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Lab Manual for Moffitt-Long and Mount Zion

Lab Manual for SFGH

Internal Resources

Tests Not Listed/Send-Out Tests



In addition to offering in-house tests, the Clinical Laboratory will forward requests for most commonly available laboratory tests with proven medical utility that are not performed in-house to reference laboratories that have been approved by the SFGH&TC Medical Executive Committee (these tests are referred to as send-outs).


The table lists the more commonly requested send-out tests. Additional send-outs may be found in the alphabetical test name list or on the website of our most commonly utilized reference laboratory, ARUP.


Please note that send-out tests are often expensive with limited opportunity for reimbursement in our system, and generally have limited, very specific indications. Most send-outs are therefore subject to approval by Laboratory Medicine Residents or specialty service consultants. Send-outs are not generally orderable from the Emergency Department, as test results for send-outs are not available for several days after submission of the sample(s). For questions about test order restrictions, see archived memos Send-out Test Restriction and Send-out Tests no longer available from the Emergency Department, and Clin Lab Manual section Consultation and Test Approval, OR contact the appropriate Laboratory Section BEFORE ordering the test.


An up-to-date list of restricted tests and providers authorized to approve them is maintained in LCR/Invision (Restricted Tests), also accessible in LCR from the patient test menu by clicking on "Results," then "Lab," then "Restricted Labs Info."


REFER TO THE ALPHABETICAL LIST OF TESTS, OR CONTACT THE APPROPRIATE RESIDENT OR SERVICE FOR FURTHER INFORMATION.


Test

* Requires Approval of Laboratory Medicine Resident

Specimen

Reference Range

Actin (Smooth Muscle) Antibody, IgG

1 mL serum/gold top gel tube

< 19 Units: Negative

20-30 Units: Equivocal - Suggest repeat testing in 2 to 3 weeks with fresh specimen.

Positive: ≥ 31 Units: Positive - Suggestive of autoimmune hepatitis or chronic active hepatitis.

Alpha-1-Antitrypsin

1 mL plasma in green top gel tube

100-200 mg/dL

Amitriptyline

(includes Nortriptyline)

2 mL Serum in plain red top tube

(non-gel)

Combined total:

Therapeutic 95-250 ng/mL

Toxic > 500 ng/mL

Angiotensin-1-Converting Enzyme

1 mL serum/gold top gel tube

0-6 years: 18-90 U/L

7-14 years: 24-121 U/L

15-17 years: 18-101 U/L

18+ years old: 9-67 U/L

Anti-DNA, double stranded

1.0 mL serum/gold top gel tube

None detected

Anti-ENA Antibodies

(SM and RNP Antibodies)

1.0 mL serum/gold top gel tube

Negative: < 29 AU/mL

Equivocal: 30-40 AU/mL

Positive: ≥ 41 AU/mL

Anti-Mitochondrial M2 Antibody

1.0 mL serum/gold top gel tube

20.0 Units or less: Negative

20.1-24.9 Units: Equivocal

25.0 Units or greater: Positive

Anti-Neutrophilic Cytoplasmic Antibodies

(includes P-ANCA and C-ANCA)

1.0 mL serum/gold top gel tube

< 1:20; Not significant

Anti-Sjogren's Antibodies

(includes SSA and SSB)

1.0 mL serum/gold top gel tube

Negative: < 29 AU/mL

Equivocal: 30-40 AU/mL

Positive: ≥ 41 AU/mL

Bordetella pertussis PCR*

2.0 mL Nasopharyngeal aspirate or wash; or NP swab in viral transport medium

Not detected

Cardiolipin Antibodies, IgG and IgM *

1 mL serum/gold top gel tube

IgG:

0-14 GPL: Negative

15-19 GPL: Indeterminate

20-80 GPL: Low to Medium positive

>81 GPL: High positive

IgM:

0-12 MPL: Negative

13-19 MPL: Indeterminate

20-80 MPL: Low to Medium positive

>81 MPL: High positive

Ceruloplasmin

0.5 mL serum/gold top gel tube

Adults, 18+ yrs: 17-54 mg/dL

Cyclic Citrullinated Peptide Antibody, IgG

1 mL serum/gold top gel tube

19 Units or less: Negative

20-39 Units: Weak positive

40-59 Units: Moderate positive

60 Units or greater: Strong positive

Cytomegalovirus Antibody, IgG

1 mL serum/gold top gel tube

< 0.89 IV: Negative - No significant level of detectable CMV IgG antibody.

0.90-1.09 IV: Equivocal - Repeat testing in 10 to 14 days may be helpful.

Positive: ≥ 1.10 IV: Positive - IgG antibody to CMV detected, which may indicate a current or past CMV infection.

