| 140 | ACTIVATED PROTEIN C RESISTANCE | COAG | APCR is the most commonly recognized abnormality among patients with venous thromboembolism. Heterozygous Factor V Leiden patients have 80-fold increased risk for thrombosis; Homozygous Factor V Leiden patients have approximately 7-10 fold increased risk. APCR positive patients have an increased risk of Screening test for Factor V Leiden, with sensitivity approaching 100%. fetal loss. |
| 272 | ALDOLASE | KS | Detection of aldolase is a useful tool in the diagnosis and monitoring of many skeletal muscle disorders, myocardial infarction and liver disease. |
| 338 | ALPHA 1-ANTITRYPSIN | NEPH | Measurement of alpha-1-antitrypsin aids in the diagnosis of juven-ile and adult cirrhosis of the liver. Alpha 1-antitrypsin deficiency has been associated with neonatal respiratory distress syndrome, severe protein-losing disorders, and pulmonary emphysema. |
| 147 | ANGIOTENSIN CONVERTING ENZYME (ACE) | KS | ACE is increased in some cases of active sarcoidosis. Sensitivity about 75%, specificity about 95%. Elevated ACE levels will return to normal in sarcoidosis as a result of spontaneous or cortico-steroid-induced remission. Decreased ACE activity is found in patients having chronic obstructive lung disease, lung cancer, emphysema, and cystic fibrosis. ACE may modulate the some cardiovascular diseases. |
| 105 | ANTI-ACTIN AB, IgG | EIA | Anti-actin autoantibodies are the main component of what have been called smooth muscle antibodies (ASMA). Anti-actin antibodies are found in 52-85% of patients with AIH or chronic active hepatitis (CAH) and in 22% of patients with primary biliary cirrhosis (PBC). Useful marker for Celiac Disease. |
| 10 | ANTI-ADRENAL AB | IFA | Adrenal antibody (AA) is a marker, particularly in females, for a gonadal dysfunction due to autoimmune oophoritis. AA is detected in about two-thirds of patients with idiopathic Addison disease. |
| 185 | ANTI-ALPHA FODRIN AB, IgA | EIA | According to the latest findings, the routine screening for antibodies directed against alpha-fodrin can be a useful tool in diagnosing early stage Sjogren 19s syndrome. |
| 184 | ANTI-ALPHA FODRIN AB, IgG | EIA | According to the latest findings, the routine screening for antibodies directed against alpha-fodrin can be a useful tool in diagnosing early stage Sjogren 19s syndrome. |
| 6 | ANTI-BETA-2-GLYCOPROTEIN I ABS, IgG, IgA & IgM | EIA | The presence of b2 GPI IgA, IgG and IgM antibodies can be used in conjunction with clinical findings and other laboratory tests to aid in the diagnosis of certain autoimmune disease thrombotic disorders such as antiphospholipid syndrome and systemic lupus erythematosus (SLE) or other lupus-like thrombotic diseases. |
| 158 | ANTI-C1q IgG AB | EIA | Serial testing shows that increasing amounts of IgG anti-C1q predict renal flares in SLE patients. Elevated serum titers of anti-C1q antibodies tend to be associated with proliferative forms of lupus, glomerulonephritis and subendothelial deposits of immune complexes. |
| 9 | ANTI-CARDIOLIPIN ABS, IgG, IgA & IgM ISOTYPES | EIA | Anticardiolipin antibodies (ACA) have been strongly associated with venous and arterial thrombosis. These findings were first observed during studies on systemic lupus erythematosus (SLE), recurrent pregnancy loss and thrombocytopenia. Combined testing for phosphatidylserine antibodies and lupus anticoagulant (LA) in addition to ACA improve the sensitivity. |
| 12 | ANTI-CENTROMERE AB | IFA | The most common setting for finding anti-centromere antibodies is in patients with a limited cutaneous form of scleroderma. Anti-centromere abs are found in 22% of patients with systemic sclerosis and in 12% of patients with primary biliary cirrhosis, and are rarely present in normal individuals. |
| 78 | ANTI-CHROMATIN AB, IgG | EIA | Chromatin is comprised of native DNA wrapped around the (H2A-H2B-H3-H4)2 histone octamer, with histone H1 and some non-histone proteins associated. The presence of chromatin antibodies can be used in conjunction with clinical findings and other laboratory tests to aid in the diagnosis of drug-induced lupus (DIL) and Systemic Lupus Erythematosus (SLE). |
| 165 | ANTI-CYCLIC CITRULLINATED PEPTIDE AB 2 (ANTI-CCP), IgG | EIA | Anti-CCP 2 antibodies are a highly specific marker for RA. The specificity of anti-CCP 2 was 97% relative to disease controls (11/333 were positive), and 99% specific versus normal controls (1100 being positive). The sensitivity of anti-CCP 2 for both seropositive and seronegative RA taken together was 87% (155/179), 93% of seropositive RA was positive (144/155), and 46% of seronegative disease (11/24) was positive. The majority of RA sera were strongly reactive in anti-CCP 2 assay. |
| 283 | ANTI-CYCLIC CITRULLINATED PEPTIDE AB 3 (ANTI-CCP3), IgG | EIA | CCP3 has a higher sensitivity than CCP2 but with 8% of anti-centromere patients showing low levels of CCP3 antibodies. |
| 14 | ANTI-DNA AB (SINGLE STRANDED) | EIA | Single-stranded DNA (ssDNA) autoantibodies aid in the diagnosis of Systemic Lupus Erythematosus (SLE) and related connective tissue diseases. Anti-ssDNA abs are found in 80-90% of SLE patients during the administration of certain drugs (e.g., procaine-mide or quinidine) and other autoimmune diseases including rheumatoid arthritis, scleroderma, linear localized scleroderma, polymyositis-dermatomyositis, Sjogren's syndrome, mixed connective tissue disease (MCTD) and overlap syndromes, myasthenia gravis, chronic active hepatitis, infectious mononucleosis, chronic glomerulonephritis, and biliary cirrhosis. |
| 38 | ANTI-dsDNA AB (CRITHIDIA) | IFA | The crithidia IFA method couples a good sensitivity to high disease specificity and is one of the preferred methods for screening for the presence of anti-dsDNA. The method detects the intermediate to high avidity anti-dsDNA antibodies. |
| 13 | ANTI-dsDNA AB (FARR ASSAY, DOUBLE STRANDED) | RIA | The Farr method detects the high-affinity anti-dsDNA antibodies. The Farr assay is the most sensitive method for detecting dsDNA autoantibodies. Significant elevations in dsDNA autoantibody concentrations confirm the diagnosis of systemic lupus erythematosus (SLE). Serial studies of elevated values of dsDNA autoantibodies are useful for predicting activity of SLE and for measurement of serum C3 or C4 concentrations. Absence of dsDNA autoantibodies does not exclude the diagnosis of SLE. Doubling of dsDNA autoantibody concentrations or increases greater than 30 IU/mL in less than 10 weeks are reliably predictive of exacerbations of SLE. A simultaneous decrease in serum C4 complement enhances this predictive value. |
| 136 | ANTI-dsDNA AB by ELISA | EIA | Aids in the diagnosis of systemic lupus erythematosus (SLE) and related connective tissue diseases. The EIA method can detect low to high avidity of anti-dsDNA antibodies. It is specific for active SLE, but other autoimmune diseases such as Scleroderma, autoimmune hepatitis, Sjogren's syndrome, and Myasthenia gravis were positive for anti-dsDNA by EIA. |
| 514 | ANTI-ENA ABS (ANTI-SM & ANTI-RNP) | EIA | Aids in the diagnosis of Systemic Lupus Erythematosus (SLE), and related connective tissue diseases such as Sjogren's Syndrome. Anti-Sm is highly specific for SLE. Anti-RNP is found with a variety of rheumatoid diseases with high titers associated mainly with MCTD. |
| 52 | ANTI-ENDOMYSIAL AB, IgA | IFA | Endomysial antibodies, IgA are found in at least 70-80% of patients with dermatitis herpetiformis (DH) on a normal gluten-containing diet and 100% with celiac disease (CD), gluten-sensitive entero-pathy with severe villous atrophy. The sensitivity in untreated CD is 85-100%. The specificity for active gluten-sensitive enteropathy is over 98%. |
