Test Id : ALPRT
Alport (Collagen IV Alpha 5 and Alpha 2) Immunofluorescent Stain, Renal Biopsy
Useful For
Suggests clinical disorders or settings where the test may be helpful
Assisting in the diagnosis of hereditary nephritis (Alport syndrome)
Method Name
A short description of the method used to perform the test
Direct Immunofluorescence
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
RBALPRTIF
Specimen Type
Describes the specimen type validated for testing
Special
Shipping Instructions
1. Advise shipping frozen specimens (unstained slides or tissue block) in Styrofoam transportation coolers filled with dry ice to ensure specimens are received at required specimen stability temperature.
2. Attach the green "Attention Pathology" address label (T498) to the outside of the transport container before putting into the courier mailer.
Necessary Information
A pathology/diagnostic report is required.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Unstained slides (unfixed)
Source: Kidney tissue or skin tissue
Slides: 1 Slide
Collection Instructions: Submit 1 frozen tissue unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections should be 4-microns thick, centered on the slide, and shipped on dry ice.
Acceptable:
Specimen Type: Unfixed tissue block (O.C.T)
Source: Kidney tissue or skin tissue
Specimen Volume: Entire specimen
Collection Instructions:
1. Embed in O.C.T. compound.
2. Freeze specimen and ship on dry ice.
Acceptable:
Specimen Type: Wet tissue
Source: Kidney tissue or skin tissue
Supplies: Renal Biopsy Kit (T231)
Container/Tube: Renal Biopsy Kit, Zeus/Michel's
Specimen Volume: Entire specimen
Collection Instructions:
1. Collect specimens according to the instructions in Renal Biopsy Preparation Instructions.
2. If standard immunoglobulin and complement immunofluorescence has already been performed, ship the residual frozen tissue (must contain glomeruli) on dry ice.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
1. Renal Biopsy Patient Information
2. If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) 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
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 |
|---|---|---|---|
| Special | Frozen | ||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Assisting in the diagnosis of hereditary nephritis (Alport syndrome)
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Alport syndrome is a hereditary disease of basement membrane collagen type IV. Variants in collagen IV alpha genes cause characteristic abnormal immunofluorescence staining patterns within the glomerular basement membrane. Alport syndrome is characterized by hematuria, proteinuria, progressive kidney failure, and high-tone sensorineural hearing loss.
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.
An interpretive report will be provided.
Interpretation
Provides information to assist in interpretation of the test results
This test (when not accompanied by a pathology consultation request) will be reported as one of the following:
1) Normal pattern
2) Consistent with X-linked hereditary nephritis
3) Consistent with autosomal hereditary nephritis
If additional interpretation or analysis is needed, request PATHC / Pathology Consultation along with this test and send the corresponding renal pathology light microscopy and immunofluorescence (IF) slides (or IF images on a CD), electron microscopy images (prints or CD), and the pathology report.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Approximately one-third of patients with established hereditary nephritis based on typical ultrastructural findings and family history show loss of glomerular basement membrane or epidermal basement membrane staining for the alpha 5 chain of type IV collagen. Therefore, a normal staining pattern does not exclude the diagnosis of hereditary nephritis.
Because alpha 3 and alpha 4 chains of type IV collagen are not expressed in the epidermal basement membranes, patients with autosomal hereditary nephritis have preserved staining for alpha 5 on epidermal basement membranes and, therefore, skin biopsy cannot exclude autosomal hereditary nephritis.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Kagawa M, Kishiro Y, Naito I, et al. Epitope-defined monoclonal antibodies against type-IV collagen for diagnosis of Alport's syndrome. Nephrol Dial Transplant. 1997;12(6):1238-1241
2. Hashimura Y, Nozu K, Kaito H, et al. Milder clinical aspects of X-linked Alport syndrome in men positive for the collagen IV alpha 5 chain. Kidney Int. 2014;85(5):1208-1213
3. Kamiyoshi N, Nozu K, Fu XJ, et al. Genetic, clinical, and pathologic backgrounds of patients with autosomal dominant Alport syndrome. Clin J Am Soc Nephrol. 2016;11(8):1441-1449
4. Said SM, Fidler ME, Valeri AM, et al. Negative staining for COL4A5 correlates with worse prognosis and more severe ultrastructural alterations in males with Alport syndrome. Kidney Int Rep. 2016;2(1):44-52
Method Description
Describes how the test is performed and provides a method-specific reference
Direct immunofluorescence staining on sections of fresh/frozen tissue.(Unpublished Mayo method)
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 and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It 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.
88346
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 |
|---|---|---|
| ALPRT | ALPORT Immunofluorescence | 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.
|
|---|---|---|
| 71285 | Interpretation | 50595-8 |
| 71268 | Participated in the Interpretation | No LOINC Needed |
| 71272 | Material Received | 81178-6 |
| 71271 | Gross Description | 22634-0 |
| 71269 | Report electronically signed by | 19139-5 |
| 71270 | Addendum | 35265-8 |
| 71619 | Disclaimer | 62364-5 |
| 71848 | Case Number | 80398-1 |