Test Id : RPR9
Respiratory Profile, Region 9, Great Plains (KS, ND, NE, SD), Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Assessing sensitization to various inhalant allergens commonly found in the Great Plains region including Kansas, North Dakota, Nebraska, and South Dakota
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
This test is not useful for patients previously treated with immunotherapy to determine if residual clinical sensitivity exists or in whom the medical management does not depend upon identification of allergen specificity.
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 |
|---|---|---|---|
| IGE | Immunoglobulin E (IgE), S | Yes | Yes |
| DP | House Dust Mites/D.P., IgE | Yes | Yes |
| DF | House Dust Mites/D.F., IgE | Yes | Yes |
| CAT | Cat Epithelium, IgE | Yes | Yes |
| DOGD | Dog Dander, IgE | Yes | Yes |
| BERG | Bermuda Grass, IgE | Yes | Yes |
| TIMG | Timothy Grass, IgE | Yes | Yes |
| COCR | Cockroach, IgE | Yes | Yes |
| PENL | Penicillium, IgE | Yes | Yes |
| CLAD | Cladosporium, IgE | Yes | Yes |
| ASP | Aspergillus Fumigatus, IgE | Yes | Yes |
| ALTN | Alternaria Tenuis, IgE | Yes | Yes |
| BXMPL | Box Eld/Maple, S, IgE | Yes | Yes |
| CED | Mountain Cedar, IgE | Yes | Yes |
| OAK | Oak, IgE | Yes | Yes |
| ELM | Elm, IgE | Yes | Yes |
| CTWD | Cottonwood, IgE | Yes | Yes |
| ASHW | White Ash, IgE | Yes | Yes |
| MULB | Mulberry, IgE | Yes | Yes |
| SRW | Short Ragweed, IgE | Yes | Yes |
| RUSS | Russian Thistle, IgE | Yes | Yes |
| SORR | Red Sorrel, IgE | Yes | Yes |
| NETT | Nettle, IgE | Yes | Yes |
Method Name
A short description of the method used to perform the test
Fluorescence Enzyme Immunoassay (FEIA)
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
Refer to individual tests for lists of aliases
Great Plains Respiratory Panel
Great Plains Allergen Panel
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies
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: 1.6 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 an Allergen Test Request (T236) 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.
1.4 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | OK |
| Gross lipemia | 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 | 90 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Assessing sensitization to various inhalant allergens commonly found in the Great Plains region including Kansas, North Dakota, Nebraska, and South Dakota
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
This test is not useful for patients previously treated with immunotherapy to determine if residual clinical sensitivity exists or in whom the medical management does not depend upon identification of allergen specificity.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Immunoglobulin E (IgE) is one of the 5 immunoglobulin classes and is defined by the presence of the epsilon heavy chain. It is the most recently described immunoglobulin, having first been identified in 1966. IgE exists as a monomer and is present in blood circulation at very low concentrations, approximately 300-fold lower than that of IgG. The physiologic role of IgE is not well characterized, although it is thought to be involved in defense against parasites, specifically helminths.
The function of IgE is distinct from other immunoglobulins in that it induces activation of mast cells and basophils through the cell-surface receptor Fc epsilon RI. Fc epsilon RI is a high-affinity receptor specific for IgE present at a high density on tissue-resident mast cells and basophils. Because of this high-affinity interaction, almost all IgE produced by B cells is bound to mast cells or basophils, which explains the low concentration present in circulation. Cross-linking of the Fc epsilon RI-bound IgE leads to cellular activation, resulting in immediate release of preformed granular components (histamine and tryptase) and subsequent production of lipid mediators (prostaglandins and leukotrienes) and cytokines (interleukin-4 and interleukin-5).
Elevated concentrations of IgE may occur in the context of allergic disease. However, increases in the amount of circulating IgE can also be found in various other diseases, including primary immunodeficiencies, infections, inflammatory diseases, and malignancies. Total IgE measurements have limited utility for diagnostic evaluation of patients with suspected allergic disease. In this scenario, testing for the presence of allergen-specific IgE may provide more information.
Clinical manifestations of allergic disease result from activation of mast cells and basophils, which occurs when Fc epsilon RI-bound IgE antibodies interact with allergen.
In vitro serum testing for specific IgE antibodies may provide an indication of the immune response to an allergen that may be associated with allergic disease.