| 575 | ANTI-F-ACTIN AB, IgA | | Anti-actin autoantibodies are the main component of what have been called smooth muscle antibodies (ASMA). These antibodies display specificity towards the actin component of the cytoskeleton and are traditionally detected by indirect immunofluorescence utilizing thin sections of rodent liver, kidney or stomach as sub-strate. Anti-actin IgG antibodies are found in 52-85% of patients with AIH or chronic active hepatitis (CAH) and in 22% of patients with primary biliary cirrhosis (PBC). Anti-actin antibodies have been reported, usually in low titers, in 3-18% of sera from the general healthy population. Anti-actin IgG Antibody positive patients were more prone to be unresponsive to corticosteroid therapy (16% vs. 4%) and were more prone to suffer liver failure (20% vs. 4%). In contrast to anti-F-Actin, IgG antibodies which are characterisitc of patients with autoimmune hepatitis, anti-F-Actin, IgA antibodies are clinically relevant to patients with celiac disease. Recent studies have found that IgA antibodies to F-Actin show a strong correlation with the degree of intestinal villus atrophy present in celiac disease patients. Anti-F-Actin, IgA antibodies decrease following institution of a gluten-free diet and suggest measurement of these antibodies may have a role in monitoring with gluten free diet compliance. |
| 452 | ANTI-GLIADIN AB, IgG & IgA | EIA | IgG and IgA gliadin antibodies (GA) are useful in screening persons at risk for celiac disease (CD), assessing patients clinically suspect for CD or other gluten-sensitive enteropathies (GSE) and for monitoring compliance with a gluten-free diet (GFD). For CD, anti-gliadin IgG are more sensitive (about 100%) than IgA (about 50%), but IgA antibodies are more specific (about 95%) than IgG (about 60%). |
| 452 | ANTI-GLIADIN II (DGP) AB, IgG & IgA | EIA | IgG and IgA gliadin antibodies (GA) are useful in screening persons at risk for celiac disease (CD), assessing patients clinically suspect for CD or other gluten-sensitive enteropathies (GSE) and for monitoring compliance with a gluten-free diet (GFD). For CD, anti-gliadin II (DGP) IgG & IgA are more sensitive (100%) than the standard gliadin (92.5%). In disease controls of SLE & RA patients, none were positive with the new gliadin II (DGP), but 20-40% were positive with the standard gliadin test. |
| 956 | ANTI-GLOMERULAR BASEMENT MEMBRANE AB (ANTI-GBM) | EIA | Anti-GBM autoantibodies are recognized as being important in the pathogenesis of the rapidly progressive glomerulonephritis of Goodpasture's syndrome. Detects the presence of circulating glomerular basement membrane-specific antibodies in autoimmune renal disorders such as Goodpasture's syndrome. |
| 15 | ANTI-HISTONE AB | EIA | Aids in the diagnosis of Systemic Lupus Erythematosus (SLE), drug-induced SLE and related connective tissue diseases such as rheumatoid arthritis, dermatomyositis and Sjogren's Syndrome. Determination of the patient's histone antibody status may be useful in the differential diagnosis between SLE and drug induced SLE. |
| 559 | ANTI-HUMAN HEAT SHOCK PROTEIN 70-kd AB (HSP-70) | WB | Autoimmune inner ear disease (AIED) is a heterogeneous group of diseases with regard to clinical presentation and immunoreactivity to inner ear components. They include rapidly progressive sensorineural hearing loss (SNHL), Meniere's disease (MD) and sudden deafness (SD). Animals that have been immunized with HSP-70 and have elevated anti-HSP-70 antibodies did not develop hearing loss. Nevertheless, numerous studies have shown that patients with AIED had anti-HSP-70 antibody. The Western blot method has been recommended to identify HSP-70 antibody that may be reacting against inner ear antigens. A recent study shows that detection of anti-HSP-70 antibody is higher specificity, sensitivity, and less false positive and false negative than Immuno-blotting. This data indicates that the presence of circulating antibodies to HSP-70-kd serves as a marker for the diagnosis of AIED. RDL has developed a new Western Blot immunoassay for anti-HSP-70 antibody. |
| 260 | ANTI-HUMAN HEAT SHOCK PROTEIN 70-kd AB (HSP-70) | EIA | Autoimmune inner ear disease (AIED) is a heterogeneous group of diseases with regard to clinical presentation and immunoreactivity to inner ear components. They include rapidly progressive sensorineural hearing loss (SNHL), Meniere's disease (MD) and sudden deafness (SD). Animals that have been immunized with HSP-70 and have elevated anti-HSP-70 antibodies did not develop hearing loss. Nevertheless, numerous studies have shown that patients with AIED had anti-HSP-70 antibody. |
| 259 | ANTI-INNER EAR MEMBRANE AB, IgG | EIA | Autoimmune inner ear disease (AIED) is a heterogeneous group of diseases with regard to clinical presentation and immunoreactivity to inner ear components. They include rapidly progressive sensorineural hearing loss (SNHL), Meniere's disease (MD), and sudden deafness (SD). The search for a diagnostic test led to the finding that most AIED patients had antibodies that react with 130-kd, 68-kd, 58-kd, 42-kd and 30-kd (P0) proteins from human and bovine ears. The presence of antibodies to a 68-kd antigen, identified by Western blot, has been the best candidate to date as a diagnostic test for AIED and may be useful in predicting steroid responsiveness in the patient population. Moreover, reactivity with the 68-kd protein was present in serum samples from 89% of 47 patients with active disease compared to none of 25 patients with inactive disease. Of the 36 patients with a positive test result on Western blot assay for antibodies to the 68-kd protein, 27 (75%) responded to steroid therapy. Only four (18%) of the 22 patients with a negative test result responded to steroid therapy. A recent study showed a positive reaction to PO (from guinea pig inner ear extraction) in all bilateral MD and bilateral sudden hearing loss patients and indicates these pathologies are the result of an ongoing autoimmune process directed against specific inner ear antigens. The 68-kd inner ear antigen identified by Ramakrishnam is not HSP-70. The 68-kd protein binds supporting cells in the organ of Corti, while HSP-70 antibody does not bind to any site in the inner ear. Also, the commercial recombinant HSP-70 could not bind to sera from patients with AIED. This data indicates that the presence of circulating abs to human or bovine inner ear extract serves as a useful marker for the dx of AIED and that its presence correlates with disease activity and responsiveness to corticosteroid treatment. RDL developed a new EIA anti-bovine inner ear membrane antibody assay including 130-kd, 68-kd, 42-kd and 30-kd (PO) abs. |
| 53 | ANTI-ISLET CELL AB | IFA | Multiple antibodies are detected in the Islet Cell IgG autoantibodies assay (ICA), including GAD (Glutamic Acid Decarboxylase) autoantibodies. Sensitivity in new Insulin-dependent diabete mellitus is usually over 80%. Specificity is greatly improved if subjects have both ICA and other autoantibodies such as GAD and anti-insulin antibodies. |
| 434 | ANTI-JO 1 AB | EIA | Jo-1 antibodies are found in approximately 20% of adult patients with myositis (including polymyositis, dermatomyositis and overlap syndromes) and particularly common (about 60%) in patients with both myositis and interstitial lung disease (cryptogenic fibrosing aveolitis or pulmonary interstitial fibrosis). |
| 526 | ANTI-LA AB (SS-B) | EIA | Autoantibodies to SS-B/La antigen are detected by EIA in 70-90% of primary and about 50% of secondary Sjogren syndrome (SS) and as well as in 30% of SLE and 80% of subacute cutaneous lupus and a majority of infants with complete heart block. |
| 129 | ANTI-LIVER/KIDNEY MICROSOMAL AB | EIA | The LKM-1 reactivity is characterized by staining of the hepatocyte cytoplasm and the proximal, but not the distal kidney tubules. Patients with AIH, type 2a disease tend to be young, female, have severe disease, have low IgA levels, have a good response to immunosuppressive therapy and are hepatitis C virus (HCV) negative. The major target antigen of LKM-1 antibodies has been identified as cytochrome P450 2D6, a microsomal protein found in the endoplasmic reticulum. LKM-1 antibodies have been reported in up to 8% of patients with chronic HCV infection. |
| 18 | ANTI-MITOCHONDRIAL AB | IFA | Anti-mitochondrial antibodies (AMA) have been reported in 90?96% of patients with primary biliary cirrhosis (PBC). AMA are also occasionally found in sera of patients with other liver conditions, including chronic active hepatitis, cryptogenic cirrhosis and in patients with clinical but no biochemical evidence of liver disease. |
| 428 | ANTI-MITOCHONDRIAL AB M2 EP (MIT3) AB | EIA | Anti-mitochondrial antibodies (AMA) have been reported in 90?96% of patients with primary biliary cirrhosis (PBC). AMA are also occasionally found in sera of patients with other liver conditions, including chronic active hepatitis, cryptogenic cirrhosis and in patients with clinical but no biochemical evidence of liver disease. |
