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Test ID: SASP
Aspergillus fumigatus, IgG Antibodies, Serum

NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating patients suspected of having lung disease caused by Aspergillus fumigatus

Method Name A short description of the method used to perform the test

Fluorescence Enzyme Immunoassay (FEIA)

Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name

Aspergillus fumigatus, IgG Ab, S

Aliases Lists additional common names for a test, as an aid in searching

A fumigatus, IgG Antibodies

Specimen Type Describes the specimen type needed for testing

Serum

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

Forms: If not ordering electronically, submit a General Request Form (Supply T239) 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.

0.3 mL

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 TypeTemperatureTime
SerumRefrigerated (preferred)14 days
 Frozen 90 days

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Aspergillus fumigatus is a causative agent of hypersensitivity pneumonitis (HP) as well as invasive lung disease with cavitation or pneumonitis, and allergic bronchopulmonary disease.(1) Other causative microorganisms of HP include Micropolyspora faeni, and Thermoactinomyces vulgaris. The development of HP and allergic bronchopulmonary disease caused by Aspergillus fumigatus is accompanied by an immune response to Aspergillus fumigatus antigen with production of IgG or IgE antibodies, respectively. While the immunopathogenesis of HP and allergic bronchopulmonary disease is not known, several immune mechanisms are postulated to play a role, including both cellular and humoral mechanisms.

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.

<4 years: not established

> or =4 years: < or =102 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.

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 concentrations of antibodies to Aspergillus fumigatus are found in patients with invasive aspergillosis and cavitary lung disease as well as HP.

 

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 were found in 37 sera from 34 patients with aspergillosis. The levels of antibodies were often markedly elevated (>10 times the upper limit of normal), and there was no difference in subgroups of patients with hypersensitivity pneumonitis (HP) and cavitary disease with HP.(2)

Clinical Reference Provides recommendations for further in-depth reading of a clinical nature

1. Fink JN, Zacharisen MC: Chapter 69: Hypersensitivity pneumonitis. In Allergy Principles and Practice. Vol 1. Fifth edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, Mosby Year Book Inc, 1998

2. Anderson E, Jacob GL, Roberts 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, 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 fluorescent 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 nonspecific 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.

Saturday; 9 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.

Same day/1 day

Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result

3 days

Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location The location of the laboratory that performs the test

Rochester

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.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

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

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 IDReporting NameLOINC Code
SASPAspergillus fumigatus, IgG Ab, S26954-8