Monoclonal gammopathies are characterized by the secretion of a monoclonal protein or M-protein. A wide variety of conditions can produce an M-protein, and the initial screening and monitoring of these patients require an array of tests. Herein we described best practices for protein electrophoresis ordering at Corewell Health.
Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.
Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.
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.
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
Recommended test is Angelman/Prader-Willi mPCR
If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.
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.
Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids. This component will be displayed in Epic as an absolute PMN count, body fluid.
• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.
• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).
• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).
• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.
The Spectrum Health Laboratory Coagulation Department announces the following changes occurring on 6.29.21 because of new instrumentation:
• New coagulation instrumentation will go-live on 6.29.21.
• This new instrumentation will align the Spectrum Health Regional Laboratory (in GR) with current Regional/Blodgett reportable upper limit for Protime/INR results.
• The current Protime (PT) upper limit of 120 seconds will change to 90 seconds. Any result that is greater than 90 seconds, will be reported as >90 seconds.
• The current INR upper limit of 12.0 will change to 8.0. Any result that is greater than 8.0 will be reported as >8.0.
Any questions can be directed to the Spectrum Health Regional Laboratory Coagulation Department using the Contact Us link above.