After consultation with our clinical partners, Spectrum Health West Michigan Laboratory will be adjusting the pediatric reference ranges for our new ALT and AST reagents in an effort to better serve our population. Numerous academic studies were reviewed, and the values listed below were adopted on August 3, 2022:
Browsing Tag
Internal Medicine
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.
The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing.
Compliance & Safety, Education & Training, Microbiology
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
Advanced Technology Laboratory, Cytogenetics
Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
• Prader-Willi/Angelman (15q11-q13) by FISH
Recommended test is Angelman/Prader-Willi mPCR
• Smith Magenis (17p11) by FISH
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.
Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory.
West Michigan influenza infections peaked mid-March 2022 and have been declining in the weeks that followed. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
| Low Influenza Prevalence |
High Influenza Prevalence |
|
| Recommended Order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
More detailed information can be found as published by the CDC:
TEST INFORMATION
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
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.
Go Live Date delayed to 3/3/2022
Go-Live Date: 3/2/2022
Due to new instrumentation at Spectrum Health Blodgett Hospital Laboratory (BIRL) and to standardize across the Spectrum Health system, we will be adopting new tests for AST and ALT. The difference between our current test and this new test is the addition of the co-factor pyridoxal phosphate (Vitamin B6). The new test is the recommended test of the International Federation of Clinical Chemistry and ultimately will provide our patient population more accurate AST and ALT results. We did not adopt the new test in the past because it came with logistical and stability issues that made its use in the lab difficult. The new instrumentation we obtained has solved some of these concerns.
Historically, if patients had a Vitamin B6 deficiency, their AST and ALT levels may have been falsely lower than the true values. This decrease was due to the lack of endogenous co-factor causing a slower reaction rate when we tested the patient sample. After we implement the new test across the system, you may notice an increase in your patient’s AST and ALT results. This increase may be evidence that your patient had some degree of Vitamin B6 deficiency. If you were trending results, we recommend you establish a new baseline with the new test versions. The lab has been changed slightly in EPIC to prevent trending between the two test versions, since the results may not be able to be correlated if your patient had a Vitamin B6 deficiency.