Test ID: SCLAM
Chlamydia Serology, Serum
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
As an aid in the clinical diagnosis of chlamydial infections
Method Name A short description of the method used to perform the test
Micro-Immunofluorescent Antibody (MIF) Assay
Includes Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis.
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
Chlamydia Antibodies Differentiation Panel
Chlamydia Antibodies, IgG and IgM
Chlamydia Differentiation Antibody Panel
Chlamydia pneumoniae (TWAR)
Chlamydia pneumoniae, IgG and IgM
Chlamydia psittaci, IgG and IgM
Chlamydia Species Differentiation Antibody Panel
Chlamydia trachomatis Antibody
Chlamydia trachomatis, IgG and IgM
Chlamydia TWAR
Chlamydophila
Chlamydophila pneumoniae
Chlamydophila psattaci
LGV (Lymphogranuloma Venereum)
Lymphogranuloma Venereum (LGV) Antibodies
Ornithosis
Psittacosis Antibodies
TWAR (Chlamydia pneumoniae)
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.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 0.2 mL
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 | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| 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 |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Members of the family Chlamydiaceae are small, nonmotile, gram-negative, obligate intracellular organisms that grow in the cytoplasm of host cells. Two genera of clinical importance are Chlamydia, which includesChlamydia trachomatis, and Chlamydophila, which includesChlamydophila pneumoniae and Chlamydophila psittaci. These organisms share many features of bacteria and are susceptible to antibiotic therapy. They are also similar to viruses, requiring living cells for multiplication.
The chlamydial life cycle can be divided into 2 distinct phases: a extracellular, nonreplicating, infectious stage and an obligate intracellular, replicating, noninfectious stage. The infectious form, or elementary body (EB), attaches to the target cell membrane and enters the cell via a phagosome. After cell entry, the EB reorganizes into reticulate particles (forming inclusion bodies) and binary fission begins. After 18 to 24 hours, reticulate particles condense to form EBs. These new EBs are released, beginning another infection cycle.
Chlamydophila psittaci is the causative agent of psittacosis, a disease characterized by pneumonia, headache, altered mentation, and hepatosplenomegaly. Psittacosis is acquired by airborne transmission from infected birds.
Chlamydophila pneumoniae (formerly known as TWAR and, more recently, as Chlamydia pneumoniae) causes pneumonia in humans. It is unique because it is a primary pathogen of humans, is spread from human to human, and apparently has no animal or bird host. Chlamydophila pneumoniae is responsible for approximately 10% of pneumonia cases.
Chlamydia trachomatis has been implicated in a wide variety of infections in humans. It is a common cause of nongonococcal urethritis and cervicitis, and many systemic complications of chlamydial infections have been described. In females, this organism is a cause of pelvic inflammatory disease, salpingitis, and endometritis. In males, epididymitis and Reiter's syndrome occur. Lymphogranuloma venereum is a sexually transmitted infection caused by Chlamydia trachomatis. It presents with a transient primary genital lesion followed by suppurative regional lymphadenopathy. Occasionally, severe proctitis or proctocolitis may develop. Chlamydia trachomatis also causes ophthalmologic infections, such as trachoma (rare in the United States), adult inclusion conjunctivitis and inclusion conjunctivitis in neonates. These disorders have traditionally been diagnosed by cytologic detection or culture. However, molecular detection methods (#81096 "Chlamydia trachomatis by Nucleic Acid Amplification") may now represent a more sensitive diagnostic approach.
Fitz-Hugh and Curtis syndrome (perihepatitis) has been associated with chlamydiae.
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.
Chlamydophila pneumoniae
IgG: <1:64
IgM: <1:10
Chlamydophila psittaci
IgG: <1:64
IgM: <1:10
Chlamydia trachomatis
IgG: <1:64
IgM: <1:10
Interpretation Provides information to assist in interpretation of the test results
IgG
Chlamydophila pneumoniae
> or =1:512
IgG endpoint titers of > or =1:512 are considered presumptive evidence of current infection.
<1:512 and > or =1:64
A single specimen endpoint titer of > or =1:64 and <1:512 should be considered evidence of infection at an undetermined time. A second specimen drawn 10 to 21 days after the original draw should be tested in parallel with the first. If the second specimen exhibits a titer > or =1:512 or a 4-fold increase over that of the initial specimen, current (acute) infection is indicated. Unchanging titers >1:64 and <1:512 suggest past infection.