| 88 | ANTI-MYELOPEROXIDASE AB (ANTI-MPO) | EIA | Anti-MPO autoantibodies aid in assessment of certain autoimmune vasculitides such as microscopic polyarteritis, and crescentic glomerulonephritis. MPO is the main target antigen for the antineutrophil cytoplasmic autoantibodies (ANCA) which give a perinuclear (P-ANCA) immunofluorescence pattern. |
| 19 | ANTI-MYOCARDIAL AB | IFA | Myocardial autoantibodies are found in a variety of clinical conditions including Dressler syndrome. The titer also rises in about 66% of patients with coronary artery bypass and need not be related to post cardiotomy syndrome. The antibodies are found in most patients with acute rheumatic fever. |
| 156 | ANTI-NEURONAL ANTIBODY (IgG) | FC | Neurologic and/or psychiatric manifestations occur in up to two thirds of patients with Systemic Lupus Erythematosus (SLE). The cerebral manifestations are extremely diverse, ranging from mild depression to severe, life-threatening presentations. Studies have shown that anti-neuronal antibodies are more frequently found in the blood and CSF of neuropsychiatric lupus erythematosus (NPLE) patients to a much greater frequency than in SLE patients without NPLE. The study shows that serial test results of anti-neuronal antibody appear to correlate well with clinical response to SLE therapy. Detection of serum or CSF anti-neuronal lgG antibodies using the SK-N-MC may provide laboratory correlative evidence for the diagnosis NPLE but must be used as an adjunct to clinical and other laboratory findings. |
| 990 | ANTI-NEUTROPHIL CYTOPLASMIC AB (ANCA) | IFA | Although C-ANCA and P-ANCA are typically of the IgG isotype, C-ANCA are frequently reactive with PR-3. P-ANCA frequently react with MPO. ANCA/MPO antibodies are 30% in glomerular base-ment membrane disease (Wegener's Disease). Eighty-eight percent of patients with vasculitis-associated pulmonary hemorr-hage have elevated IgM ANCA; whereas, no patients who are IgM ANCA-negative have pulmonary hemorrhage. IgA ANCA is associated with Cholangitis, Kawasaki disease, Cystic fibrosis and Henoch-Schonlein purpura. |
| 20 | ANTI-NUCLEAR AB (FANA) | IFA | ANA are commonly found in a variety of autoimmune diseases. Antibody frequency increases with age in apparently healthy people. ANA patterns on Hep-2 slides provide only general clues about particles (chromatin, nucleosomes, and spliceosomes). ANA patterns (other than centromere pattern) are not reliably correlated with the presence of specific antibodies and must be further evaluated by EIA using individual ENA antigens. |
| 205 | ANTI-NUCLEAR AB (FANA), BODY FLUID | IFA | See Anti-Nuclear Ab (FANA) above. |
| 55 | ANTI-OVARY AB | IFA | Anti-ovary antibodies are present in 78% of patients with premature ovarian failure and Addison disease. |
| 21 | ANTI-PARIETAL CELL AB | IFA | Early studies emphasized the high frequency (90-100%) of parietal cell antibodies (PCA) in pernicious anemia (PA) but low frequency (about 55%) in younger patients. Explanations for the seronega-tive cases in pernicious anemia patients could include: a. juvenile PC prior to the development of autoantibodies, b. an immunological reaction restricted to a cellular response rather than antibody response, c. exhaustion of autoimmune response as the parietal cell antibodies are developed, d. incorrect diagnosis, e. unrecog-nized antibodies directed towards highly sensitive epitopes. |
| 1888 | ANTI-PHOSPHATIDYLSERINE ABS, IgG & IgM | EIA | Patients with positive reactions to both cardiolipin and phospha-tidylserine were more likely to have clinical complications than those positive for only one. Higher prevalence and mean serum levels of IgG antiphosphatidylserine antibodies have been reported in autoimmune patients. In addition, anti-phosphatidylserine antibodies in SLE patients correlated with clinical manifestations of anti-phospholipid syndrome, and their pathogenic role has been demonstrated in a murine model. |
| 69 | ANTI-PM/SCL AB | EIA | PM/Scl antibodies are found in patients with homogenous overlap connective tissue disease characterized by Raynaud's phenomenon, scleroderma, myositis, arthritis and pulmonary restriction. The presence of PM/Scl autoantibodies is a good prognostic sign unlike the poor prognosis seen with other myositis and systemic sclerosis-specific antibodies. |
| 73 | ANTI-PROLIFERATING CELL NUCLEAR AB (ANTI-PCNA) | DD | Anti-proliferating cell nuclear antibodies (PCNA) are found in <10% of SLE patients. The presence of PCNA is associated with renal, CNS involvement and thrombocytopenia in SLE; PCNA titers are elevated prior to develop-ment of proteinuria and decrease following corticosteroid treatment. |
| 89 | ANTI-PROTEINASE 3 AB (PR-3) | EIA | PR-3 are an aid in the assessment of certain autoimmune vasculitides such as microscopic polyarteritis and crescentic glomerulonephritis. PR-3 is the major target antigen of antineutrophil cytoplasmic autoantibodies (ANCA) that give a cytoplasmic (C-ANCA) immunofluorescence pattern. Elevated levels of PR-3 autoantibodies are classically observed in patients with Wegener granulomatosis (WG), particularly with active disease and less frequently in other forms of necrotizing vasculitis. |
| 23 | ANTI-RETICULIN Ab, IgG & IgA | IFA | Anti-reticulin antibodies (ARA) IgA are highly specific (>98%) for untreated celiac disease (CD). Sensitivity of ARA IgA in untreated, biopsy-proven CD is 90-95%. ARA IgG antibodies can be very useful in IgA-deficient individuals being evaluated for CD. |
| 72 | ANTI-RIBOSOMAL P PROTEIN AB | EIA | Ribiosomal P protein antibodies (RPPA) are detected in 45-90% of patients with severe depression or psychosis due to SLE; 7-20% in non-psychotic SLE patients. RPPA are occasionally found in Sjogren, syndrome associated with SLE and CNS complications and uncommon in patients with scleroderma and overlap with SLE. |
| 449 | ANTI-RNA POLYMERASE I/III IgG AB | EIA | The detection of anti-RNAP I/III antibodies is useful in the diagnosis of SSc and for the identification of patients at risk for developing progressive skin thickening and renal crisis. The prevalence of IgG RNAP I/III antibodies is from 3-58% in SSC patients. |
| 524 | ANTI-RNP AB | EIA | Anti-U1snRNP antibodies typically appear in both SLE and MCTD. In MCTD, the presence of U1 snRNP is required for diagnosis, whereas, anti-snRNP antibodies occur in only 30-40% of SLE. MCTD is typified by the high-titer RNP antibody activity in isolation; anti-RNP antibody activity in SLE commonly accompanies anti-Sm antibodies. |
| 525 | ANTI-RO AB (SS-A) | EIA | Anti-Ro (SS-A) antibodies occur in 40-50% of SLE, 60-75% of primary Sjogren's syndrome (PSS) and in a high proportion of secondary SS whether the associated disease is in SLE, RA, PSS, polydermatomyositis, or primary biliary cirrhosis, but is >90% of subacute cutaneous lupus and in vasculitis-associated SS. |
| 515 | ANTI-RO AB (SS-A) & ANTI-LA AB (SS-B) - SJOGREN'S | EIA | The association of antibodies to Ro and La with symptoms of dry eyes, xerostomia and a positive Rose Bengal staining or Schirmer test, has a sensitivity and specificity of 94% for primary Sjogren's syndrome. The fact that sera containing antibodies to Ro and La bind and mask antibodies to dsDNA might explain why SLE patients with both Ro and La antibodies have a lower frequency of dsDNA antibodies and a relatively low frequency of nephritis. |
| 944 | ANTI-SACCHAROMYCES CEREVISIAE AB, IGA & IGG (ASCA) | EIA | Anti-Saccharomyces cervisiae antibodies aid in the diagnosis of patients with Crohn's disease, IgA antibodies should be used to complement but not to replace or to substitute for ASCA IgG antibody testing. |
| 527 | ANTI-SCL-70 AB | EIA | The presence of anti-Scl-70 antibodies confirms the diagnosis of scleroderma but does not exclude additional diagnosis, e.g., scleroderma and SLE or scleroderma and Sjogren's syndrome. Anti-Scl-7 antibodies are present in 20-40% of scleroderma patients irrespective of age and in the same percentage of males and females. In American patients with proximal scleroderma, anti-Scl-70 Abs are more common in Blacks than in Caucasians. |
| 57 | ANTI-SKIN AB, PEMPHIGUS & PEMPHIGOID | IFA | Skin antibodies are highly specific in the patients with Pemphigus vulgaris and P. foliaceus. The titers correlate with disease activity and may be used to monitor therapy. Skin antibodies (inter-epith-elial) are found in 90% of patients with Pemphigus vulgaris and P. foliaceus. Dermal-epidermal skin antibodies are antibodies found in 90% of patients with Bullous pemphigoid and 90% of Cicatricial pemphigoid. |
