Test ID: SAL
Hypersensitivity Pneumonitis IgG Antibodies, Serum
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
Evaluation of patients suspected of having hypersensitivity pneumonitis induced by exposure to Aspergillus fumigatus, Thermoactinomyces vulgaris, or Micropolyspora faeni
Method Name A short description of the method used to perform the test
Fluorescence Enzyme Immunoassay (FEIA)
Includes IgG antibodies to Micropolyspora faeni, Thermoactinomyces vulgaris, and Aspergillus fumigatus.
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
Aspergillus fumigatus
Farmer's Lung Antibody
Micropolyspora faeni
Precipitin-Aspergillus fumigatus
Precipitin-Micropolyspora faenii
Precipitin-Thermoactinomyces vulgar
Thermoactinomyces vulgaris
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: 0.5 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 OK |
| Lipemia | Mild OK; Gross OK |
| 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) | 14 days |
| Frozen | 90 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Hypersensitivity pneumonitis (HP) is a heterogeneous disease caused by exposure to organic dust antigens, animal proteins, chemicals, medications, or microorganisms (eg, Thermoactinomyces vulgaris, Micropolyspora faeni, Aspergillus fumigatus). The immunopathogenesis of disease is not known; but, several immunologic mechanisms may play a role in producing alveolitis, including cellular immunity mediated by CD4 and CD8 T-lymphocytes, immune-complex mediated inflammation, complement activation or activation of alveolar macrophages.(1)
HP is suspected clinically in patients who present with intermittent or progressive pulmonary symptoms and interstitial lung disease. The diagnosis is established by compatible clinical and radiographic findings, pulmonary function tests, and demonstration of specific antibodies to organic antigens known to cause the disease.
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.
Aspergillus fumigatus, IgG ANTIBODIES
<4 years: not established
> or =4 years: < or =102 mg/L
Micropolyspora faeni, IgG ANTIBODIES
0-12 years: < or =4.9 mg/L
13-18 years: < or =9.1 mg/L
>18 years: < or =13.2 mg/L
Thermoactinomyces vulgaris, IgG ANTIBODIES
0-12 years: < or =6.6 mg/L
13-18 years: < or =11.0 mg/L
>18 years: < or =23.9 mg/L
Interpretation Provides information to assist in interpretation of the test results
Elevated concentrations of IgG antibodies to Aspergillus fumigatus, Thermoactinomyces vulgaris, or Micropolyspora faeni in patients with signs and symptoms of hypersensitivity pneumonitis is consistent with disease caused by exposure to 1 or more of these organic antigens. Extreme elevations (>5 times the upper limit of normal) occur in some patients with active disease.(2)
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
IgG antibodies to Aspergillus fumigatus, Thermoactinomyces vulgaris, or Micropolyspora faeni are detectable in sera from healthy individuals and the presence of antibodies is not sufficient to establish the diagnosis of hypersensitivity pneumonitis (HP).
Elevated concentration of antibodies to Aspergillus fumigatus are found in patients with invasive aspergillosis and cavitary lung disease as well as HP.(2)
The levels of antibodies to these antigens often decrease following treatment; but elevated levels may persist in treated patients for long periods.
Supportive Data
Elevated concentrations of IgG antibodies to Aspergillus fumigatus, Thermoactinomyces vulgaris, or Micropolyspora faeni were found in 43 of 54 sera from patients with clinically documented hypersensitivity pneumonitis.(2)
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Fink JN, Zacharisen MC: Hypersentivity pneumonitis. In Allergy Principles and Practice. Vol. 1. Fifth edition. Edited by E Middleton, Jr., CE Reed, EF Ellis, et al. St. Louis, MO, Mosby Year Book, Inc., 1998, Chapter 69
2. Anderson E, Jacob GL, Robert GD, Homburger HA: Comparative evaluation of enzyme immunoassay and immunodiffusion for detection of IgG antibodies to hypersensitivity pneumonitis antigens. Poster Presentation, AAAAI Annual Meeting, San Diego, CA, March 3-8, 2000. J Allergy Clin Immunol 2000;105:S304
Method Description Describes how the test is performed and provides a method-specific reference
The Phadia ImmunoCAP System specific IgG fluorescence enzyme immunoassay (FEIA) provides an in vitro method for measuring the levels of circulating specific IgG antibodies in human blood samples. Specific IgG from the patient's serum reacts with the antigen of interest, which is covalently coupled to an ImmunoCAP. After washing away non-specific IgG, enzyme labeled anti-IgG antibodies are added to form a complex. After incubation, unbound enzyme-anti IgG is washed away and the bound complex is then incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. The fluorescence is proportional to the amount of specific IgG, which is present in the patient's sample, ie, the higher the fluorescence value, the more specific IgG antibody is present.(Package insert: Phadia AB, Uppsala, Sweden 2009)
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; 9 a.m.-8 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
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.
86606-Aspergillus fumigatus
86671 x 2-Fungus, not elsewhere specified
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 |
|---|---|---|
| SASP | Aspergillus fumigatus, IgG Ab, S | 26954-8 |
| MPSF | Micropolyspora faeni, IgG Ab, S | 26948-0 |
| TAMV | Thermoactinomyces vulgaris, IgG Ab | 34190-9 |
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