Test Catalog

Test Id : CIFA

Cutaneous Immunofluorescence Antibodies, IgA, Serum

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

Confirming a diagnosis of pemphigoid, pemphigus, epidermolysis bullosa acquisita, or bullous lupus erythematosus

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

Indirect Immunofluorescence Assay (IFA)

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

Cutaneous Immfluor. Ab (IgA), S

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

Basement Membrane Antibodies

Bullous Lupus Erythematosus

Bullous Pemphigoid

Cicatricial Pemphigoid

CII, Serum

Circulating IgA Basement Membrane Zone Antibody

Circulating Intercellular Ab Study

Epidermal Cell Surface Antibody

Epidermal Fluorescence Antibody

Epidermolysis Bullosa Acquisita

Epithelial Antibody

Herpes gestationis

IMF - Epidermal Fluorescent Ab

Indirect Immunofluorescence

Intercellular Substance Antibody

Lupus Erythematosus (LE)

Pemphigoid

Pemphigus

Skin Basement Membrane Antibodies

Split-Skin Assay

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

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 2 mL

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

0.5 mL

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

Gross hemolysis OK
Gross lipemia Reject
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
Serum Refrigerated (preferred) 14 days
Frozen 30 days
Ambient 14 days

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

Confirming a diagnosis of pemphigoid, pemphigus, epidermolysis bullosa acquisita, or bullous lupus erythematosus

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

Immunoglobulin A anti-basement zone (BMZ) antibodies are produced by patients with pemphigoid. In most patients with bullous pemphigoid, serum contains IgA anti-BMZ antibodies, while in cicatricial pemphigoid circulating IgA anti-BMZ antibodies are found in a minority of cases. Sensitivity of detection of anti-BMZ antibodies is increased when serum is tested using sodium chloride (NaCl)-split human skin as substrate.

 

Circulating IgA anti-BMZ antibodies are also detected in patients with epidermolysis bullosa acquisita (EBA) and bullous eruption of lupus erythematosus.

 

IgA anti-cell surface (CS) antibodies are produced by patients with pemphigus. The titer of anti-CS antibodies generally correlates with disease activity of pemphigus.

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.

Report includes presence and titer of circulating antibodies. If serum contains basement zone (BMZ) antibodies on split-skin substrate, patterns will be reported as: 1) epidermal pattern, consistent with pemphigoid or 2) dermal pattern, consistent with epidermolysis bullosa acquisita.

 

Negative in normal individuals

Interpretation
Provides information to assist in interpretation of the test results

Indirect immunofluorescence (IF) testing may be diagnostic when histologic or direct IF studies are only suggestive, nonspecific, or negative.

 

Anti-cell surface (CS) antibodies correlate with a diagnosis of pemphigus.

 

Anti-basement zone (BMZ) antibodies correlate with a diagnosis of bullous pemphigoid, cicatricial pemphigoid, epidermolysis bullosa acquisita (EBA), or bullous eruption of lupus erythematosus (LE).

 

If serum contains anti-BMZ antibodies, the pattern of fluorescence on sodium chloride (NaCl)-split skin substrate helps distinguish pemphigoid from EBA and bullous LE. Staining of the roof (epidermal side) or both epidermal and dermal sides of NaCl-split skin correlates with the diagnosis of pemphigoid, while fluorescence localized only to the dermal side of the split-skin substrate correlates with either EBA or bullous LE.

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

Results should be interpreted in conjunction with clinical information, histologic pattern, and results of direct immunofluorescence (IF) study. In particular, the finding of low titer (< or =1:80) anti-CS antibodies should not be used alone (ie, without histologic or direct IF support) to confirm a diagnosis of pemphigus.

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

1. Caux F, Kirtschig G, Lemarchand-Venencie F, et al: IgA-epidermolysis bullosa acquisita in a child resulting in blindness. Br J Dermatol. 1997 Aug;137(2):270-275

2. Chorzelski TP, Jablonska S: IgA linear dermatosis of childhood (chronic Bullous disease of childhood). Br J Dermatol. 1979 Nov;101(5):535-542

3. Guide SV, Marinkovich MP: Linear IgA bullous dermatosis. Clin Dermatol. Nov-Dec 2001;19(6):719-727

4. Hashimoto T, Ebihara T, Nishikawa T: Studies of autoantigens recognized by IgA anti-keratinocyte cell surface antibodies. J Dermatol Sci. 1996 Apr;12(1):10-17

5. Lally A, Chamberlain A, Allen J, Dean D, Wojnarowska F: Dermal-binding linear IgA disease: an uncommon subset of a rare immunobullous disease. Clin Exp Dermatol. 2007 Sep;32(5):493-498

6. Tsuruta D, Ishii N, Hamada T, et al: IgA pemphigus. Clin Dermatol. 2011 Jul-Aug;29(4):437-442

7. Vodegel RM, de Jong MCJM, Pas HH, Jonkman MF: IgA-mediated epidermolysis bullosa acquisita: two cases and review of the literature. J Am Acad Dermatol. 2002 Dec;47(6):919-925

8. Willsteed E, Bhogal BS, Black MM, McKee P, Wojnarowska F: Use of 1M NaCl split skin in the indirect immunofluorescence of the linear IgA bullous dermatoses. J Cutan Pathol. 1990 Jun;17(3):144-148

9. Wilson BD, Beutner EH, Kumar V, Chorzelski TP, Jablonska S: Linear IgA bullous dermatosis. An immunologically defined disease. Int J Dermatol. 1985 Nov;24(9):569-574

10. Wojnarowska F, Collier PM, Allen J, Millard PR: The localization of the target antigens and antibodies in linear IgA disease is heterogeneous, and dependent on the methods used. Br J Dermatol. 1995 May;132(5):750-757

 

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

Frozen sections of rhesus monkey esophagus and sodium chloride-split human skin are overlaid with dilutions of patient's serum, incubated, covered with fluorescein-conjugated IgA antiserum, and interpreted with a fluorescence microscope.(Unpublished Mayo method)

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

No

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.

2 to 7 days

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

14 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, and its performance characteristics 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.

88346

88350

LOINC® Information

Test Id Test Order Name Order LOINC Value
CIFA Cutaneous Immfluor. Ab (IgA), S In Process
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
610628 Cell Surface Ab IgA In Process
610629 Basement Membrane IgA In Process
610630 Monkey Esophagus IgA In Process
610631 Human Split Skin IgA In Process
610632 Other 48767-8

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