| 529 | ANTI-SM AB | EIA | Anti-Sm antibodies offer a highly specific but relatively insensitive clinical marker of SLE. Their overall prevalence ranges from approximately 20-30% in SLE. Anti-Sm reactivity is not described definitively on other diseases, although a few studies describe SM antibodies in monoclonal gammopathies and uveitis. |
| 30 | ANTI-SMOOTH MUSCLE AB | IFA | Smooth muscle antibodies (SMA) are the standard diagnostic marker of autoimmune hepatitis (AH), the classical expression of which includes an insidious onset of lethargy, malaise, loss of appetite, arthralgia-myalgia, amenorrhea, signs of hepatospleno-megaly, jaundice and an acneiform skin rash. The sensitivity is relatively high (at least 90%) and specificity of high titer reaction (1:40) approaches 100% for the diagnosis of AH. We see some nonspecific SMA by IFA. |
| 126 | ANTI-SOLUBLE LIVER AG | EIA | Anti-SLA antibodies aid in the diagnosis of conditions with elevated levels of SLA antibody including autoimmune hepatitis (AIH), type 2. AIH patients are generally divided into 2 groups based on the presence of specific auto-antibodies. AIH type 1 (also referred to as classic, active chronic, lupoid, plasma cell, or autoimmune chronic active hepatitis) is the more common type of AIH. |
| 1152 | ANTI-SS-A 52 kD AB, IgG | EIA | Just like anti-SS-A 60, anti-SS-A 52 is commonly found in patients with SLE and Sjogren's Syndrome, and occasionally in other autoimmune disorders. However, anti-SS-A 52 autoantibodies are also found in patients with systemic sclerosis, polymyositis and dermatomyositis. Anti-SS-A 52 are linked with antibodies to tRNA synthetases like Jo-1, PL-7, PL-12, EJ and OJ, which are often found in patients with interstitial lung involvement. Studies show that 10 - 45% of myositis is positive for SSA52 antibody. The RDL study revealed 38% of myositis patients (18/47) were positive for SS-A 52 antibody. RDL offers SS-A 52 antibody test as part of the myositis panel. |
| 31 | ANTI-STREPTOLYSIN O AB (ASO) | NEPH | A marked rise in titer or a persistently elevated titer indicates that a Streptococcus infection or poststreptococcal sequelae are present. Increased ASO levels are observed in approximately 85% of the cases of rheumatic fever or pharyngitis associated with group A b--hemolytic streptococcal infection. ASO titers rise as early as 1 week post onset and peak at 3-5 weeks. Values typically return to normal levels within 6-12 months. |
| 28 | ANTI-STRIATED MUSCLE AB | IFA | Anti-striated muscle antibodies have definite diagnostic utility especially in myasthenia gravis patients aged 20-60. |
| 64 | ANTI-TESTES AB | IFA | Antibodies can access testicular target antigens during the development of autoimmune orchitis. |
| 1332 | ANTI-THYROGLOBULIN AB | CH | Autoantibodies to thyroglobulin (TG autoantibodies) are often present in patients with autoimmune thyroid disease. Approximate-ly 10 percent of healthy individuals have TG autoantibodies at low levels; higher concentrations are found in 30 and 85 percent of patients with Graves' disease and Hashimoto's thyroiditis, respect-ively. Elevated levels of antibodies to thyroid peroxidase (TPO autoantibodies) occur more frequently than high anti-TG levels in these diseases. Anti-TG determinations there-fore do not seem to add to the diagnostic information provided by anti-TPO results. |
| 1333 | ANTI-THYROID MICROSOMAL PEROXIDASE AB (TPO) | CH | In virtually all cases of Hashimoto's disease and in the majority of Graves' disease cases, TPO autoantibodies are elevated. High levels of TPO autoantibodies, in the context of the clinical presentation of hypothyroidism confirms the diagnosis of Hashimoto's disease. |
| 106 | ANTITHROMBIN III FUNCTION (ACTIVITY) | COAG | Low levels of antithrombin III activity are associated with an increased risk of thrombosis. Acquired deficiencies frequently occur due to consumption in DIC, following major operations, in cases of nephrosis, in liver disease and in contraceptive use with estrogen. Antithrombin III function deficiency can cause heparin resistance. |
| 51 | C-REACTIVE PROTEIN | NEPH | Measurement of CRP aids for inflammatory diseases, infections, surgery, stress and neoplastic diseases. In addition to its usual value as an acute phase reactant, CRP in large concentration (>5 mg/dL) predicts progression of erosions in rheumatoid arthritis. Elevated serum CRP is characteristic of bacterial, but not viral, meningitis or meningoencephalitis. It may be useful in monitoring the clinical course of these illnesses. Serial monitoring of serum and CSF CRP concentrations may be useful clinically. |
| 550 | C-REACTIVE PROTEIN, ULTRASENSITIVE | NEPH | The ability to measure CRP at extremely low concentrations has raised the possibility of using CRP to detect early inflammatory responses and potentially detect cardiac disease in the preclinical stages. Recent evidence supporting this potential application has shown that high baseline values of CRP in individuals without a history of cardiac disease were associated with an increased incidence of subsequent cardiac events. It is recommended, therefore, that any estimations of inflammation be based on changes in CRP values from multiple measurements and be used in conjunction with the values of other cardiac risk indicators. |
| 145 | C1Q CIRCULATING IMMUNE COMPLEX (C1Q CIC) | EIA | Measurement of the serum concentrations of C1q binding CIC by ELISA is prognostically important. It is particularly suitable for monitoring CIC levels in patients with systemic lupus erythematosus where the levels vary with disease activity and depressed complement responses. |
| 35 | C3 COMPLEMENT | NEPH | Measurement of C3 is used to detect individuals with inborn deficiency of this factor or those with immunologic disease in whom complement is consumed at an increased rate. These include lupus erythematosus, chronic active hepatitis, certain chronic infections, poststreptococcal and membranoproliferative glomerulonephritis, and others. |
| 206 | C3 COMPLEMENT, BODY FLUID | NEPH | See Test #35, C3 Complement above. |
| 36 | C4 COMPLEMENT | NEPH | Measurement of C4 in serum is used to detect individuals with inborn deficiency of this factor or those with immunologic disease in whom complement is consumed at an increased rate. These include lupus erythematosus, chronic active hepatitis, certain chronic infections, poststreptococcal and membranoproliferative glomerulonephritis, and others. |
| 208 | C4 COMPLEMENT, BODY FLUID | NEPH | See Test #36 C4 Complement above. |
| 1631 | CA 19-9 | CH | Studies have found assays for CA 19-9 more useful in the diagno-sis and management of patients with pancreatic cancer than colon neoplasia. CA 19-9 has also been shown to be a more sensitive and specific marker of pancreatic cancer than other serologic markers. The clinical management of pancreatic cancer is extremely difficult with most pancreatic cancers having metastasized by the time of diagnosis. Treatment consists of surgical intervention, radiation therapy, chemotherapy and palliative care measures as well as nutritional management. Monitoring the progression of disease is critical in the management of this disease. Therefore, the serial monitoring of CA 19-9 levels as an adjunct to imaging and clinical assessment is valuable in the management of pancreatic cancer patients. |
| 1630 | CA-125 | CH | Measurement of CA125 before and after cytoreductive surgery for ovarian cancer has been shown to predict the likelihood of a patient being left with residual disease. |
| 1301 | CALCIUM | CH | Calcium is the major mineral component of bone; 99% of the body 19s calcium is in bone. Calcium ions play an important role in the transmission of nerve impulses and in maintaining normal muscle contraction. Abnormal concentrations of serum calcium may indicate malfunction of the parathyroid glands, bone diseases, carcinoma, malnutrition and malabsorption syndrome, vitamin D deficiency, overdose with calcium-containing antacids, and renal diseases. |
| 1632 | CARCINOEMBRYONIC AG (CEA) | CH | CEA monitors the course of adenocarcinoma of the lung, patient response to treatment and disease recurrence. The CEA has broad tumor specificity and the elevation is seen in cancers of the colon, rectum, stomach, breast, lung, pancreas, etc. |
