Test ID: 8104
Renal Biopsy, Immunohistology
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
The evaluation of patients with undiagnosed kidney disease
Following the course of therapy or progression of disease
Diagnosing disease cause by immune mechanisms
The evaluation of kidney and/or lung specimens for Goodpasture’s disease
Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| 84226 | Immunofluorescent C4d Stain | Yes | No |
| 60328 | IgG1 IF, Renal | No | No |
| 60329 | IgG2 IF, Renal | No | No |
| 60330 | IgG3 IF, Renal | No | No |
| 60331 | IgG4 IF, Renal | No | No |
| 60285 | C1q Paraffin IF, Renal | No | No |
| 60287 | IgA Paraffin IF, Renal | No | No |
| 60288 | IgG Paraffin IF, Renal | No | No |
| 60289 | IgM Paraffin IF, Renal | No | No |
| 60290 | Kappa Paraffin IF, Renal | No | No |
| 60291 | Lambda Paraffin IF, Renal | No | No |
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| 60301 | IgA IF, Renal | No | Yes |
| 60302 | IgG IF, Renal | No | Yes |
| 60303 | IgM IF, Renal | No | Yes |
| 60304 | Lambda IF, Renal | No | Yes |
| 60305 | Kappa IF, Renal | No | Yes |
| 60306 | C1q IF, Renal | No | Yes |
| 60307 | C3 IF, Renal | No | Yes |
| 60308 | Albumin IF, Renal | No | Yes |
| 60309 | Fibrinogen IF, Renal | No | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
The first 9 stains are not orderable individually but are performed when 8104 Renal Biopsy, Immunohistology is ordered. In most cases, the first 9 immunofluorescent stains are the only ones required and performed. In certain cases pronase-digested paraffin-based slides can be used for immunofluorescence staining as a salvage technique when there is no Zeus sample or an inadequate Zeus sample (eg, no glomeruli). Determining the subtype of IgG antibody found in renal immunofluorescent panel can be helpful in confirming a select few disease processes affecting the kidney. The C4d stain will be setup on Zeus specimens for transplant/allograft kidney biopsies. The C4d stain can also be ordered separately without the full immunofluorescence panel stains.
88501 Renal Pathology Consultation and 8331 Renal Biopsy, Light Microscopy must be ordered with this test and will be charged separately.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Immunohistology (Immunofluorescence)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Goodpasture's syndrome, kidney or lung biopsy
IF
Immunofluorescence, Kidney or Lung Biopsy
Kidney Biopsy
Renal Biopsy
XIF RBIH
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
This test is not a stand-alone, orderable test, but must be accompanied by 88501 Renal Pathology Consultation and 8331 Renal Biopsy, Light Microscopy.
Sources: Renal or lung
Container/Tube: Renal Biopsy Kit (Supply T231)
Specimen Volume: Adequate amount
Collection Instructions:
1. Collect specimens according to the instructions in Renal Biopsy-Procedures of Handling Tissue for Light Microscopy, Immunohistology, and Electron Microscopy in Special Instructions.
2. If Zeus is not available, tissue may be submitted frozen on dry ice.
Additional Information:
1. A hematoxylin-and-eosin slide and a copy of the preliminary pathology report are required.
2. Immunofluorescence on lung tissue must be ordered in conjunction with 5439 Surgical Pathology Consultation.
Forms:
1. Renal Biopsy Patient Information Sheet in Special Instructions
2. If not ordering electronically, submit a Pathology/Cytology Request Form (Supply T246) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Tissue | Refrigerated (preferred) | |
| Ambient | ||
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Kidney biopsy has proven to be of value in the clinical evaluation and management of patients with undiagnosed kidney disease. The clinical setting may include acute renal failure, nephrotic syndrome, asymptomatic proteinuria and hematuria. Kidney diseases in the setting of a systemic disease are often diagnosed on kidney biopsy.
Biopsy of the transplanted kidney is important in the determination of the presence of acute rejection, infection, or recurrent disease.
Optimal interpretation of a kidney biopsy requires integration of clinical and laboratory results with light microscopic, immunofluorescent histology, and electron microscopy findings.
Immunofluorescent histology is necessary in the diagnosis of immune complex mediated disease such and IgA nephropathy, membranous nephropathy, and post-infectious glomerulonephritis; for evaluation of light-chain related disease such as amyloidosis, light-chain deposition disease, and light-chain cast nephropathy, and other immune-mediated diseases such as Goodpasture's disease and lupus nephritis.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Interpretation Provides information to assist in interpretation of the test results
A written report is issued upon completion of immunohistologic examination. If material is also submitted for light microscopy, the immunohistologic report will be incorporated with the light microscopic findings and a written report will be issued.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Accurate and timely interpretation of a kidney biopsy requires integration of light microscopic, immunofluorescent histology, and electron microscopic findings with clinical and laboratory data.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Velosa JA, Holley KE: Pathology and immunopathology of renal diseases. In Renal Function Tests: Clinical Laboratory Procedures and Disorders. Edited by CG Duarte. Boston, MA, Little, Brown, and Company, 1980, pp 347-385
Method Description Describes how the test is performed and provides a method-specific reference
Standard techniques are utilized in the preparation of frozen tissue for immunofluorescence. In some cases, paraffin embedded tissue can be examined by immunoperoxidase methodology, ie, demonstration of IgA (eg, demonstration of IgA). (Velosa JA, Holley KE: Pathology and immunopathology of renal diseases. In Renal Function Tests: Clinical Laboratory Procedures and Disorders. Edited by CG Daurte. Boston, MA, Little, Brown, and Company, 1980, pp 354-358)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; Continuously, 7 a.m.-3 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
88346 x 9
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 19335 | Renal Bx, Immunohistology | N/A |
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