Test Id : CHAGS
Trypanosoma cruzi Total Antibody, Enzyme-Linked Immunosorbent Assay, Serum
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Diagnosis of chronic Trypanosoma cruzi infection (Chagas disease)
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Only orderable as part of a profile. For more information see CRUZI / Trypanosoma cruzi (Chagas) Antibody Panel, Serum.
Enzyme-Linked Immunosorbent Assay (ELISA)
    
        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
                
            
    
    CHAGS
American trypanosomiasis
Chagas
Chagas disease
Kissing bug
Reduviid
T. cruzi
Triatoma
Trypanosoma
Trypanosomiasis
CRUZI
    
        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
                
            
    
    Only orderable as part of a profile. For more information see CRUZI / Trypanosoma cruzi (Chagas) Antibody Panel, Serum.
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.
    
        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.
                
            
    
    0.4 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    | Gross hemolysis | Reject | 
| Gross lipemia | 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 | Frozen | 14 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Diagnosis of chronic Trypanosoma cruzi infection (Chagas disease)
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    Chagas disease (American trypanosomiasis) is caused by the protozoan hemoflagellate Trypanosoma cruzi and can lead to acute and chronic clinical manifestations of disease. T cruzi is endemic in many areas of South and Central America. The parasite is usually transmitted by the bite of reduviid (or "kissing") bugs of the genus Triatoma but may also be transmitted by blood transfusion, organ transplantation, food ingestion, and vertically from mother to fetus. The acute febrile stage of disease is frequently undiagnosed and often resolves spontaneously. Diagnosis of acute T cruzi infection is typically confirmed by microscopic identification of trypomastigotes in fresh preparations of anticoagulated blood or buffy coat or by molecular detection. Parasitemia decreases and is undetectable within approximately 90 days of infection.
Chronic T cruzi infections are often asymptomatic but may progress to produce disabling and life-threatening cardiac (cardiomegaly, conduction defects) and gastrointestinal (megaesophagus and megacolon) disease. These damaged tissues contain the intracellular amastigote of T cruzi. The parasite is not seen in the blood during the chronic phase. Diagnosis of chronic T cruzi infection relies on serologic detection of antibodies to this organism. However, no single serologic assay is sensitive and specific enough to be relied upon alone. Therefore, per current expert guidelines and the Centers for Disease Control and Prevention, serologic confirmation of chronic T cruzi infection requires positivity on 2 tests utilizing two different methodologies and/or two different T cruzi antigen preparations. When results are discordant, testing by a third assay is recommended to resolve the initial results or, alternatively, repeat testing on a new sample may be required.
    
        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.
                
            
    
    Only orderable as part of a profile. For more information see CRUZI / Trypanosoma cruzi (Chagas) Antibody Panel, Serum.
Negative
Reference values apply to all ages.
    
        Interpretation
            
                
                
                    
                    Provides information to assist in interpretation of the test results
                
            
    
    | CHAGS result | CHAGL result | Interpretive comment | 
| Positive | Positive | Antibodies to Trypanosoma   cruzi (Chagas disease) detected by two separate methods, suggesting   current or past infection. Results should be interpreted alongside clinical   presentation and exposure history. | 
| Positive | Negative | Antibodies to Trypanosoma   cruzi (Chagas disease) detected by one of two assays. Discordant results   can be resolved through submission of a new sample for testing or through   additional testing at a public health laboratory. | 
| Positive | Invalid | Submission of a   new sample is recommended to resolve discordant results. | 
| Indeterminate | Positive | Antibodies to Trypanosoma   cruzi (Chagas disease) detected by one of two assays. Discordant results   can be resolved through submission of a new sample for testing or through   additional testing at a public health laboratory. | 
| Indeterminate | Negative | Submission of a   new sample is recommended to resolve discordant results. | 
| Indeterminate | Invalid | Submission of a   new sample is recommended to resolve discordant results. | 
| Negative | Positive | Antibodies to Trypanosoma   cruzi (Chagas disease) detected by one of two assays. Discordant results   can be resolved through submission of a new sample for testing or through   additional testing at a public health laboratory. | 
| Negative | Negative | No antibodies to Trypanosoma   cruzi (Chagas disease) detected. False negative results may occur in   patients tested within 4 weeks of infection. | 
| Negative | Invalid | Submission of a   new sample is recommended to resolve discordant results. | 
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    False-positive results may occur in patients infected with Leishmania or other Trypanosoma species, including Trypanosoma rangeli.
A diagnosis of chronic Chagas disease requires both clinical evaluation (including exposure history) and laboratory results. Chagas disease should not be diagnosed based on a single serologic result alone.
A single negative result does not exclude the diagnosis of Chagas disease as antibodies to the pathogen may not yet be detectable. Sensitivity of the assay may be decreased in significantly immunosuppressed patients.
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Bern C, Montgomery SP, Herwaldt BL, et al. Evaluation and treatment of Chagas disease in the United States: a systematic review JAMA. 2007;298(18):2171-2181
2. Bern C, Messenger LA, Whitman JD, Maguire JH. Chagas disease in the United States: A public health approach. Clin Microbiol Rev. 2019;33(1):e00023-19. doi:10.1128/CMR.00023-19
3. Forsyth CJ, Manne-Goehler J, Bern C, et al. Recommendations for screening and diagnosis of Chagas disease in the United States. J Infect Dis. 2022;225(9):1601-1610. doi:10.1093/infdis/jiab513
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    The Wiener Chagatest ELISA (enzyme-linked immunosorbent assay) recombinante v.3.0 test kit is a qualitative technique for the detection of anti-Trypanosoma cruzi antibodies. The sample is diluted in the support in which the recombinant antigen (1, 2, 13, 30, 36, and SAPA) is immobilized (3rd generation method). These antigens are obtained by DNA recombinant techniques starting from specific proteins from the epimastigote and trypomastigote stages of the T cruzi corresponding to highly-conserved zones among different strains. The technology used allows us to ensure an antigenic mixture of known and permanent composition batch to batch, giving reproducible, specific, and highly-sensitive results. If the sample contains specific antibodies, these will form a complex with the antigens and will remain bound to the support. The unbound fraction is eliminated by washing, after which antihuman immunoglobulin antibodies conjugated to peroxidase are added. If a reaction is produced in the first step of the process, the conjugate is bound. After a new wash, the enzymatic substrate is added. If bound conjugate is present, a light-blue color is developed. The reaction is stopped by adding sulfuric acid, and the color changes to yellow.(Package insert: Chagatest ELISA recombinante v.3.0. Wiener Laboratorios S.A.I.C.; 801146000/00)
    
        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
    
        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 :
            
                
                
                    
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        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 has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
    
        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.
86753
    
        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 | 
|---|---|---|
| CHAGS | T. cruzi Total Ab, EIA, S | 57320-4 | 
| 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.
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|---|---|---|
| CHAGS | T. cruzi Total Ab, EIA, S | 57320-4 |