| 641 | CD19 DETECTION | FC | B activation/differentiation cells share CD19 and CD20 markers. Studies of the roles played by B cells and B cell depletion in autoimmune diseases have suggested that B cells contribute to the expression of autoimmunity and that antibodies targeting B cells (such as anti-CD20) may substantially abate expression of autoimmune disease by four possible mechanisms. B activation/differentiation cells share CD19 and CD20 markers. B regulates the signaling for B lymphocyte development, activation and proliferation. Treatment with anti-CD20 antibody (i.e., Rituximab) destroys mature B cells in central lymphoid organs, the synovium, and the peripheral blood. The CD19 B cell count was depleted. Our new CD19 Detection assay is a useful aid in monitoring rituximab (anti-CD20 antibody) therapy in autoimmune disease patients. |
| 632 | CD20 DETECTION | FC | Studies of the roles played by B cells and B cell depletion in RA and SLE have suggested that B cells contribute to the expression of autoimmunity and that antibodies targeting B cells (such as anti-CD20) may substantially abate expression of disease by four possible mechanisms. First, after anti-CD20 antibody binds to the extracellular domain of the CD20 antigen, it may activate complement and lyse the targeted cell. Second, anti-CD20 may permit antibody dependent, cell-mediated cytotoxicity, which occurs after the Fc portion of the anti-body is recognized by appropriate receptors on cytotoxic cells. Third, the antibody may alter the ability of B cells to respond to antigens or other stimuli. Finally, anti-CD20 antibodies may initiate programmed cell death or apop-tosis of B cells. Treatment with anti-CD20 antibodies (ie. Rituximab) destroys mature B cells in central lymphoid organs, the synovium and the peripheral blood. The B cells play a critical role in RA in terms of the afferent arm of the immune response, acting as highly efficient antigen presenting cells which assist in the activation of auto-reactive T cells. B cells both respond to and produce the chemokines and cytokines that promote leukocyte infiltra-tion into the joints, formation of ectopic lymphoid structures, angio-genesis and synovial hyperplasia. The success of B cell depletion therapy in RA may depend on disruption of some or all of these diverse functions. Several clinical trials have provided a substantial body of evidence that the B cell depleting agent, Rituximab, alone or in combination with other disease-modifying antirheumatic drugs, produces profound and prolonged depletion of B cells and confers clinically meaningful benefits to patients with RA & SLE. However, with B cell targeted therapies, as with other biologics, careful monitoring of immunocompetence is required. Our new CD20 detection assay is a useful aid in monitoring on or off label Rituximab (anti-CD20 ab) therapy in RA & SLE patients. CD20 Detection is an in-house bioassay using Analyte Specific Reagents (ASRs) for the quantitative determination of CD20 B cell depletion in blood by flow cytometry. |
| 626 | CD4 - HELPER/INDUCER COUNT | FC | Measure the CD4 Helper T-lymphocyte population. |
| 344 | CERULOPLASMIN | NEPH | The measurement of ceruloplasmin aids in the diagnosis of copper metabolism disorders. |
| 34 | COLD AGGLUTININS | DHA | The cold hemagglutination procedure detects the presence of nonspecific cold agglutinins present in the serum of patients suspected of having primary atypical pneumonia. The reaction occurs at low temperature but not at body temperature. The action of these agglutinins is nonspecific in that they will agglutinate the patient's own cells as well as the cells from various other animals. The agglutination is reversible; erythrocytes clumped by cold agglutinins will disperse when warmed to 37 degrees C. |
| 324 | CREATINE KINASE (CPK) | ENZ | Measurements of total creatine kinase are used in the investigation of skeletal muscle disease, and in the diagnosis of myocardial infarction and cerebrovascular accidents. |
| 1380 | CRYOGLOBULINS | MAC | Cryoglobulinemia is most usually associated with plasma cell myeloma or macroglobulinemia, but is also found associated with various other neoplasms, in some infectious diseases and in various systemic disorders. The most prominent symptoms attributed to cryoglbulinemia are sensitivity to the cold, Raynaud's Syndrome, purpura or urticaria and bleeding from mucous membranes. |
| 760 | CYTOMEGALOVIRUS (CMV) AB, IgG | EIA | Prevalence studies based on the frequency of seropositive individuals in the general population (40-100%), show inverse correlation between the acquisition of CMV infection and the socioeconomic condition of the population. |
| 761 | CYTOMEGALOVIRUS (CMV) AB, IgM | EIA | In primary CMV infections, the development of antibodies is thought to follow the pattern typical of other viral infections. That is, CMV IgM antibody levels rise transiently, while CMV IgG antibody levels rise later but may persist. Recurrence of CMV IgM in reactivated infection is not absolute and appears to be dependent upon the patient population. |
| 716 | CYTOMEGALOVIRUS (CMV) ABS, IgG & IgM | EIA | Infection by CMV cannot be clinically diagnosed without confirmation by laboratory testing such as isolation of the virus or the demonstration of IgM specific antibody or a significant rise in IgG specific antibody levels. |
| 276 | EJ | IPP | Anti-histidyl-tRNA synthetase autoantibodies (anti-Jo-1) are the most common Myositis Specific Antibodies, but autoantibodies reading with synthetase for alanine (PL-12), threonine (PL-7), glycine (EJ), and isoleucine (OJ) also exist. |
| 617 | EPSTEIN BARR NUCLEAR AG (EBNA) AB, IgG | EIA | EBNA-1 IgG ELISA test system provides a means for the qualitative detection of IgG antibodies to the nuclear antigen-1 of Epstein-Barr virus (EBNA-1) in human sera. The results of this test together with other testing, such as the heterophile test, and the EBV-VCA IgG and IgM tests, may aid in the diagnosis of, and provide information on infectious mononucleosis (IM), that may be of value in patient management and treatment. |
| 619 | EPSTEIN BARR VIRAL CAPSID AG (VCA), IgG | EIA | Both IgM and IgG antibodies to the viral capsid antigen (VCA) peak 3 to 4 weeks after primary EBV infection. IgM anti-VCA decline rapidly and are usually undetectable after 12 weeks. IgG anti-VCA titers decline slowly after peaking but last indefinitely. |
| 620 | EPSTEIN BARR VIRAL CAPSID AG (VCA), IgM | EIA | Both IgM and IgG antibodies to the viral capsid antigen (VCA) peak 3 to 4 weeks after primary EBV infection. IgM anti-VCA decline rapidly and is usually undetectable after 12 weeks. IgG anti-VCA titers decline slowly after peaking but last indefinitely. |
| 618 | EPSTEIN BARR VIRAL CAPSID AGS (VCA), IgG & IgM | EIA | See either test #619 or #620 above. |
| 621 | EPSTEIN BARR VIRUS, EARLY ANTIGEN (EA) | EIA | Antibodies to EA may appear transiently for up to three months or longer during the acute phase of IM in 85% of patients. A definitive diagnosis of primary EBV infection can be made with 95% of acute phase sera based on antibody titers to VCA, EBV-NA, and EA. |
| 1634 | FERRITIN, SERUM | CH | Clinical applications of the serum ferritin assay have been extensively reviewed. It has important roles to play in the diagnosis of iron deficiency and excess, and in the management of conditions and treatments posing a threat to iron balance. |
| 232 | FIBRILLARIN (U3 RNP) | IPP | The U3-RNP (Fibrillarin) particle is thought to participate in the first step of preribosomal RNA processing. Anti-U3 RNP antibodies have been shown to be highly specific for patients with SSc. |
| 345 | FIBRINOGEN | COAG | A high level of fibrinogen is a risk factor for thrombosis and is a strong predictor of cardiovascular risk and stroke, particularly in young adults. Low-dose heparin and ACE-inhibitors reduce fibrinogen and risk of adverse cardiovascular events. |
| 142 | FREE PROTEIN S | COAG | Hereditary protein S deficiency is associated with recurrent venous thromboembolic disease often presenting in adolescents or young adults. Protein S levels are low in pregnancy and coumadin therapy. Acquired Protein S deficiency is documented in DIC, Type I and II diabetes mellitus, pregnancy, oral contraceptive use, nephrotic syndrome, liver disease, and essential thrombocythemia. Three types of congenital protein S deficiency have been identified: Type I with reduced total and free protein S antigen, Type II with reduced activity but normal free and total antigen, and Type III with reduced activity of protein S and reduced free protein S, but normal total protein S antigen. |
