Test Catalog

Test Id : DCME

Dendritic Cell and Monocyte Enumeration, Blood

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of patients suspected of defects in innate immunity, particularly those involving monocyte and dendritic cell development

 

This test has not been validated for the diagnosis of hematologic malignancies.

Highlights

This test enumerates plasmacytoid dendritic cells , myeloid dendritic cells , and classical monocytes.

 

It can be used as part of the diagnostic assessment of patients suspected of defects in innate immunity, particularly those in monocyte and dendritic cell development, which can manifest in isolation or as part of a broader clinical phenotype.

Method Name
A short description of the method used to perform the test

Flow Cytometry 

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

DC and Monocyte Enumeration, B

Aliases
Lists additional common names for a test, as an aid in searching

Innate

Myeloid dendritic cells

Conventional dendritic cells

Plasmacytoid dendritic cells

Classical Monocytes

Non-Classical Monocytes

Specimen Type
Describes the specimen type validated for testing

WB Sodium Heparin

Shipping Instructions

Specimens are required to be received in the laboratory weekdays and by 4 p.m. on Friday. Collect and package specimen as close to shipping time as possible.

 

It is recommended that specimens arrive within 24 hours of collection.

 

Samples arriving on the weekend and observed holidays may be canceled.

Necessary Information

Ordering physician name and phone number are required.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Container/Tube: Green top (sodium heparin)

Specimen Volume: 3 mL

Collection Instructions: Send whole blood specimen in original tube. Do not open tube. Do not aliquot.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Clotted Reject
Gross lipemia OK
Gross icterus OK

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
WB Sodium Heparin Ambient (preferred) 36 hours GREEN TOP/HEP

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of patients suspected of defects in innate immunity, particularly those involving monocyte and dendritic cell development

 

This test has not been validated for the diagnosis of hematologic malignancies.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Dendritic cells (DC) play a critical role in both innate and adaptive immune responses. DC include 2 major subsets: myeloid (or conventional) dendritic cells (mDC) and plasmacytoid dendritic cells (pDC).

 

mDC can capture and present antigens to CD4+ T cells and cross-present them to CD8+ T cells. They are also a source of inflammatory cytokines.

 

pDC take part in priming of antiviral T cells and are the major source of type I interferons; as such they act as a primary defense against viremia.

 

Monocytes are the archetypal myeloid mononuclear cells. Although human monocytes do have phenotypic heterogeneity, the majority are CD14+ and are classified as classical or inflammatory monocytes.

 

The list of conditions where this test can be used as part of the assessment include, but are not limited to, GATA-binding protein 2 deficiency, IKZF1 deficiency, IRF8 deficiency, STAT3 gain-of-function disease, HYOU1 deficiency, reticular dysgenesis due to AK2 variants, WHIM syndrome (warts, hypogammaglobulinemia, infections, and myelokathexis), dedicator of cytokinesis 8 (DOCK8) deficiency, IRF7 deficiency, and Hermansky-Pudlak syndrome type II. In addition, unexplained monocytopenia can be a relevant clue in detecting DC deficiency.

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.

The appropriate reference values will be provided on the report.

Interpretation
Provides information to assist in interpretation of the test results

Interpretive comments will be provided, where applicable, to complement the reported plasmacytoid dendritic cells, myeloid (or conventional) dendritic cells, and monocyte counts, and their respective reference ranges.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Plasmacytoid dendritic cells, myeloid (or conventional) dendritic cells, and monocyte counts should be interpreted in the context of the patient's clinical presentation and in conjunction with other laboratory findings.

 

The full range of immune defects caused by dendritic cell (DC) deficiency is not yet established. Therefore, not all instances of decreased dendritic cell count can be attributed to an already defined condition.

