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1 Sarasota Memorial Laboratory Services is pleased to announce that we are now performing the following testing in house: Immature Platelet Fraction (IPF) The Immature Platelet Fraction (IPF) is used to monitor thrombopoiesis. The presence of immature platelets (also called Reticulated Platelets) helps to distinguish between bone marrow failure and peripheral platelet consumption or destruction. Provides a direct cellular measurement of thrombopoietic activity Supports determination of the cause/differential diagnosis of thrombocytopenia May help in determining need for prophylactic transfusions Direct measurement of immature platelet production for faster indication of response to therapy Recovery from chemotherapy and/or bone marrow transplant IPF is an indicator of platelet production by the bone marrow and is expressed as a percent of the total platelet count. RET (added with retic order) 0.5 ml of EDTA whole blood Lavender EDTA tube Daily Reference Range 1.1% to 6.1% CPT Code 85046
2 Anti-CCP Anti-CCP Test Cyclic Citrullinated Peptide (CCP) Used to detect antibodies to RA May be used in combination with clinical findings in the diagnosis of RA. Reference Range CCP 1 ml serum Gold top Tuesday and Thursday 5 U/mL = Negative >5 U/mL = Positive CPT Code 86200
3 The Reticulocyte Hemoglobin Equivalent (RET-HE) The Reticulocyte Hemoglobin Equivalent (RET-HE) quantifies the hemoglobin content of reticulocytes an aide in assessing iron available for erythropoiesis. Low hemoglobin content in reticulocytes indicates inadequate iron supply relative to demand. In patients with end-stage renal disease (ESRD) iron stores may not be adequate to sustain normal red cell production. RET-HE is useful for: A more comprehensive anemia work up, for early diagnosis of iron deficiency Monitoring iron status of patients with chronic kidney disease on hemodialysis, as well as for monitoring I.V. iron replacement and optimizing iron therapy Monitoring erythropoietin therapy To monitor athletes for use of EPO drugs The RET-HE is an indicator of the amount of hemoglobin in reticulocytes and is expressed as picograms. RET (added with retic order) 0.5 ml of EDTA whole blood Lavender EDTA tube Daily Reference Range pg CPT Code 85046
4 Immature Granulocyte Percent (IG%) Immature Granulocyte Percent (IG%) is a measurement of metamyelocytes, myelocytes and promyelocytes. (Bands and blasts are not included). Blasts will be reported separately. IG% will be a part of every CBC that is ordered. (No need to order) Anytime the IG% is greater than 5.0% manual review of a smear and/or a manual differential will be performed. with every CBC automatically 1 ml plasma Lavender EDTA tube Daily Reference Range 0-5% CPT Code 85025
5 Vitamin-D, 25-HYDROXY Low levels are associated with liver disorders, intestinal malabsorption, nephritic syndrome and calcium homeostasis as well as increased mortality including cardiovascular mortality, cancer incidence and mortality, Type 1 diabetes, hypertension, and autoimmune diseases such as multiple sclerosis. Special Instructions VITD25 Best practices related to the clinical lab testing efficacy demonstrate that PTH needs to be measured when 25-hydroxy Vitamin D is deficient. In addition, 1,25 Vit D is of diagnostic value only after elevated PTH has been measured. Physicians will be contacted prior to performing 1,25 Vit D if o The Lab has not received a prior order for Vitamin D, 25- hydroxy o The Vitamin-D, 25-hydroxy results are normal o The Lab has not received a prior order for a PTH o The PTH results are not elevated 1.0 ml serum Gold top Monday-Friday Reference Range Range Level ng/ml Deficient <10 Insufficient Sufficient Potential Intoxication >100 CPT Code 82306
6 The Epstein-Barr Virus Antibody Panel (EBV) The Epstein-Barr Virus Antibody Panel (EBV): consists of 4 components: VCA-IGG VCA-IGM EA-IGG EBNA Specimen Requirements Interpretation EBV 0.5 ml serum Gold top Monday, Wednesday and Friday The Epstein-Barr Virus Antibody Panel Interpretation: VCA- VCA- EA- EBNA IGG IGM IGG Susceptible Acute infection + + ± - Convalescent phase + ± ± + Chronic or reactivated ± Old infection ± CPT Code x 2, 86664, 86663
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