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.
• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS
Mayo Clinic recently completed a four-year review of Myasthenia Gravis serum evaluations and will be implementing changes to our testing algorithm.
Effective February 24, 2021, Cerebrospinal Fluid (CSF) Xanthochromia results of “Present” will be considered a critical laboratory value.
This change was approved by the MEC and driven by a collaboration between neurology and laboratory departments to assist in expediting the diagnosis and management of patients with possible subarachnoid hemorrhage (SAH).
As of February 11, 2021, this has been resolved. Testing has resumed at Spectrum Health Regional Laboratory Immunochemistry Department.
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.
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 Changes”
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.
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:
Cardiolipin IgG and IgM Antibodies
Beta-2 Glycoprotein 1 IgG and IgM Antibodies