Browsing Tag

Hematology

Hemostasis/Coagulation

New Test: Factor VIII Chromogenic Assay

Effective July 1, 2021, the Coagulation Department within the Spectrum Health Regional Laboratory will go live with an in-house, bovine based, Chromogenic Factor VIII assay.

This assay, a photometric determination of Factor VIII activity, is useful for monitoring coagulation factor replacement therapy of selected extended half-life coagulation factor replacements and Emicizumab therapy, a recombinant, monoclonal antibody that restores the function of the missing activated factor VIII by bridging FIXa and FX. The action of Emicizumab interferes with all APTT clot based and human chromogenic based assays, leading to an overestimation of Factor VIII activity.  As such, the bovine based Chromogenic Factor VIII assay is recommended.  The Chromogenic Factor VIII activity also assists in the diagnosis of hemophilia A using a 2-stage assay, particularly when the 1-stage clot based assay is normal.

For questions about this test, please refer to the laboratory catalog or use the Contact Us link above.

TEST INFORMATION

Chromogenic Factor VIII Activity – Epic Code: LAB1230831 | Interface Code: 1230831 | CPT: 85240

General Information, Hemostasis/Coagulation

Update: Platelet Aggregation Studies

The Spectrum Health Regional Laboratory Coagulation Department will be going live with the Helena AggRam analyzer on February 3, 2021.  This analyzer uses platelet rich plasma to analyze human platelet aggregation which is measured by absorbance.  The following aggregating agents are used in these studies: Arachidonic Acid, ADP, Collagen, Epinephrine, and Ristocetin.

Patients for platelet aggregation studies should be resting, fasting, and non-smoking. Patients should avoid taking any prescription or over the counter medications known to affect platelet function for ten (10) days to two (2) weeks prior to the studies. For a list of medications known to have anti-platelet effects, click here. 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

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

General Information, Immunochemistry

Test Update: Beta-2 Glycoprotein 1 Antibodies

Effective November 5th, testing for Beta-2 Glycoprotein 1 antibodies (IgG and IgM, serum) will change from a reference send out test to Mayo Medical Laboratories to an in-house test available at Spectrum Health Laboratories.  This testing is useful for evaluation of patients of suspected antiphospholipid antibody syndrome.

In addition, a new Antiphospholipid Antibody Syndrome Panel will be added which allows for appropriate and complete testing for antiphospholipid antibody syndrome. This panel includes:

Lupus Screen

Cardiolipin IgG and IgM Antibodies

Beta-2 Glycoprotein 1 IgG and IgM Antibodies

Continue Reading

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.