Effective immediately there has been an update to scheduling breath testing. Both the Bacterial Overgrowth and Lactose Intolerance breath tests must be scheduled through Epic or via Spectrum Health MyChart app.
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Immunochemistry
Compliance & Safety, General Information, Immunochemistry, Main lab
Serum Kappa/Lambda Free Light Chain Assay Update
Effective September 28th, 2020, a new generation of the serum kappa/lambda free light chain assay has been implemented.
With the implementation of the new generation of the assay there is an approximately 20% negative bias for kappa free light chains in serum containing >20 mg/dL kappa free light chain. This may affect the trending for patient who are serially monitored by this assay.
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 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.
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. |
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.
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.
General Information, Immunochemistry, Microbiology, Molecular Diagnostics, Referral/Sendouts
Herpes Simplex Virus (HSV) IgM Antibody Testing Update
As of November 25th 2019 the following tests for Herpes Simplex Virus (HSV) IgM antibody testing will be obsoleted.
Herpes IgM Antibody Screen – LAB3576
Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum – LAB3578
Herpes Simplex Panel – LAB1230539
General Information, Immunochemistry, Main lab, Test Utilization
Protein Electrophoresis Testing Update
In December, serum and urine protein electrophoresis testing will be simplified and standardized. The only testing available will be:
Protein electrophoresis, serum, IFE if indicated
Protein electrophoresis, random urine, do IFE if indicated
Protein electrophoresis, 24 hour urine, do IFE if indicated
In addition, on December 5, 2019, a new panel will be added which reflects expert recommendations for first line testing for monoclonal gammopathy, including plasma cell myeloma and most cases of amyloidosis, called “Monoclonal Gammopathy Screen”
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:
Lupus Screen
Cardiolipin IgG and IgM Antibodies
Beta-2 Glycoprotein 1 IgG and IgM Antibodies