| 241 | FTA-FLUORESCENT TREPONEMAL AB, ABSORBED | IFA | This is a confirmatory test for syphilis. |
| 1601 | GP 210 | EIA | Primary biliary cirrhosis (PBC) is an organ-specific autoimmune disease that predominantly affects women and is characterized by chronic progressive destruction of small intrahepatic bile ducts with portal inflammation and ultimately fibrosis. PBC affects women more than men (female: male ratio of 1:9) and typically occurs between the ages of 30 and 65. The prevalence of PBC in first-degree relatives of PBC patients range is from 1.3 to 6.4%. Serologic assays are important aids to the recognition and diagnosis of PBC since many antibodies associated with PBC are present before symptoms become evident. Anti-gp210 and/or sp100 antibodies can be detected in approximately 25% of all PBC patients and 30% of AMA-negative PBC patients. The gp210 and sp100 antibodies have a relatively low sensitivity, but the specificity is greater than 99%. Additionally, the antibodies may identify a subgroup of patients with a more severe disease course. The gp210 and sp100 EIA will provide clinicians with additional serological markers for detection of PBC and may help earlier identification, diagnosis, and treatment of patients negative for conventional markers of PBC. Combined testing for three markers (M2, gp210 and sp100) identified 92% of PBC patients. |
| 368 | HAPTOGLOBIN | NEPH | Measurement of haptoglobin may aid in the diagnosis of hemolytic diseases related to the formation of hemoglobin-haptoglobin complexes and certain kidney diseases. |
| 1052 | HELICOBACTER PYLORI AB (H-PYLORI), IgG | EIA | Aids in the diagnosis of Helicobacter pylori infection. A positive serological response to H. pylori antigens has been determined in individuals with duodenitis, chronic gastritis, and gastric or duodenal ulcer. Further, many people without clinical symptoms are seropositive for H. pylori antibodies, with the prevalence increasing with age. |
| 1721 | HEPATITIS A VIRUS (HAV), IgM | EIA | During the acute phase of HAV infection, IgM class antibody to hepatitis A virus (anti-HAV IgM) appears in the patient's serum and is nearly always detectable at the onset of symptoms. In most cases, anti-HAV IgM persists throughout the first three to six months of convalescence. |
| 1722 | HEPATITIS A VIRUS (HAV), TOTAL | EIA | The presence of anti-HAV in human serum or plasma is indicative of past or present infection with hepatitis A virus. |
| 721 | HEPATITIS A VIRUS (HAV), TOTAL & IgM | EIA | Anti-HAV IgM declines in late convalescence, and is not detected in normal subjects regardless of the presence of IgG antibody to hepatitis A virus (anti-HAV IgG) in their serum. Anti-HAV IgM is primarily used as an aid in the diagnosis of acute hepatitis A. |
| 1723 | HEPATITIS B CORE (HBc) AB, IgM | CH | Aids in the diagnosis of acute or recent (usually six months or less) hepatitis B viral infection. |
| 1724 | HEPATITIS B CORE (HBc) AB, TOTAL | CH | Anti-HBV core antibodies are indicated for the screening of licensed blood and blood products intended for transfusion and as an aid in the diagnosis of ongoing or previous hepatitis B viral infection. |
| 723 | HEPATITIS B CORE (HBc) ABS, TOTAL & IgM | CH | Total anti-HBc (both IgM and IgG antibodies) is detected before or at the onset of symptoms. However, such reactivity can persist for years after illness, may even outlast anti-HBs and occasionally may be the only marker of either current or past infection. |
| 725 | HEPATITIS B SURFACE AB (HBsAb), TOTAL | CH | Presence of hepatitis B surface antibody is an indicator of clinical recovery and subsequent immunity to hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risk for exposure to the hepatitis B, ie., hemodialysis unit personnel, venipuncturists, and evaluation of the need for hepatitis B immune globulin after needle stick injury. |
| 146 | HEPATITIS B SURFACE AB, QUANTITATIVE | CH | Presence of hepatitis B surface antibody is an indicator of clinical recovery and subsequent immunity to hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risk for exposure to hepatitis B, ie., hemodialysis unit personnel, venipuncturists, and evaluation of the need for hepatitis B immune globulin after needle stick injury, evaluation of the need for hepatitis B vaccine, and to follow immune status after hepatitis B vaccine. |
| 726 | HEPATITIS B SURFACE ANTIGEN (HBsAg) | CH | Presence of HBs antigen indicates an ongoing infection with HBV, and is detectable in the acutely ill and in chronic carriers. |
| 727 | HEPATITIS B SURFACE ANTIGEN (HBsAg), NEUTRALIZATION-CONFIRMATION | CH | Presence of HBs antigen indicates an ongoing infection with HBV, and is detectable in the acutely ill and in chronic carriers. The presence of HBsAg in a sample can be confirmed by demonstrating a significant reduction in signal following specific antibody neutralization. |
| 430 | HEPATITIS C SIGNAL TO CUTOFF RATIO (HCV S/CO RATIO) | EIA | RDL reports the signal to cutoff ratio (S/CO) for positive HCV's. It has been suggested by the CDC that this could help the clinician decide if confirmatory testing, ie. RIBA or HCV PCR is necessary. If the S/CO Ratio is => 3.8, studies have shown that 95% correlate with a positive RIBA or HCV PCR. If the S/CO Ratio is <3.8 it is strongly recommended that confirmatory testing be performed. |
| 730 | HEPATITIS C VIRUS AB, IgG (HCV) | EIA | At least 170 million individuals worldwide are chronically infected with HCV. HCV infection is often asymptomatic, however, the majority (over 55-85%) of the individuals exposed to HCV become chronically infected. In 20% of these chronically infected individuals, the disease progresses to cirrhosis, liver failure, and possibly hepatocellular carcinoma or cholangiocarcinoma. Common modes of HCV transmission include blood transfusion, intravenous drug use, nosocomial exposure, during assisted reproductive techniques, and from mother-to-infant during pregnancy, delivery, or the postpartum period. According to CDC documents: An S/CO ratio of "65 11.0 predicated RIBA positivity in 97% or more of screening-test-positive samples. If the ADVIA HCV assay with S/CO ratio is "65 11.0, RDL 19s comment: Signal-to cutoff ratio "65 11.0 would predict a true antibody-positive result (as defined by the results of supplemental testing) "65 95% of the time. If the ADVIA HCV assay S/CO ration is < 11.0 (patient 19s OD/Cutoff OD), RDL 19s comment: The weak positive result should be confirmed by RIBA or NAT testing. |
| 90 | HLA-B27 | FC | There is a strong association between the presence of the HLA-B27 antigen and an increased incidence of ankylosing spondylitis (AS) as well as several other disorders such as Reiter's syndrome, psoriatic arthritis, and arthropathies associated with inflammatory bowel disease. |
| 44 | IgA, IMMUNOGLOBULIN A | NEPH | Measurement of immunoglobulin A aids in the diagnosis of abnormal protein metabolism and the body's lack of ability to resist infectious agents. |
| 1637 | IGE, IMMUNOGLOBULIN E | CH | IgE constitutes a fraction of the total antibody in serum (50 13 300 ng/mL compared to 10 mg/mL), and is important in primary immune responses. The immunogenetic mechanisms underlying IgE responsiveness seen in the atopic diseases can be divided into antigen-specific and non-antigen-specific responses. |
| 43 | IgG, IMMUNOGLOBULIN G | NEPH | The measurement of gamma globulin in serum and other body fluids aids in the diagnosis of autoimmune diseases, sarcoidosis, chronic liver disease, chronic and recurrent infections, lymphoid malignancies, multiple myeloma and severe combined and variable immunodeficiencies. |
| 45 | IgM, IMMUNOGLOBULIN M | NEPH | Measurement of immunoglobulin M aids in the diagnosis of abnormal protein metabolism and the body's lack of ability to resist infectious agents. |
| 115 | IMMUNOFIXATION ELECTROPHORESIS (IFE) | EL | Immunofixation is used most frequently for the identification of monoclonal immunoglobulins for studying protein polymorphism and for genetic studies. |
