2 - SEROLOGY

full name and birth date

Pre-Analytics

Always check the two patient identifiers; (2) of the patient

2000

Pre-Analytics

Barcode starting with “_” should always be attached in the tube

500

Pre-Analytics

Barcode starting with “_” should be attached in “SEROLOGY LOGSHEET”

2000

1000

Pre-Analytics

Starting barcode for Serology samples: _ – for regular requests; _ – for ACTH

Free Testosterone

plasma insulin

LAC

Pre-Analytics

_ _ – with albumin from chemistry (299)

• 403 – _ _

• 400 – _ (APAS)

Pre-Analytics

_ _ – with albumin from chemistry (299)

• 403 – _ _

• 400 – _ (APAS)

Atellica

Routine Tests

_

AFP, HCG-BETA, E2

TPSA, FSH, PTH

CEA, LH, VIT D

CA 15-3, PROG, TSH

CA 19-9, PRL, FT3

FPSA, TESTO, FT4

T3

T4

Architect i2000SR

Routine Tests

_ _

Hbe Ag, SHBG, A-HBS, Ferritin

HBs Ag, VB12, HAV-IgM2, Insulin

Core-IgM, HAV-IgG2, C peptide, Folate II

Core-Total, A-HCV, CA125, DHEAS

A-Hbe, CYFRA 21-1, HE4

PIVKA II, SCC

PEPSINOGEN I, PRO-GRP

PEPSINOGEN II

AU480

Routine Tests

_

CRPH, C3

ASO, C4

CRP, IgG

RF, IgA

IgM

LPAX, IgE

AAT, TRF

PAB, CER

Access 2

Routine Tests

_ _

TG2

ATG

ATPO

EPN

HGrH

IL-6

OSTASE

AMH

VIDAS 3

Routine Tests

_ _

PCT, CMV, IgM

HIV 5, CMV IgG

HAV-Total, RUB IgM

LYME-IgG, RUB IgG

LYME-IgM, TOXO IgM

TOXO IgG

COVID IgG

COVID IgM

MAGLUMI- SNIBE

Routine Tests

_ _

Neutralizing Ab

IGF

BMG

ACTH

Atellica-DLC

Routine Tests

_ _

Cystatin C

AFP, TSA, CEA, CA 15-3, CA125, CA19-9, B-HCG, BAP (Bone Alkaline Phosphatase)

Routine Tests

Tumor Markers requires Delta Check: (8)

ACTH

Routine Tests

_ – needs separated plasma samples if from another hospital; If originated from in-patient, outpatient, and other satellite laboratories it should be on ice, cold, and 5cc lavender

Immunoassay (aka HIV Testing)

Routine Tests

_ – must have a completed consent forms and 2 yellow tubes & 3 lavender tubes

Chlamydia Swab

Chlamydia Urine

Routine Tests

_ _ and _ _ – should have a complete name and store in Sanyo Ref (2-8C)

15 minutes, 4000 rpm

Routine Tests

Centrifuge settings

Chemiluminescence Immunoassay (CLIA)

Serology Machines

Atellica SCI

?

Chemiluminescence Microparticle Immunoassay (CMIA)

Serology Machines

Architect i2000SR

?

Nephelometry and Turbidimetry

Serology Machines

Immage 800

?

Chemiluminescence Immunoassay (CLIA)

Serology Machines

Access 2

?

Enzyme-Linked Fluorescence Assay (ELFA)

Serology Machines

Vidas

?

Enzyme-Linked Immunosorbent Assay (ELISA)

Serology Machines

Alegria

?

Chemiluminescence Immunoassay (CLIA)

Serology Machines

Snibe (Manual)

?

