Immunochemistry

New Test: COVID-19 IgG Antibody – Serology test

Effective May 18, 2020, Spectrum Health Regional Laboratory is pleased to be offering in-house COVID-19 serology testing, with initial availability 1,000 tests per day.

 

What is Serology Testing?

•  Serology testing measures the body’s immune response to COVID-19 infection in the form of antibody production against the SARS-CoV-2 virus.

•  There is a single COVID-19 serology order available in Epic, however, the Spectrum Health laboratory performs two versions of antibody testing to increase specificity and avoid reporting false positive results. An initial screen will be used to measure total antibody (IgA, IgM, and IgG), and positives will be confirmed by a second method that is specific to IgG.

•  Specificity is critical when the expected prevalence in a community is low. This serology testing is not expected to cross-react with other circulating coronaviruses that cause the common cold.

•  A positive IgG result indicates previous infection with COVID-19, but does not indicate immunity or protection against future infection.

•  This test should not be used to detect acute COVID-19 disease. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.

•  Whether positive or negative for the presence of COVID-19 antibodies, serology testing results do not support easing of behaviors such as social distancing, wearing masks, or hand hygiene.

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General Information, Hemostasis/Coagulation

Test Update: D-Dimer

Effective April 30, 2020, Spectrum Health Laboratories will no longer be performing the D-Dimer Semi-Quantitative assay. D-Dimer (quantitative) will be the only orderable for the D-Dimer assay. This D-Dimer will be reportable up to 35,000 ng/mL FEU. The cut-off value used in the diagnosis of venous thromboembolism (VTE), deep vein thrombosis (DVT), or pulmonary embolism (PE) remains at 500 ng/mL FEU. It is important to note inpatients can be (falsely) elevated in many underlying non-thrombotic conditions common in hospitalized patients.

Questions and inquiries regarding this change may be sent to the Coagulation Department using the “Contact Us” link above.

 

TEST INFORMATION

D-Dimer – [Epic Code: LAB313, Interface Code: 10123, CPT 85379]

Discontinued: D-Dimer Semiquantitative for DIC [Epic Code: LAB760, Interface Code: 10122, CPT: 85378]

General Information, Immunochemistry

Immunochemistry ANA (Antinuclear Antibodies) Testing Name Update

Effective April 22nd, 2020, the following ANA (Antinuclear Antibodies) Tests’ name will be updated.  The change in naming convention comes in hopes of enhancing proper test utilization.  This update includes only the name change with no changes in laboratory testing workflow.

Old Test Name New Test Name Test Code Clinical Utility
ANA (Antinuclear Antibodies) Screen, Double Reflex to ANA IFA Hep2 Titer and Pattern, and if positive to ANA antibodies ANA screen LAB1230491 Preferred initial ANA screen for autoimmune connective tissue diseases.
ANA (Antinuclear Antibodies), Hep2 Substrate IFA with reflex to Titer and Pattern if positive IFA ANA (Rheumatology)

 

LAB3540 Preferred confirmatory ANA test for autoimmune connective tissue diseases.  With ordering recommendations for rheumatology only.
Advanced Technology Laboratory, Cytogenetics, General Information, Referral/Sendouts

Test Update: Chromosome Analysis Breakage Study

Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the Chromosome Analysis Breakage Study will no longer be offered by the Spectrum Health Cytogenetics Department.

If need arises for this test, please place an order for a Reference Miscellaneous (EPIC# LAB848) and enter “Test 140 DEB Breakage Study to Integrated Genetics” in the comments.  The testing will be sent out through Spectrum Health Referrals Department to Integrated Genetics. Continue Reading

Hemostasis/Coagulation

New Test: Thrombin Time

Effective March 4th, 2020, Thrombin Time will change from a sendout reference test performed by Mayo Clinic Laboratories to an in-house test performed by Spectrum Health Regional Laboratory. This test will be performed in the Coagulation Laboratory and will include a new reference range (please see link in Test Information below).

Thrombin Time is suitable for monitoring fibrinolysis therapy, screening for disorders of fibrin formation and in cases of suspected fibrinogen deficiency states. It is also useful for the differentiation between a heparin induced prolongation of the thrombin time and fibrin formation disorders.

For questions around this test, please contact the Coagulation Department at 616-267-2740.

TEST INFORMATION

Thrombin Time – Epic Code: #LAB11230581, Interface Code: #11230581, CPT: #85670

Toxicology

Updated Fecal Calprotectin Testing

As of February 12, 2020 testing for fecal calprotectin will be brought in-house.

As result Calprotectin, Feces (LAB3290) will be replaced with Calprotectin, Feces (LAB1230580).

Please note the following differences between the new and previous test in terms of specimen requirements and reference ranges.

Questions may be directed to the Toxicology Laboratory using the “Contact Us” link above.