| 279 | Ku | IPP | Ku antibodies are strongly associated with systemic autoimmunity in Japanese patients in contrast to SLE (15-50%) and overlap syndromes in Americans. Ku antibodies are also found in some patients with MCTD, scleroderma, polymyositis, Graves disease and primary pulmonary hypertension. |
| 46 | LE CELL PREPARATION | ZH | The occurrence of leukocytes containing a characteristic inclusion body (the LE cell) in blood of patients with systemic lupus erythematosus (SLE). |
| 116 | LUPUS ANTICOAGULANT | DVVT, DVVT CONFIRM | The presence of lupus anticoagulant can cause hypercoagulable states and fetal loss. Due to its heterogeneous nature, no single assay can absolutely identify the presence of LA. Other LA tests should be performed if DRVVT is negative. |
| 764 | LYME C6 PEPTIDE AG | EIA | C6 peptide antibody EIA has good sensitivity and specificity, reacts with B. burgdorferi and other Borrelia spp. and is useful in patients who have received the vaccine for Lyme disease. In contrast to C6 EIA, all other Lyme antibody tests use either a sonicated or whole B. burgdorferi cell preparation as capture antigens and will be positive in vaccinated patients because of the strong OspA antibody reactions that are not common in Lyme disease with erythema migrans. |
| 710 | LYME DISEASE, EIA, REFLEXIVE TO WESTERN BLOT | EIA, WB | The EIA results should only be used for patients with signs and symptoms that are consistent with Lyme disease. Equivocal or positive results must be supplemented by testing with a standardized Western blot procedure. Positive supplemental results are supportive evidence of exposure to B. burgdorferi and can be used to support a clinical diagnosis of Lyme disease. |
| 792 | LYME DISEASE, WESTERN BLOT, IgG & IgM | WB | The Western Blot is useful for characterizing the specificity of the antibody response to B. burgdorferi. The Western Blot has been reported to have greater sensitivity than either the IFA or EIA procedures. |
| 237 | Mi-2 | IPP | Anti-Mi-2 antibodies appear to be a marker for dermatomyositis. Anti-Mi-2 is detected in 8% of all myositis patients and in 15 to 20% of dermatomyositis patients. Serum samples containing anti-Mi-2 antibody immunoprecipitate a 240 KD major protein. |
| 1638 | MYOGLOBIN | CH | Aid in the diagnosis of acute myocardial infarction (AMI). |
| 1399 | MYOSITIS AB 3 PANEL | IPP, EIA | See Test #217, Myositis Ab Panel. |
| 217 | MYOSITIS AB PANEL (Mi2, PL-12, PL-7, EJ, OJ, Ku, SRP & U2 snRNP) | IPP | The idiopathic inflammatory myopathies (IIM) are a heterogeneous group of disorders characterized by muscle weakness resulting from chronic muscle inflammation of unknown cause. Patients with IIM have a variety of autoantibodies with various clinical utilities. One group of these autoantibodies, which is found only in patients with myositis, is known as myositis specific autoantibodies (MSA). The other type of these autoantibodies is considered myositis associated autoantibodies (MAS) and can be found in patients with overlap syndromes such as myositis/scleroderma and polymyo-sitis/scleroderma but can also be found in these conditions alone. The myositis antibody panel detection is an in-house bioassay to be performed at RDL for qualitative determinations of Myositis anti-bodies in serum by immunoprecipitation. The myositis antibody panel assay will be labeled as an "Analytic Specific Reagent (ASR)". |
| 245 | MYOSITIS AB PANEL, COMPREHENSIVE | IPP; EIA | See Test #217, Myositis Ab Panel. |
| 244 | NTx (N-Telopeptide) | EIA | A Serum N-Telopeptide (NTx) level is used to aid in predicting skeletal response (bone mineral density) to antiresorptive therapy and in monitoring bone resorption changes following initiation of antiresorptive therapy. |
| 277 | OJ | IPP | Anti-histidyl-tRNA synthetase autoantibodies (anti-Jo-1) are the most common MSA, but autoantibodies reading with synthetase for alanine (PL-12), threonine (PL-7), glycine (EJ), and isoleucine (OJ) also exist. |
| 1314 | P140 or CADM-140 | IPP | P140 or CADM-140: These antibodies were significantly associ-ated with JDM and calcinosis. Also 50% of adult patients with clinically-amyopathic dermatomyositis (CADM) and interstial pneumonia had anti-P-140 antibodies (anti-CADM-140). |
| 1311 | P155/140 | IPP | P155/140 autoantibodies directed against P155 kDa protein (in most cases with a second weaker 140 kDa band) and significantly associated with cancer-associated myositis (CAM). These antibodies have been detected in high frequency in patients with juvenile dermatomyositis. |
| 1639 | PARATHYROID HORMONE (PTH), INTACT | CH | PTH decreases reabsorption of phosphate by the proximal tubule and stimulates the production of 1,25 hydroxyvitamin D, which stimulates the intestinal absorption of both calcium and phosphate. Generally, less than 5 to 25% of total immunoreactive PTH is intact hormone. The remaining 75 to 95% is inactive midregion/carboxyl fragments. In hypercalcemia, secretion of these inactive forms persist while secretion of intact hormone is greatly reduced or absent. The Intact PTH assay, therefore, is most useful for monitoring dialysis patients. |
| 2747 | PARVOVIRUS B-19 AB, IgG | EIA | Joint involvement occurs frequently in adults after infection with B19 virus. The results of these assays may be used to make a serological determination of past, recent, or current infection with B 19V. Also this test may be used for testing women of childbearing age to determine their serological status where there is a suspicion of exposure to B19V. |
| 2748 | PARVOVIRUS B-19 AB, IgM | EIA | Joint involvement occurs frequently in adults after infection with B19 virus. The results of these assays may be used to make a serological determination of recent infection with B 19V. Also this test may be used for testing women of childbearing age to determine their serological status where there is a suspicion of exposure to B19V. |
| 748 | PARVOVIRUS B-19 ABS, IgG & IgM | EIA | See Test #793, Parvovirus B-19 Ab, IgG. |
| 239 | PL-12 | IPP | PL-12, like PL-7 are considered myositis specific antibodies (MSA) and can have these clinical features: myositis, interstitial lung disease (ILD), Raynaud's phenomenon, non-erosive arthritis, mechanic's hands, acute onset with fever and is found predomin-antly affecting young patients. |
| 238 | PL-7 | IPP | See Test #239, PL-12. |
| 1640 | PROSTATE SPECIFIC AG (PSA) | CH | Aids in the detection of prostate cancer when used in conjunction with digital rectal examination (DRE) in men aged 50 years or older. And an aid in the management of prostate cancer patients. |
| 124 | PROTEIN C ACTIVITY | COAG | Protein C and S are activated in vitro by thrombin in the presence of thrombomodulin. Acquired deficiencies of Protein C and S are associated with hepatic disorders, oral anticoagulant therapy, and disseminated intravascular coagulation |
| 113 | PROTEIN ELECTROPHORESIS, SERUM (SPE)-REFLEXIVE | EL | SPE is useful in the evaluation of myeloma, macroglobulinemia of Waldenstrom, collagen diseases, and monoclonal gammopathies, inflammatory states, low back pain, arthritis, amyloidosis, lymphoma, leukemia, anemia. |
| 536 | PROTEIN S ACTIVITY | COAG | Protein C and S are activated in vitro by thrombin in the presence of thrombomodulin. Acquired deficiencies of Protein S is associated with DIC, Type I & II diabetes mellitus, pregnancy, hepatic disorders, oral anticoagulant therapy, and essential thrombocythemia. |
| 42 | QIG, QUANTITATIVE IMMUNOGLOBULINS | NEPH | Quantitation of immunoglobulins (lgG, IgA, and IgM) in serum provides useful information for the evaluation of certain disease states. Increased concentrations of these proteins may occur in disorders such as monoclonal or polyclonal gammopathies. Differentiation of these gammopathies can be supported by measuring selective increases in immunoglobulins. Decreased concentrations of immunoglobulins may indicate hypogammaglobulinemia as a result of primary or secondary immunodeficiency. |
| 534 | RHEUMATOID FACTOR, IGA BY EIA | EIA | Several groups have reported that a high level of IgA RF is prognostic for a more severe disease outcome. When RF isotype levels are compared with radiological abnormalities of the joints, the strongest correlation is with raised levels of RF IgA. High levels of RF IgA within three years of the onset of symptoms have been associated with a more severe disease after six years of onset. Studies from as early as 1984 suggest that the detection of RF IgA in early disease indicates poor prognosis and justifies a more aggressive course of treatment. |