Alpha-fetoprotein (AFP)

Serology Machines

Atellica

• Checks the baby’s risk for having certain genetic problems and birth defects

• Tumor marker for liver cancer & germ cell tumors of the testicles or ovaries

Estradiol (E2)

Serology Machines

Atellica

• Measures the amount of estradiol in the blood, which can reflect issues ranging from fertility problems to liver damage

hCG-Beta

Serology Machines

Atellica

• Helpful to diagnose pregnancy by determining the presence of the hormone. It is also helpful to check the age of the fetus, abnormal pregnancy, and potential risk for miscarriages

Total Prostate Specific Antigen (TPSA)

Serology Machines

Atellica

• Tumor marker for early detection and management of prostate carcinoma

Follicle Stimulating Hormone (FSH)

Serology Machines

Atellica

• Helps find the cause of infertility, problems in the ovarian function, finding the reason for irregular or stopped menstrual periods, and confirms the start of menopause

Parathyroid Hormone (PTH)

Serology Machines

Atellica

• Used along with calcium testing to diagnose hyperparathyroidism and hypoparathyroidism, monitor kidney disease

Carcinoembryonic Antigen (CEA)

Serology Machines

Atellica

• Used to help diagnose and manage certain types of cancers. Most especially used for cancers of the large intestine and rectum

• Tumor marker for colon cancer

Luteinizing Hormone (LH)

Serology Machines

Atellica

• Used to check fertility problems, ovulation, menstrual changes, early or late puberty, pituitary gland problems, and low testosterone

Vitamin D (Vit D)

Serology Machines

Atellica

• Used to check for Osteomalacia, soft bones, often with muscle weakness, Low bone density (which can lead to osteoporosis), and Rickets (a problem with bone growth in children)

Cancer Antigen 15-3 (CA 15-3)

Serology Machines

Atellica

• Tumor maker test that monitors metastatic breast cancer and its response to treatment

• Tumor marker for breast cancer

Progesterone (PROG)

Serology Machines

Atellica

• It may be used to identify issues with fertility and other health problems

Thyroid Stimulating Hormone (TSH)

Serology Machines

Atellica

• It can help diagnose thyroid disorders such as hypothyroidism and hyperparathyroidism

Cancer Antigen 19-9

Serology Machines

Atellica

• High ? are often a sign of pancreatic cancer, gallstones, and cirrhosis of the liver

• Tumor marker for pancreatic cancer

Prolactin Test (PRL)

Serology Machines

Atellica

• Used to diagnose Prolactinoma, help find the cause of a woman’s menstrual irregularities, and/or infertility, find the cause of a man’s low sex drive and/or erectile dysfunction

Free Prostate-Specific Antigen (FPSA)

Serology Machines

Atellica

• Help detect Prostate Cancer

Testosterone (TESTO)

Serology Machines

Atellica

• Used to diagnose the cause of symptoms that could be from testosterone levels that are too high or too low, in children and teens to find out what’s causing early puberty and delayed puberty

Calcitonin (CALCT)

Serology Machines

Atellica

• It is used to help diagnose C-cell hyperplasia and Medullary Thyroid Cancer

T3 & T4

Serology Machines

Atellica

• It helps diagnose thyroid conditions, especially hyperthyroidism and hypothyroidism

Hepatitis B Envelope Antigen (HBe Ag)

Serology Machines

Architect i2000SR

• High levels of virus and high degree of infectivity. It is usually not detectable in serum because viral envelope tend to cover HBe antigen

Hepatitis B Surface Antigen (HbsAg)

Serology Machines

Architect i2000SR

• Best indicator of early acute infection – 1st marker to appear around 2-10 weeks after infection. Indicates acute or chronic HBV infection

Anti-HBc

Serology Machines

Architect i2000SR

• IgM – window period (indicator of current infection)

• IgG – lifelong marker of Hepatitis B

Total Anti-HBc

Serology Machines

Architect i2000SR

• Detection of antibodies (all classes) to Hepatitis B core antigen as a measure of previous infection

