Test Id : EHRCP
Ehrlichia Antibody Panel, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
An adjunct in the diagnosis of infection with Anaplasma phagocytophilum or Ehrlichia chaffeensis
Seroepidemiological surveys of the prevalence of the infection in certain populations
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ANAP | Anaplasma phagocytophilum Ab, IgG,S | Yes | Yes |
| EHRC | Ehrlichia Chaffeensis (HME) Ab, IgG | Yes | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Acute Tick-Borne Disease Testing Algorithm.
Method Name
A short description of the method used to perform the test
Immunofluorescence Assay (IFA)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Tick Borne Diseases
E. chaffeensis
A. phagocytophilum
HME (Human Monocytotropic Ehrlichiosis)
Human Granulocytic Anaplasmosis (HGA)
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Acute Tick-Borne Disease Testing Algorithm.
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated specimen | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
An adjunct in the diagnosis of infection with Anaplasma phagocytophilum or Ehrlichia chaffeensis
Seroepidemiological surveys of the prevalence of the infection in certain populations
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For more information see Acute Tick-Borne Disease Testing Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Anaplasma phagocytophilum is an intracellular rickettsia-like bacterium that preferentially infects granulocytes and forms inclusion bodies, referred to as morulae. A phagocytophilum is transmitted by Ixodes species ticks, which also transmit Borrelia burgdorferi and Babesia species. Infection with A phagocytophilum is also referred to as human granulocytic anaplasmosis (HGA) or human granulocytic ehrlichiosis, and symptoms in otherwise healthy individuals are often mild and nonspecific, including fever, myalgia, arthralgia, and nausea. Clues to the diagnosis of anaplasmosis in a patient with an acute febrile illness after tick exposure include laboratory findings of leukopenia or thrombocytopenia and elevated liver enzymes. HGA is most prevalent in the upper Midwest and in other areas of the United States that are endemic for Lyme disease.
Ehrlichia chaffeensis is an intracellular rickettsia-like bacterium that preferentially infects monocytes and is sequestered in parasitophorous vacuoles referred to as morulae. Infections with E chaffeensis are also referred to as human monocytotropic ehrlichiosis (HME). E chaffeensis is transmitted by Amblyomma species ticks, which are found throughout the Southeastern and South-Central United States.
Many cases of HME are subclinical or mild, however, the infection can be severe and life-threatening, particularly in immunosuppressed individuals. Reported mortality rates range from 2% to 3%. Fever, fatigue, malaise, headache, and other "flu-like" symptoms occur most commonly. Leukopenia, thrombocytopenia, and elevated hepatic transaminases are frequent laboratory findings.
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.
ANAPLASMA PHAGOCYTOPHILUM
<1:64
Reference values apply to all ages.
EHRLICHIA CHAFFEENSIS
<1:64
Reference values apply to all ages.
Interpretation
Provides information to assist in interpretation of the test results
A positive immunofluorescence assay result (titer > or =1:64) suggests current or previous infection. In general, the higher the titer, the more likely the patient has an active infection. Four-fold rises in titer also indicate active infection.
Previous episodes of ehrlichiosis may produce a positive serology result although antibody levels decline significantly during the year following infection.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Serology results for IgG may be negative during the acute phase of infection (<7 days post-symptom onset), during which time detection using targeted nucleic acid amplification testing (eg, polymerase chain reaction) is recommended.
Detectable IgG-class antibodies typically appear within 7 to 10 days post-symptom onset.
IgG-class antibodies may remain detectable for months to years following prior infection. Therefore, a single time point-positive titer needs to be interpreted alongside other findings to differentiate recent versus past infection.
Other members of the Ehrlichia genus (eg, Ehrlichia ewingii) may not be detected by this assay.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
Centers for Disease Control and Prevention (CDC), Division of Vector-Borne Diseases: Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers. 6th ed. US Department of Health and Human Services; 2022. Accessed September 5, 2024. Available at www.cdc.gov/ticks/tickbornediseases/TickborneDiseases-P.pdf
Method Description
Describes how the test is performed and provides a method-specific reference
The patient's serum is diluted and is placed in microscopic slide wells that have been coated with Anaplasma phagocytophilum-infected cells or Ehrlichia chaffeensis-infected cells. After incubation, the slides are washed and a fluorescein-isothiocyanate conjugate is added to each well. The slides are then read using a fluorescence microscope and significant fluorescent staining of intracellular organisms constitutes a positive reaction.(Dumler JS, Asanovich KM, Bakken JS, Richter P, Kimsey R, Madigan JE. Serologic cross-reactions among Ehrlichia equi, Ehrlichia phagocytophila, and human granulocytic Ehrlichia. J Clin Microbiol. 1995;33[5]:1098-1103; Pancholi P, Kolbert CP, Mitchell PD, et al. Ixodes dammini as a potential vector of human granulocytic ehrlichiosis. J Infect Dis. 1995;172[4]:1007-1012; Dawson JE, Fishbein DB, Eng TR, Redus MA, Green NR. Diagnosis of human ehrlichiosis with the indirect fluorescent antibody test: kinetics and specificity. J Infect Dis. 1990;162[1]:91-95; package insert: Ehrlichia chaffeensis IFA IgG. DiaSorin Molecular; 08/2016)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
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 instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US 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 Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86666 x 2
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| EHRCP | Ehrlichia Ab Panel | 77165-9 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 81157 | Anaplasma phagocytophilum Ab, IgG,S | 23877-4 |
| 81478 | Ehrlichia Chaffeensis (HME) Ab, IgG | 47405-6 |