| 533 | RHEUMATOID FACTOR, IGG BY EIA | EIA | Two different groups demonstrated that raised levels of RF IgG are virtually confined to the sera of patients with rheumatoid arthritis and not other arthritides. The most striking clinical association with RF IgG appears to be RA vasculitis. |
| 555 | RHEUMATOID FACTOR, IGG, IGA, IGM BY EIA | EIA | EIA methods have the added advantage of being able to simultaneously detect RF of IgG and IgA subclasses in addition to RF IgM and are not susceptible to prozone. It has become apparent that the specificity and predictive value of the RF test is substantially increased by the detection of all three RF isotypes. |
| 535 | RHEUMATOID FACTOR, IGM BY EIA | EIA | IgM-RF is the main isotype identified by clinically available diag-nostic assays for RF detection. The most consistent serological finding in patients with Rheumatoid Arthritis (RA) is an increase in the concentration of RF IgM in blood and synovial fluid. RF IgM has been reported to occur in approximately 70-80% of patients with confirmed RA. |
| 207 | RHEUMATOID FACTOR, IgM by NEPHELOMETRY (BODY FLUID) | NEPH | IgM-RF is the main isotype identified by clinically available diagnostic assays for RF detection. The most consistent serological finding in patients with Rheumatoid Arthritis (RA) is an increase in the concentration of RF IgM in blood and synovial fluid. RF IgM has been reported to occur. |
| 49 | RHEUMATOID FACTOR, IgM by NEPHELOMETRY (SERUM) | NEPH | See Test #207, Rheumatoid Factor, IgM by Nephelometry (Body Fluid). |
| 48 | RHEUMATOID FACTOR, SSC (ROSE WAALER) | PHA | The RHEUMATON test provides a simple, rapid qualitative and quantitative method for the detection of rheumatoid factor (RF) in serum and synovial fluid. |
| 7 | RPR (RAPID PLASMA REAGIN) | FLOC | The ASI RPR (rapid plasma reagin) Card Test for Syphilis is a qualitative and semiquantitative nontreponemal flocculation test for the detection of reagin antibodies in human serum and plasma as a screening test in syphilis serology. Also RPR can detect anti-nontreponemal antibodies (reagin). |
| 104 | SEDIMENTATION RATE, WESTERGREN | WEST | ESR and viscosity are preferred for monitoring chronic inflammation, including disease severity in rheumatoid arthritis. ESR and C-reactive protein measurements are the assays used most often by rheumatologists in monitoring response to treatment in inflammatory diseases, such as rheumatoid arthritis (RA). |
| 1602 | SP 100 | EIA | See Test #1601, GP 210. |
| 196 | SRP-SIGNAL RECOGNITION PARTICLE ANTIBODY | IPP | Anti-SRP (Signal recognition particle) antibody was first described in a polymyositis patient in 1986. Anti-SRP antibodies are rare, in only about 4% of myositis patients and are often found in black females with an acute severe onset of polymyositis, and poor response to therapy. |
| 1152 | SSA-52 Kd AB, IGG | EIA | Just like anti-SS-A 60, anti-SS-A 52 is commonly found in patients with SLE and Sjogren 19s Syndrome, and occasionally in other autoimmune disorders. However, anti-SS-A 52 autoantibodies are also found in patients with systemic sclerosis, polymyositis and dermatomyositis. Anti-SS-A 52 are linked with antibodies to tRNA synthetases like Jo-1, PL-7, PL-12, EJ and OJ, which are often found in patients with interstitial lung involvement. These are a subset of polymyositis and dermatomyositis patients with synthetase syndrome that benefit from treatment that is different than most other autoimmune diseases. The SSA 52 kd antibody test can be ordered as a single test and is also included in our new Myositis 3 Ab Panel. |
| 200 | SYNOVIAL FLUID ANALYSIS, COMPLETE | MANUAL | Impaired function of the synovial fluid may play a role in the development of degenerative joint disease such as osteoarthritis. Com-plete analysis consists of the following: appearance and volume, cell count and differential, crystal examination, mucin & viscosity. |
| 201 | SYNOVIAL FLUID, CELL COUNT & DIFFERENTIAL | MANUAL | See Test #200, Synovial Fluid Analysis, Complete. |
| 202 | SYNOVIAL FLUID, CRYSTAL EXAM | MANUAL | See Test #200, Synovial Fluid Analysis, Complete. |
| 203 | SYNOVIAL FLUID, MUCIN CLOT | MANUAL | See Test #200, Synovial Fluid Analysis, Complete. |
| 204 | SYNOVIAL FLUID, VISCOSITY | MANUAL | See Test #200, Synovial Fluid Analysis, Complete. |
| 1644 | T3 UPTAKE | CH | The thyroid uptake test is ordinarily used in conjunction with an immunoassay for total T4 to correct for the influence which alterations in the levels of circulating thyroid hormone-binding proteins have on the total T4 level. |
| 1635 | T3, FREE | CH | Used to evaluate thyroid function and binding protein status. In hyperthyroidism, if TSH levels are low but the Free T4 level is normal, a T3 measurement should be performed, since the serum T3 concentration is often elevated earlier in the course of hyperthy-roidism, and to a greater degree than is the T4 concentration. |
| 1636 | T4, FREE | CH | Since abnormal T4 levels may signify either abnormal thyroid function or carrier protein variation (physiological or pathological), free T4 measurements more highly correlate with thyroid status than total T4 measurements. |
| 1641 | T4, THYROXINE (TOTAL) | CH | T4 (total) is the primary secretory product of the normal thyroid gland. Total T4 undergoes peripheral deiodination of the outer ring at the 5' position to yield T3. The total T4 assay is used to evaluate thyroid function, independent of binding protein status. |
| 233 | TH/TO Antibody | IPP | The Th/To is a component of the 7-2/MRP RNP. Most of the 7-2/MRP RNP is found in the GC region of the nucleolus and <1% of this snoRNP appears located in mitochondria. The Th/To antibodies are present in 10-19% of patients with limited SSc, in 11% of patients with diffuse cutaneous SSc, and in 3% of patients with primary Raynaud's disease. Anti-Th/To antibody has been shown to be highly specific for patients with SSc. The anti-Th/To antibody detection is an in-house bioassay to be performed at RDL for a qualitative determination of Th/To antibody in serum by immunoprecipitation. The Th/To antibody assay will be labeled as an "Analytic Specific Reagent (ASR)". |
| 1643 | THYROID STIMULATING HORMONE (TSH), 3rd GENERATION | CH | Measurements of circulating TSH have been used as a primary test for differential diagnosis of hypothyroidism and as an aid in monitoring the adequacy of thyroid hormone replacement therapy. |
| 271 | TISSUE TRANSGLUTAMINASE AB | EIA | Use of native human red blood cell tTG rather than guinea pig or recombinantly derived human antigen affords the advantage of ease of purification and results in preparations free from bacterial, insect or other contaminating proteins. The endomysial antigen has been identified as the protein cross-linking enzyme known as tissue transglutaminase (tTG). Antigen specific ELISA procedures incorporating tTG afford a reliable, objective alternative to the traditional immunofluorescent-based assays incorporating thin sections of primate esophagus as substrate. |
| 37 | TOTAL HEMOLYTIC COMPLEMENT (CH50) | EIA | Deficient or decreased levels of serum complement activity of the classical pathway are associated with a number of diseases. A normal CH50 assay indicates that C1 through C9 are present and functional in the serum being tested. Although CH50 can be used to assess the integrity of the classical pathway, it must not be used as a sensitive test for in vivo complement fixation. In vitro degrada-tion can also cause low CH50 activity. |
| 112 | TOTAL PROTEIN, SERUM | COL | Total Protein, serum measures the total amount of protein in one 19s blood. |
| 234 | U2 snRNP | IPP | U2 snRNP autoantibodies, known as a type of myositis-associated autoantibodies (MSAs) are found frequently, but not exclusively in patients with myositis. MSAs include autoantibodies to U1-RNP, U2-RNP, PM/SCL and Ku. |
| 114 | URIC ACID | COL | Uric acid is a waste product that is most helpful in the diagnosis of gout. Other possible causes of increased uric acid may be renal failure, hereditary diseases, and nondiabetic ketosis. |
| 148 | VITAMIN D, 25-HYDROXY (CALCIFEDIOL) | RIA | Serum concentration of 25-OH D is considered to be the most reliable measure of overall vitamin D status and thus can be used to determine whether a patient is vitamin D sufficient. |