Anti-HBe

Serology Machines

Architect i2000SR

• 1st serologic evidence of convalescent phase

Anti-HBs

Serology Machines

Architect i2000SR

• Bestows immunity to further HBV infection

• Viral clearance of HBV

Hepatitis A Virus-IgM (HAV-IgM2)

Serology Machines

Architect i2000SR

• Used for the diagnosis of acute or recent hepatitis A infection

Hepatitis A Virus-IgG (HAV-IgG2)

Serology Machines

Architect i2000SR

• Used for detecting previous exposure or immunity to hepatitis A infection

Hepatitis C (A-HCV)

Serology Machines

Architect i2000SR

• Test to detect Hepatitis C Virus

Insulin

Serology Machines

Architect i2000SR

• It helps evaluate insulin production by the pancreas and detect the possible causes of low or high blood glucose

• It can help diagnose and monitor diabetes and insulinoma

C-Peptide

Serology Machines

Architect i2000SR

• It helps to determine what type of diabetes a person has: Type 1 or Type 2

Folate II

Serology Machines

Architect i2000SR

• It is used to check for a folate deficiency, which may cause anemia and other symptoms

Cancer Antigen 125 (CA-125)

Serology Machines

Architect i2000SR

• ? may be increased in ovarian, endometrial, peritoneal, and fallopian tube cancers

• Tumor marker for ovarian cancer

Dehydroepiandrosterone Sulfate (DHEAS)

Serology Machines

Architect i2000SR

• A high-test result may indicate an adrenal tumor or polycystic ovarian syndrome (PCOS), while a low test result may indicate Addison’s Disease

CYFRA 21-1

Serology Machines

Architect i2000SR

• It is a cytoplasmic protein fragment of cytokeratin 19 (CK 19)

• It is found in various epithelial malignancies, such as lung cancer, gastrointestinal cancer, and cervical cancer

• Tumor marker for non-small cell lung cancer

HE4

Serology Machines

Architect i2000SR

• Is a glycoprotein on the normal glandular epithelia that line the reproductive tracts, renal tubules, and respiratory tracts

• A remarkable biomarker for the diagnosis of cancers in women, especially ovarian cancer and endometrial cancer

PIVKA II

Serology Machines

Architect i2000SR

• Decarboxy Prothrombine is used as a tumor marker to aid in the diagnosis of hepatocellular carcinoma (HCC)

Squamous Cell Carcinoma Antigen (SCC)

Serology Machines

Architect i2000SR

• It is a test for Squamous Cell Carcinoma antigen levels using serum/plasma

PRO-GRP

Serology Machines

Architect i2000SR

• Detection of small cell lung cancer recurrence

(decreased) PEPSINOGEN I

Serology Machines

Architect i2000SR

• Advanced gastric atrophy and hypo- or achlorhydrias

(increased) PEPSINOGEN II

Serology Machines

Architect i2000SR

• progression of gastritis to acute and pangastritis

IL-6

Serology Machines

Access 2

• It measures that amount of IL-6 circulating in the blood, and are used as one sign of systemic inflammation

• This assay is used to assist in identifying severe inflammatory responses in patients with confirmed COVID-19 illness to aid in determining the risk of intubation with mechanical ventilation, in conjunction with clinical findings and the results of other laboratory testing

OSTASE

Serology Machines

Access 2

• Laboratory test that measures bone alkaline specific phosphatase (BALP or sALP), an enzyme that reflects bone formation activity

• It can also be used as an aid in the management of metabolic bone disorders such as Postmenopausal Osteoporosis and Paget’s Disease

• Measurement of serum levels of BAP has been shown to be useful in evaluating patients with Paget's dișease, osteomalacia, primary hyperparathyroidism, renal osteodystrophy, osteoporosis and metastases to bone

Human Growth Hormone-Releasing Hormone (HGRH)

Serology Machines

Access 2

• Used in diagnosis and treatment of disorders involving the anterior lobe of the pituitary gland