Cytomegalovirus PCR * (blood, bone marrow)

5 mL lavender top (EDTA) tube

Not detected

Dehydroepiandrosterone Sulfate

1 mL serum/gold top gel tube

Age & gender dependent;

call Lab

Dehydroepiandrosterone (DHEA-Unconjugated)

1 mL serum/gold top gel tube

Age & gender dependent;

call Lab

Desipramine

2 mL Serum in plain red top tube

(non-gel)

Therapeutic Range: 100-300 ng/mL

Toxic: > 500 ng/mL

Erythropoietin

1 mL serum/gold top gel tube

4-27 mU/mL

Estradiol

1 mL serum/gold top gel tube

Age & gender dependent;

call Lab

Fecal Fat, Qualitative

5 g stool (no preservative)

Normal

Fungal Susceptibility Testing *

Fungal isolate

For further information, call Microbiology Lab at 206-8576

Gastrin

1 mL serum/gold top gel tube, fasting (10 hours)

Adult, < 100 pg/mL

Growth Hormone

1 mL serum/gold top gel tube

Male:

0-6 yrs: 0.10-8.80 ng/mL

7-17 yrs: 0.03-14.90 ng/mL

18+ yrs: 0.01-1.00 ng/mL

Female:

0-6 yrs: 0.10-8.80 ng/mL

7-17 yrs: 0.6-23.80 ng/mL

18+ yrs: 0.03-10.00 ng/ml


Haldol (Haloperidol)

2.5 mL serum in plain red top tube

Therapeutic Range: 2.0-15.0 ng/mL

Toxic range not well-established; some patients experience toxicity within the therapeutic range.

Helicobacter pylori Antigen

5 grams or 0.5 mL stool (semi-solid)

Negative

Hepatitis Be Antibody

1 mL serum/gold top gel tube

Negative

Hepatitis Be Antigen

1 mL serum/gold top gel tube

Negative

Hepatitis C Viral RNA, Genotype

2 mL plasma/PPT tube or 2 mL serum/gold top gel tube

For further info call Lab at

206-8590

Hepatitis C Viral RNA, High Resolution Genotype

2 mL plasma/PPT tube or 2 mL serum/gold top gel tube

For further info call Lab at

206-8590

Histoplasma Antigen *

2 mL urine

Negative: < 2.0 EIA Units

Weak Positive: 2.0-4.0 EIA Units

Positive: ≥ 4.1 EIA Units

IgE


1 mL serum/gold top gel tube

15+ years: 0-180 IU/L

Imipramine

(includes Desipramine)

2 mL serum in plain red top tube

(non-gel)

Therapeutic Range: 150-300 ng/mL

Toxic: ≥ 500 ng/mL

Metanephrines,

Fractionated (Urine)

24 hr Urine

(Adjust pH to 2-3 after collection using 6N HCl);

Refrigerate

18 years and older:

Metanephrine: 152-1775 nmol/day

Normetanephrine: 273-3548 nmol/day

Methotrexate

1 mL serum in plain red top tube

(non-gel)

Protect from light.

For further info call Lab at

206-8590

Nortriptyline

2 mL Serum in plain red top tube

(non-gel)

Therapeutic 50-150 ng/mL

Toxic > 500 ng/mL

Progesterone

1 mL serum in gold top gel tube

Male (10 years and older):
0.6 ng/mL or less
Female: 
Follicular: 1.1 ng/mL or less
Luteal: 1.0-21.0 ng/mL
Mid-luteal: 6.0-24.0 ng/mL
Postmenopausal: 1.0 ng/mL or less
1st trimester: 9.3-33.2 ng/mL
2nd trimester: 29.5-50.0 ng/mL
3rd trimester: 83.1-160.0 ng/mL

Quinidine

1 mL serum in plain red top tube

(non-gel)

1.5-4.5 µg/mL
Toxic: 10.1 µg/mL or greater 


Russell Viper Venom Time (RVVT) *


1.5 mL frozen plasma/blue top tube

dRVVT: 33-44 seconds

dRVVT, 1:1 Mix (performed if dRVVT > 44 seconds): 33-44 seconds

Confirmation Test (performed if dRVVT 1:1 Mix > 44 seconds): Negative

Thrombosis Risk Factors Mutations *

4.5 mL whole blood in blue or lav top tube

For further info call Lab at

206-8590

Thyroglobulin

(panel includes Anti-Thyroglobulin and Thyroglobulin)

1 mL serum/ gold top gel tube

Thryoglobulin:

0-11 yrs: 2.9-56 ng/mL

12 yrs and older: 1.3-31.8 ng/mL

Thryoglobulin Ab:

0.0-20.0 IU/mL

Percent Recovery: 80-120%


Thyroid Stimulating Immunoglobulin

1 mL serum/gold top gel tube

Negative: 113% basal activity or less

Indeterminate: 114-127% of basal activity

Positive: 128% basal activity or greater

Tissue Transglutaminase Antibody, IgA

(Reflexes to Anti-Endomysial Antibody, IgA Titer)

1.0 mL serum/gold top gel tube

Tissue Transglutaminase Ab, IgA:

19 Units or less: Negative

20-30 Units: Weak positive

31 Units or greater: Moderate to Strong positive


Anti-Endomysial, IgA Titer: less than 1:10

Viral Culture (includes the following viruses:

Adenoviruses, enteroviruses, Herpes simplex, influenza, parainfluenza, respiratory syncytial virus, and Varicella-zoster.) Includes culture for cytomegalovirus only if requested.

Various (See Virology, Routine Culture)

For further information, call 206-8576

Viral Susceptibility Testing*

Viral Isolate

For further information, call 206-8576.


Vitamin D (1,25-Dihydroxy) *

1 mL serum/gold top gel tube

Adult: 15-75 pg/mL


Von Willebrand Panel *

4 mL plasma in 3

blue top tubes



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