<1:64
IgG endpoint titers <1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
Chlamydophila pneumoniae antibody is detectable in 25% to 45% of adults tested.
Chlamydophila psittaci and Chlamydia trachomatis
> or =1:64
IgG endpoint titers of > or =1:64 are considered presumptive evidence of current infection.
<1:64
IgG endpoint titers <1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
IgM
Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis
> or =1:10
IgM endpoint titers of > or = 1:10 are considered presumptive evidence of infection.
<1:10
IgM endpoint titers <1:10 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Anti-chlamydial IgG can persist for years. All results from chlamydial serologies must correlate with clinical history and other data available to the physician.
Specimens drawn too early during primary infection may not contain detectable antibodies. If chlamydial infection is suspected, a second specimen should be drawn 10 to 21 days later and tested in parallel with the original specimen.
During a primary Chlamydia infection, the early antibody response is crossreactive with multiple Chlamydia species. Cross-reactivity may also occur due to exposure to more than 1 Chlamydia species.
Due to the unique subspecies-specific antigen on the Chlamydophila psittaci organisms, this assay for psittacosis is not expected to detect an antibody response in all cases. Sera from suspected cases of psittacosis should also be screened by complement fixation for detection of chlamydial group antigens. Complement fixation is not performed by Mayo Medical Laboratories; contact Mayo Medical Laboratories for further assistance.
Chlamydia micro-immunofluorescent antibody assay utilizes serotypes D-K of Chlamydia trachomatis. Sera from suspected cases of lymphogranuloma venereum should also be screened by complement fixation for detection of chlamydial group antigens. Complement fixation is not performed by Mayo Medical Laboratories; contact Mayo Medical Laboratories for further assistance.
Due to the limited sensitivity and specificity of Chlamydia serologic tests, patients with suspected Chlamydia trachomatis infection should be tested by a molecular method (eg, CDNA/81096 Chlamydia trachomatis by Nucleic Acid Amplification) when clinical manifestations are present.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Movahed MR: Infection with Chlamydia pneumoniae and atherosclerosis: a review. J South Carolina Med Assoc 1999;95:303-308
2. Smith T: Chlamydia. In Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. 6th edition. Edited by N Schmidt, R Emmons. Washington, DC, APHA, 1989, pp 1165-1198
3. Sheffield PA, Moore DE, Voigt LF, et al: The association between Chlamydia trachomatis serology and pelvic damage in women with tubal ectopic gestations. Fertil Steril 1993;60:970-975
Method Description Describes how the test is performed and provides a method-specific reference
The micro-immunofluorescent antibody assay is a 2-stage "sandwich" procedure. In the first stage, the patient serum is diluted in phosphate-buffered saline, added to appropriate slide wells in contact with the substrate, and incubated. After incubation, the slide is washed in buffered saline to remove unbound serum antibodies. In the second stage, each antigen well is overlaid with fluorescein-labeled antibody to IgG or IgM. The slide is incubated, allowing antigen-antibody complexes to react with the fluorescein-labeled anti-IgG. After the slide is washed, dried, and mounted, it is examined using fluorescence microscopy. Positive reactions appear as bright apple-green fluorescent elementary bodies with a background matrix of yolk sac. Semiquantitative endpoint titers are obtained by testing serial dilutions of positive specimens. (Schachter J: Chlamydiae [Psittacosis-Lymphogranuloma Venereum-Trachome Group]. In Manual of Clinical Microbiology. 4th edition. Edited by E Lennette, A Balows, W Hausler, H Shadomy. Washington, DC, ASM Press, 1985, pp 856-861; Smith T: Chlamydia. In Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. 6th edition. Edited by N Schmidt, R Emmons. Washington, DC, APHA, 1989, pp 1165-1198)
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 Saturday; 9 a.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.
86631 x 3-IgG
86632 x 3-IgM
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 |
|---|---|---|
| 185 | C. pneumoniae IgG | 6913-8 |
| 186 | C. pneumoniae IgM | 6914-6 |
| 190 | C. trachomatis IgG | 6919-5 |
| 191 | C. trachomatis IgM | 6920-3 |
| 187 | C. psittaci IgG | 6916-1 |
| 188 | C. psittaci IgM | 6917-9 |
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