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