Test Catalog

Test Id : SASP

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Aspergillus fumigatus, IgG Antibodies, Serum

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Overview

Test Catalog

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

Evaluation of patients suspected of having hypersensitivity pneumonitis (HP) induced by exposure to Aspergillus fumigatus

 

Evaluation of patients suspected of having HP who have documented environmental exposures to high-humidity environments

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.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Aspergillus fumigatus, IgG Ab, S

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

Fumigatus

Hypersensitivity pneumonitis

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: 0.5 mL

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

0.3 mL

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

Gross hemolysis OK
Gross lipemia OK
Gross icterus 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 Refrigerated (preferred) 21 days
Frozen 21 days

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

Evaluation of patients suspected of having hypersensitivity pneumonitis (HP) induced by exposure to Aspergillus fumigatus

 

Evaluation of patients suspected of having HP who have documented environmental exposures to high-humidity environments

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

Hypersensitivity pneumonitis (HP) is a type of interstitial lung disease caused by an immune-mediated response to inhaled environmental antigens.(1) Patients with HP commonly display symptoms of cough, dyspnea, and midinspiratory squeaks. Patients may present with an acute onset of symptoms (within hours of antigen exposure) or a chronic onset (which may occur over a course of weeks to months). The nature of an individual’s disease course will be affected by several factors, including quantity of inhaled antigen, intensity/frequency of exposure, and genetic background. The epidemiology of HP is also challenging to understand, as incidence and prevalence of the disease varies with geographic areas, climate, and local customs. While the immunopathogenesis of HP is not completely understood, it is presumed to involve both type III and type IV hypersensitivity reactions, with the type III reaction characterized by the presence of IgG antibodies specific for the inciting antigen.

 

There are many antigens, both organic and inorganic, that have been associated with development of HP.(2) Causative organic antigens include a wide array of bacteria, mycobacteria, fungi, and animal proteins. Aspergillus fumigatus is a fungus found in locations with high humidity, including soil, greenhouses, and compost heaps. It is fairly ubiquitous and may even be found in household dust. Some individuals exposed to A fumigatus, particularly those individuals with routine exposure to high-humidity environments, may develop IgG antibodies against this antigen, which could lead to development of HP.

 

Clinical practice guidelines for HP include a diagnostic algorithm which focuses on exposure identification, imaging evaluation, and bronchoalveolar lavage/histopathology.(3) Detection of IgG antibodies specific for certain environmental antigens can help to document the causative exposure for an individual. This is critical, as an important treatment for these patients is antigen avoidance. However, IgG testing is only useful as supportive information for the diagnosis of HP; a positive result only indicates sensitization to the antigen and a negative result does not exclude the possibility that a patient with HP may be sensitized to another antigen.

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.

<4 years: not established

> or =4 years: < or =102 mg/L

Interpretation
Provides information to assist in interpretation of the test results

Positive results for IgG antibodies to Aspergillus fumigatus, in patients with signs and symptoms of hypersensitivity pneumonitis, may be consistent with sensitization to this fungus.

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

Positive results for IgG antibodies to Aspergillus fumigatus may be found in sera from healthy individuals who are sensitized to this fungus but do not display symptoms consistent with hypersensitivity pneumonitis (HP).

 

Negative results for IgG antibodies to A fumigatus do not exclude HP as a diagnosis; patients with clinical symptoms consistent with HP may be sensitized to a different antigen.

 

Elevated concentration of antibodies to A fumigatus may be also found in patients with invasive aspergillosis and cavitary lung disease.

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

1. Sforza GG, Marinou A: Hypersensitivity pneumonitis: a complex lung disease. Clin Mol Allergy. 2017; Mar 7;15(6). doi: 10.1186/s12948-017-0062-7

2. Costabel U, Miyazaki Y, Pardo A, et al: Hypersensitivity pneumonitis. Nat Rev Dis Primers. 2020 Aug 6;6(1):65. doi: 10.1038/s41572-020-0191-z

3. Raghu G, Remy-Jardin M, Ryerson CJ, et al: Diagnosis of hypersensitivity pneumonitis in adults. An Official ATS/JRS/ALAT Clinical Practice Guideline.  Am J Respir Crit Care Med. 2020 August 1;202(3):e36-e69. doi: 10.1164/rccm.202005-2032ST

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

The Phadia ImmunoCAP System specific IgG fluorescent enzyme immunoassay provides an in vitro method for measuring the concentrations of circulating specific IgG antibodies in human blood samples. Specific IgG from the patient's serum reacts with the antigen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgG, enzyme-labeled anti-IgG antibodies are added to form a complex. After incubation, unbound enzyme-anti IgG is washed away, and the bound complex is then incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. The fluorescence is proportional to the amount of specific IgG, which is present in the patient's sample, ie, the higher the fluorescence value, the more specific IgG antibody is present.(Package insert: ImmunoCAP Aspergillus. Phadia AB; 10/2019)

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 4 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.

86606

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
SASP Aspergillus fumigatus, IgG Ab, S 26954-8
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.
SASP Aspergillus fumigatus, IgG Ab, S 26954-8

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