Gigantism

Acromegaly

Serology Machines

Access 2

• Excess GH (Children) – _

• Excess GH (Adult) – _

Anti-Mullerian Hormone (AMH)

Serology Machines

Access 2

• Used in the evaluation of ovarian reserve primarily to predict an infertile woman’s response to controlled ovarian stimulation

EPO

Serology Machines

Access 2

• Overproduction of _ may be an adaptive response associated with conditions that produce tissue hypoxia such as:

  • Living with high altitude

  • COPD

  • Cyanotic heart disease

  • Sleep apnea

  • High oxygen affinity hemoglobinopathy

  • Smoking

  • Localized renal hypoxia

• Deficient _ production is found in conjunction with certain forms of anemias

Thyroglobulin (Tg)

Serology Machines

Access 2

• Elevated circulating levels of _ have been reported in a number of thyroid conditions including Hashimoto’s disease, Grave’s disease, thyroid adenoma, subacute thyroiditis and thyroid carcinoma

Thyroglobulin Antibody II

Serology Machines

Access 2

• _ _ are often present in patients with autoimmune thyroid disease. Approximately 10% of healthy individuals have ? at measurable levels. ? can be detected in 30% of patients with Graves' disease in and in 85% of patients with Hashimoto's thyroiditis. However, elevated levels of autoantibodies to thyroid peroxidase (TPO autoantibodies) occur more frequently than high ? levels in these diseases

Thyroperoxidase (TPO) Antibody

Serology Machines

Access 2

• The determination of _ levels is the most sensitive test for detecting autoimmune thyroid disease. The highest ? levels are observed in patients suffering from Hashimoto's thyroiditis. In this disease, the prevalence of ? is about 90% of cases confirming the autoimmune origin of the disease. These autoantibodies also frequently occur (60-80%) in the course of Graves' disease

Connective Tissue Diseases (CTD)

Serology Machines

Alegria

• SLE

• Drug-induced Lupus

• Sharp syndrome / Mixed Connective Tissue Damage

• RA

• Sjogren’s Syndrome

• Scleroderma

• Photosensitive Dermatitis, Dermatomyositis

Anti-histone

Serology Machines

Alegria

• Against histone

• Determine of ? is indicated in:

  • Drug induced Lupus (Procainamide, Isoniazid, Hydralazine)

  • Spontaneous systemic lupus erythematosus

  • ANA (+) and seropositive RA

  • ANA (+) scleroderma

Anti-LKM-1

Liver Disorders

Serology Machines

Alegria

• Against type 1 liver-kidney microsomes (LKM-1)

• Disease: Diagnosis of _ _

  • Autoimmune hepatitis (AIH)

  • Primary biliary cirrhosis (PBC)

  • Sclerosing cholangitis variants in adults and children

  • AIH type I, AIH type II, Cryptogenic hepatitis, PBC, Chronic hepatitis C infection

Anti-beta-2-glycoprotein 1 IgM

Serology Machines

Alegria

• Anti phospholipid syndrome (APS, Hughes) systemic autoimmune disorders that causes thrombosis, recurrent miscarriage + intrauterine fetal death

Anti-beta-2-glycoprotein 1 IgG

Serology Machines

Alegria

• Against PR3 & MPO Anti phospholipid syndrome (APS, Hughes) systemic autoimmune disorders that causes thromboses, recurrent miscarriage + intrauterine fetal death

ANCAscreen hs (high sensitive)

Serology Machines

Alegria

• Antineutrophil cytoplasmic antibody

  • Systemic Vasculitis Syndrome

  • Wegener’s Granulomatosis

  • Microscopic Polyangitis

  • Churg-Strauss-Syndrome

  • Polyarteritis nodosa

  • Unclassified Vasculitis

Anti-GBM

Serology Machines

Alegria

• Against ? Goodpasteur syndrome along with proliferative glomerulonephritis in young man autoimmune disorder consisting of triad glomerulonephritis, lung hemorrhage, and anti-glomerular basement antibody formation