The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. Sensitization to inhalant allergens (dust mites, mold, and pollen inhalants) primarily occurs in older children, adolescents, and adults and usually manifests as respiratory disease (rhinitis and asthma).
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.
Specific IgE:
| Class | IgE kU/L | Interpretation |
| 0 | <0.10 | Negative |
| 0/1 | 0.10-0.34 | Borderline/equivocal |
| 1 | 0.35-0.69 | Equivocal |
| 2 | 0.70-3.49 | Positive |
| 3 | 3.50-17.4 | Positive |
| 4 | 17.5-49.9 | Strongly positive |
| 5 | 50.0-99.9 | Strongly positive |
| 6 | > or =100 | Strongly positive |
Concentrations of 0.70 kU/L or more (class 2 and above) will flag as abnormally high.
Reference values apply to all ages.
Total IgE:
| Age | Reference interval (in kU/L) |
| 0-5 months | < or =13 |
| 6-11 months | < or =34 |
| 1 and 2 years | < or =97 |
| 3 years | < or =199 |
| 4-6 years | < or =307 |
| 7 and 8 years | < or =403 |
| 9-12 years | < or =696 |
| 13-15 years | < or =629 |
| 16 and 17 years | < or =537 |
| 18 years and older | < or =214 |
Interpretation
Provides information to assist in interpretation of the test results
Elevated concentrations of total IgE may be found in a variety of clinical diseases, including allergic disease, certain primary immunodeficiencies, infections, inflammatory diseases, and malignancies.
Detection of allergen-specific IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines allergens that may be responsible for eliciting signs and symptoms.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
An elevated concentration of total IgE is not diagnostic for allergic disease, and it must be interpreted in the clinical context of the patient, including age, sex, travel history, potential allergen exposure, and family history.
A normal concentration of total IgE does not eliminate the possibility of allergic disease. In patients with a high index of suspicion for allergic disease, testing for allergen-specific IgE may be warranted.
Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and test results must be interpreted in the clinical context.
False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070
2. Bernstein IL, Li JT, Bernstein DI, et al. Allergy diagnostic testing: an updated practice parameter. Annals Allergy Asthma and Immunol 2008; 100:S1-S148
Method Description
Describes how the test is performed and provides a method-specific reference
Specific IgE:
Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)
Total IgE:
Anti-IgE, covalently coupled to ImmunoCAP, reacts with the IgE in a serum specimen. After washing, enzyme-labeled anti-IgE antibodies are added to form a complex. After incubation, unbound enzyme-labeled anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, fluorescence of the eluate in the well is measured. The fluorescence is directly proportional to the concentration of IgE in the test specimen.(Package insert: Phadia CAP System IgE FEIA. Phadia; Rev 10/2019)
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 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.
82785-IgE
86003 x 22-Each individual allergen
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 |
|---|---|---|
| RPR9 | Resp Profile, Reg 9, Great Plains | 94593-1 |
| 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.
|
|---|---|---|
| ALTN | Alternaria Tenuis, IgE | 6020-2 |
| ASHW | White Ash, IgE | 6278-6 |
| ASP | Aspergillus Fumigatus, IgE | 6025-1 |
| BERG | Bermuda Grass, IgE | 6041-8 |
| BXMPL | Box Eld/Maple, S, IgE | 7155-5 |
| CAT | Cat Epithelium, IgE | 6833-8 |
| CED | Mountain Cedar, IgE | 6178-8 |
| CLAD | Cladosporium, IgE | 53760-5 |
| COCR | Cockroach, IgE | 6078-0 |
| CTWD | Cottonwood, IgE | 6090-5 |
| DF | House Dust Mites/D.F., IgE | 6095-4 |
| DOGD | Dog Dander, IgE | 6098-8 |
| DP | House Dust Mites/D.P., IgE | 6096-2 |
| ELM | Elm, IgE | 6109-3 |
| IGE | Immunoglobulin E (IgE), S | 19113-0 |
| MULB | Mulberry, IgE | 6281-0 |
| NETT | Nettle, IgE | 6186-1 |
| OAK | Oak, IgE | 6189-5 |
| PENL | Penicillium, IgE | 6212-5 |
| RUSS | Russian Thistle, IgE | 6234-9 |
| SORR | Red Sorrel, IgE | 6244-8 |
| SRW | Short Ragweed, IgE | 6085-5 |
| TIMG | Timothy Grass, IgE | 6265-3 |