Test Id : GBM
Glomerular Basement Membrane Antibodies, IgG, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Evaluating patients with clinical features of anti-glomerular basement disease, including rapidly progressive glomerulonephritis or pulmonary hemorrhage
Method Name
A short description of the method used to perform the test
Multiplex Flow Immunoassay
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
Anti-GBM (Glomerular Basement Membrane)
Antiglomerular Basement Membrane Antibody-IgG
Basement Membrane Antibody
Basement Membrane, Glomerular Antibody
GBM (Glomerular Basement Membrane) Antibody
GBM Antibody
Glomerular Anti-Basement Membrane
Goodpastures Syndrome
Goodpasture Disease
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
If patient is being evaluated for autoimmune skin disease, order CIFS / Cutaneous Immunofluorescence Antibodies (IgG), Serum for evaluation of anti-intercellular substance (ICS) and antibasement membrane zone (BMZ) 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: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
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.
0.35 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| 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) | 21 days | |
| Frozen | 21 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Evaluating patients with clinical features of anti-glomerular basement disease, including rapidly progressive glomerulonephritis or pulmonary hemorrhage
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Anti-glomerular basement (GBM) disease is a rare autoimmune disease, with an estimated incidence of 0.6-1.79 cases per million population per year.(1) Without prompt treatment, this disease is potentially fatal. Patients may present with rapidly progressive glomerulonephritis, pulmonary hemorrhage, or both.(2,3) The serological hallmark of this disease is the presence of anti-GBM antibodies of the IgG isotype. Anti-GBM antibodies bind to the non-collagenous domain 1 (NC1) of the alpha3 chain of type IV collagen, which is one of the main components of the kidney and lung basement membranes. Deposition of anti-GBM antibodies in the kidney and lungs triggers complement activation and production of reactive oxygen species, ultimately leading to vascular necrosis and damage to the GBM.
The diagnosis of anti-GBM disease in a patient with compatible clinical symptoms is often confirmed by detecting the presence of anti-GBM antibodies. This can be accomplished by a variety of antigen-specific, solid-phase immunoassays. Given the implications of this testing, understanding the diagnostic sensitivity and specificity of anti-GBM antibody methods is critical. In a recent meta-analysis, a pooled sensitivity of 93% (95%CI: 84-97%) and a pooled specificity of 97% (95%CI: 94-99%) was demonstrated across 11 methods.(4) In addition, some studies have suggested a prognostic role for anti-GBM antibodies, with higher titers being associated with increased mortality. However, it appears that this effect can largely be abrogated by prompt and aggressive treatment, particularly plasmapheresis.(1)
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.
<1.0 U (negative)
> or =1.0 U (positive)
Reference values apply to all ages.
Interpretation
Provides information to assist in interpretation of the test results
A positive result for anti-glomerular basement (GBM) antibody is consistent with the diagnosis of anti-GBM disease, in patients with the appropriate clinical presentation.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A positive result for anti-glomerular basement (GBM) antibodies is not diagnostic for anti-GBM disease and must be interpreted in the clinical context of the patient.
A negative result for anti-GBM antibodies does not exclude the possibility of anti-GBM disease, particularly in patients treated with immunosuppressants or plasmapheresis prior to testing.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Kuang H, Jiang N, Jia XY, Cui Z, Zhao MH. Epidemiology, clinical features, risk factors, and outcomes in anti-glomerular basement membrane disease: A systematic review and meta-analysis. Autoimmun Rev. 2024;23(4):103531
2. Ponticelli C, Calatroni M, Moroni G. Anti-glomerular basement membrane vasculitis. Autoimmun Rev. 2023;22(1):103212
3. Reggiani F, L'Imperio V, Calatroni M, Pagni F, Sinico RA. Goodpasture syndrome and anti-glomerular basement membrane disease. Clin Exp Rheumatol. 2023;41(4):964-974
4. Shiroshita A, Oda Y, Takenouchi S, Hagino N, Kataoka Y. Accuracy of anti-GBM antibodies in diagnosing anti-glomerular basement membrane Disease: A systematic review and meta-analysis. Am J Nephrol. 2021;52(7):531-538
Method Description
Describes how the test is performed and provides a method-specific reference
Glomerular basement membrane (GBM) antigen is covalently coupled to polystyrene microspheres that are impregnated with fluorescent dyes to create a unique fluorescent signature. GBM antibodies, if present in diluted serum, bind to the GBM antigen on the microspheres. The microspheres are washed to remove extraneous serum proteins. Phycoerythrin (PE)-conjugated antihuman-IgG antibody is then added to detect IgG anti-GBM bound to the microspheres. The microspheres are washed to remove unbound conjugate, and bound conjugate is detected by laser photometry. A primary laser reveals the fluorescent signature of each microsphere to distinguish it from microspheres that are labeled with other antigens. A secondary laser reveals the level of PE fluorescence associated with each microsphere. Results are calculated by comparing the median fluorescence response for GBM microspheres to a 4-point calibration curve.(Package insert: Bio-Plex 2200 Vasculitis. Bio-Rad Laboratories; 12/2018)
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.
83516
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 |
|---|---|---|
| GBM | Glomerular Basement Membrane IgG Ab | 31254-6 |
| 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.
|
|---|---|---|
| GBM | Glomerular Basement Membrane IgG Ab | 31254-6 |