Anti-GBM

Serology Machines

Alegria

• Only test with 20 uL reagent

Anti-Gliadin IgA

Anti-Gliadin IgG

Anti-Tissue-Trans Glutamine Screen

Anti-Tissue-Trans Glutaminase IgA

Serology Machines

Alegria

• Celiac Disease (4)

Typical

Serology Machines

Alegria

• Four Possible Presentation of Celiac Disease:

  • characterized mostly by gastrointestinal signs and symptoms

Atypical / Extraintestinal

Serology Machines

Alegria

• Four Possible Presentation of Celiac Disease:

  • where gastrointestinal symptoms are minimal/ absent and a number of manifestations are present

Silent

Serology Machines

Alegria

• Four Possible Presentation of Celiac Disease:

  • where the small intestinal mucosa is damaged and CD autoimmunity can be detected by serology but there are no symptoms

Latent

Serology Machines

Alegria

• Four Possible Presentation of Celiac Disease:

  • where individuals possess genetic compatibility with CD and may also show (+) autoimmunity serology, but have a normal mucosa morphology and may or may not be symptomatic

ASCA IgA

Serology Machines

Alegria

• Against IgA class anti-saccharomyces cerevisiae autoantibody (ASCA)

ASCA IgG

Serology Machines

Alegria

• Against IgG class anti-saccharomyces cerevisiae autoantibody (ASCA)

• Accurate diagnosis of inflammatory bowel disease (IBD), differentiation between the two major IBDs ulcerative colitis and Crohn’s Disease

ASCA

Serology Machines

Alegria

• To differentiate ANCA and ASCA

  • _ – directed against oligomannosidic epitopes on the cell wall mannan (phosphor-peptalomannan) of the yeast saccharomyces

Anti-Parietal Cell

Serology Machines

Alegria

• Quantitative measurement of IgG class antibodies against parietal cell H+/K+ = ATPase

• Pernicious anemia

Hashimoto’s thyroiditis, DM Type I, and primary Addison’s disease

Serology Machines

Alegria

• Specific diseases associated with pernicious anemia: (3)

Anti-DGP Screen

Serology Machines

Alegria

• Quantitative measurement of IgG and IgA class antibodies against deaminated gliadin protein epitopes

• Celiac Disease

Anti-Intrinsic Factor

Serology Machines

Alegria

• IgG

• Biermer’s anemia or Pernicious anemia

Anti-Insulin

Serology Machines

Alegria

• IgG

• Type I DM

Anti-PR3 hs (high sensitive)

Serology Machines

Alegria

• Quantitative measurement of IgG autoantibodies against proteinase 3 (PR3) 

• Granulomatosis with polyangitis (GPA; formerly named Wegener’s granulomatosis)

Anti-MPO

Serology Machines

Alegria

• IgG against myeloperoxidase

• Microscopic polyangiitis (MPA)

• Differentiated MPA from other autoimmune diseases

Anti-Centromere B

Serology Machines

Alegria

• IgG autoantibody against centromere B

• Connective tissue diseases

• Presence of antinuclear antibodies

Anti-CCP hs (high sensitive)

Serology Machines

Alegria

• IgG autoantibody against Cyclic Citrullinated Peptides

• Rheumatoid Arthritis

Alpha1-antitrypsin

Serology Machines

Immage 800

• Measurement of _ aids in the diagnosis of juvenile and adult cirrhosis of the liver

• ? deficiency has been associated with neonatal respiratory distress syndrome, severe protein-losing disorders, and pulmonary emphysema

Antistreptolysin O

Serology Machines

Immage 800

• Streptolysin-O is one of several toxic immunogenic exoenzymes produced by group A ß-hemolytic streptococci

• An elevated ? titer usually is an indication of a recent infection with a group A ß-hemolytic streptococcus and as such has become routine for the diagnosis and management of acute rheumatic fever and acute glomerulonephritis