine
Effective August 2, 2022, reference ranges for the below tests will be updated to better align with the vendor’s recommendation and with Spectrum Health Lakeland Laboratory. Please click on the links below and scroll to the Reference Range field to see the updated ranges.
• Lithium Level [LAB29]
• PTH Intact [LAB108]
• IgM Level [LAB72]
• IgA Level [LAB73]
• CA 125 Level [LAB155]
• C4 Complement Level [LAB151]
• C3 Complement Level [LAB152]
• Albumin Level [LAB45]
• Transferrin Level [LAB133]
Questions or inquiries may be directed to the “Contact Us” link above.
The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing.
As of July 19, 2022, in alignment with recommendations from the Center for Disease Control and Prevention (CDC) the reference range for blood lead testing has been updated from 5 mcg/dL to 3.5 mcg/dL.
This applies to both: Lead, Blood Level [LAB98] and Lead Screen Filter Paper [LAB2111119].
In addition, at this time the low end of reporting for Lead Screen Filter Paper [LAB2111119] has increased from 1 mcg/dL to 2 mcg/dL.
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
West Michigan influenza infections peaked mid-March 2022 and have been declining in the weeks that followed. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
Low Influenza Prevalence |
High Influenza Prevalence |
|
Recommended Order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
More detailed information can be found as published by the CDC:
TEST INFORMATION
Test name | Epic code | Interface EMR Code | CPT Code |
Influenza PCR | LAB3255 | 11594 | 87502 |
Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting. Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.
Spectrum Health Laboratories recommends:
• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.
• Take normal dosages of medications unless the provider has instructed otherwise.
Click here for a list of tests the require or recommend fasting.
Effective February 10, 2022, Spectrum Health Regional Laboratory will offer Varicella Zoster Virus (VZV) PCR testing on swab specimens collected from cutaneous and mucocutaneous lesions (e.g. anorectal, genital, nasal, ocular, oral, skin, urethral).
PCR is the test method of choice for the diagnosis of VZV infection due to its enhanced sensitivity and speed as compared to traditional viral cultures, which should no longer be used for VZV detection.