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.
The most conclusive evidence for using thyroid peroxidase antibody (TPO) is predictive in nature when evaluating possible subclinical hypothyroidism. If this test is positive, hypothyroidism occurs at a rate of 4.3% per year versus 2.6% per year when the antibody is negative. While this scenario does not cover all clinical indications for ordering TPO, there is no definitive evidence that repeat TPO testing provides additional information.1
Based on this information the ordering of TPO within Spectrum Health is being modified. If the test is ordered more than once on a patient, a screen will appear in EPIC indicating the following: “This test should typically only be resulted once per lifetime. The duplicate checking indicates that this patient has already had this testing performed. Please see chart review for results.” This is not a “hard stop” but providers will need to click “Continue” to proceed with the order.
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”
To better align with our Allergy Specialists and reduce confusion and costs to patients, we have simplified and standardized our Allergy Panel offerings. These new panels will be available to order beginning Thursday, October 24, 2019. Also effective on this date, several of our old panels will be discontinued.
Overview
Clinical guidelines no longer recommend serologic testing as a method for the diagnosis of H. pylori infection. Rather than IgG serology testing, other non-invasive testing methods such as H. pylori stool antigen and urea breath tests may be used to both diagnose and monitor response to therapy for H. pylori infection. In anticipation of an increase in stool antigen testing, currently a reference lab send-out test, Spectrum Health Regional Laboratory (SHRL) will be implementing this test as of October 29, 2018. By offering this test in-house, results will typically be available one day faster than present state.
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.
The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis.
The following tests are now available:
Tree Nut Component Allergens
In addition to allergen components for egg, milk, and peanut, the test menu at Spectrum Health Regional Laboratory has expanded to offer component testing for tree nuts. Component testing measures sIgE antibodies to individual proteins unlike whole allergen testing which measures the presence of specific immunoglobulin E (sIgE) antibodies to a combination of allergenic and non-allergenic proteins. This next generation testing identifies the source of sensitization and helps the clinician assess the risk of systemic reaction.