 

Reports of a decrease in DC or monocyte counts in patients with a particular deficiency do not necessarily extend to every individual with that deficiency. This can be due to variable expressivity among patients, with no apparent genotype-phenotype correlation, as in the case of GATA-binding protein 2 deficiency, or because the prevalence of these findings and their potential association with specific variants in a particular gene have not been determined, for example in dedicator of cytokinesis 8 (DOCK8) and IRF8 deficiency.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Bigley V, Cytlak U, Collin M: Human dendritic cell immunodeficiencies. Semin Cell Dev Biol. 2019 Feb;86:50-61

2. Ciancanelli MJ, Huang SX, Luthra P, et al: Infectious disease. Life-threatening influenza and impaired interferon amplification in human IRF7 deficiency. Science. 2015 Apr 24;348(6233):448-453

3. Cytlak U, Resteu A, Bogaert D, et al: Ikaros family zinc finger 1 regulates dendritic cell development and function in humans. Nat Commun. 2018 Mar 27;9(1):1239

4. Dickinson RE, Griffin H, Bigley V, et al: Exome sequencing identifies GATA-2 mutation as the cause of dendritic cell, monocyte, B and NK lymphoid deficiency. Blood. 2011 Sep 8;118(10):2656-2658

5. Haapaniemi EM, Fogarty CL, Keskitalo S, et al: Combined immunodeficiency and hypoglycemia associated with mutations in hypoxia upregulated 1. J Allergy Clin Immunol. 2017 Apr;139(4):1391-1393

6. Haapaniemi EM, Kaustio M, Rajala HL, et al: Autoimmunity, hypogammaglobulinemia, lymphoproliferation, and mycobacterial disease in patients with activating mutations in STAT3. Blood. 2015 Jan;125(4):639-648

7. Hambleton S, Salem S, Bustamante J, et al: IRF8 mutations and human dendritic-cell immunodeficiency. N Engl J Med. 2011 Ju3 14;365(2):127-138

8. Keles S, Jabara HH, Reisli I, et al: Plasmacytoid dendritic cell depletion in DOCK8 deficiency: rescue of severe herpetic infections with IFN-alpha 2b therapy. J Allergy Clin Immunol. 2014 Jun;133(6):1753-1755

9. Pannicke U, Honig M, Hess I, et al: Reticular dysgenesis (aleukocytosis) is caused by mutations in the gene encoding mitochondrial adenylate kinase 2. Nat Genet. 2009 Jan;41(1):101-105

10. Prandini A, Salvi V, Colombo F, et al: Impairment of dendritic cell functions in patients with adaptor protein-3 complex deficiency. Blood. 2016 Jun;127(26):3382-3386

11. Reizis B: Plasmacytoid dendritic cells: Development, regulation, and function. Immunity. 2019 Jan 15;50(1):37-50

12. Tassone L, Moratto D, Vermi W, et al: Defect of plasmacytoid dendritic cells in warts, hypogammaglobulinemia, infections, myelokathexis (WHIM) syndrome patients. Blood. 2010 Dec 2;116(23):4870-4873

13. Vuckovic S, Gardiner D, Field K, et al: Monitoring dendritic cells in clinical practice using a new whole blood single-platform TruCOUNT assay. J Immunol Methods. 2004 Jan;284(1-2):73-87

Method Description
Describes how the test is performed and provides a method-specific reference

The method consists of a whole blood no wash assay with a lab-developed polychromatic monoclonal antibody panel. Addition of a flow count bead allows single-platform cellular quantitation reported as cells per microliter of blood. In this panel, plasmacytoid dendritic cells are defined as CD45(+), Lin2(neg), HLA-DR(+), CD123(hi); myeloid dendritic cells  as CD45(+), Lin2(neg), HLA-DR(+), CD11c(+); and monocytes as CD45(+)/CD14(+-low). Lineage 2 (Lin2) includes CD3, CD14, CD19, CD20, CD56. Isotype controls to HLA-DR, CD11c, and CD123 are included in this 4-tube test.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

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.

2 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

4 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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 Regional Manager. 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.

86356 x 3

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
DCME DC and Monocyte Enumeration, B In Process
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.
610368 Monocytes (CD14+) In Process
610369 pDC (CD123+) In Process
610370 mDC (CD11c+) In Process
610371 DCME Comment In Process

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports