|
|
| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Anaplasma phagocytophilum and E.chaffeensis Antibody Panel Reflex to Titers
Test Code16212
CPT Codes
86666 (x4)
Includes
If A. phagocytophilum (IgG) is Detected, then A. phagocytophilum (IgG) Titer will be performed at an additional charge (CPT code(s): 86317).
If A. phagocytophilum (IgM) is Detected, then A. phagocytophilum (IgM) Titer will be performed at an additional charge (CPT code(s): 86317).
If E. chaffeensis (IgG) is Detected, then E. chaffeensis (IgG) Titer will be performed at an additional charge (CPT code(s): 86317).
If E. chaffeensis (IgM) is Detected, then E. chaffeensis (IgM) Titer will be performed at an additional charge (CPT code(s): 86317).
If A. phagocytophilum (IgM) is Detected, then A. phagocytophilum (IgM) Titer will be performed at an additional charge (CPT code(s): 86317).
If E. chaffeensis (IgG) is Detected, then E. chaffeensis (IgG) Titer will be performed at an additional charge (CPT code(s): 86317).
If E. chaffeensis (IgM) is Detected, then E. chaffeensis (IgM) Titer will be performed at an additional charge (CPT code(s): 86317).
Preferred Specimen
1 mL serum
Minimum Volume
0.4 mL
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days
Refrigerated: 14 days
Frozen: 30 days
Methodology
Immunofluorescence Assay (IFA)
Setup Schedule
Set up: Mon, Wed-Sat; Report available: 1-3 days
Reference Range
| A. phagocytophilum Ab (IgG), Screen | Not Detected |
| A. phagocytophilum Ab (IgM), Screen | Not Detected |
| E. chaffeensis Ab (IgG), Screen | Not Detected |
| E. chaffeensis Ab (IgM), Screen | Not Detected |
| A. phagocytophilum Ab (IgG), Titer | <1:64 titer |
| A. phagocytophilum Ab (IgM), Titer | <1:20 titer |
| E. chaffeensis Ab (IgG), Titer | <1:64 titer |
| E. chaffeensis Ab (IgM), Titer | <1:20 titer |
Clinical Significance
This panel is for the detection of IgG and IgM antibodies against Anaplasma phagocytophilum and Ehrlichia chaffeensis. Anaplasmosis (human granulocytic anaplasmosis) and Ehrlichiosis (human monocytic ehrlichiosis) are tickborne diseases caused by transmission of the bacteria via the bite of an infected tick. Anaplasmosis is most common in the Northeastern and upper Midwestern United States. Ehrlichiosis is most common in the eastern, southeastern and south-central United States.
Testing for tickborne disease is based on a clinical evaluation and risk of tick exposure with consideration to the geographic region. Symptoms may be nonspecific, including headache, fever/chills, malaise, myalgia, gastrointestinal symptoms, and rash. Infection can have similarities with other tickborne illnesses with overlapping vectors, geographic endemicity, and similar clinical signs and symptoms, including Borrelia burgdorferi (Lyme disease) and Babesia microti.
Negative results can occur early in infection. Nucleic acid amplification tests are the preferred method for diagnosis during acute infection. Seroconversion or a four-fold increase between acute and convalescent sera can be used to support a diagnosis. The presence of IgG alone may indicate past infection, and IgM may persist for many months after infection has resolved. Antibody levels may remain elevated for several years after acute illness. Cross-reactivity between Anaplasma and Ehrlichia spp can occur. Therefore, interpretation of serologic results is done in the context of pertinent clinical picture, including timing from symptom onset.
References:
1. Tickborne Diseases of the United States. A Reference Manual for Healthcare Providers, Sixth Edition, 2022. Centers for Disease Control and Prevention.
2. Clinical Testing and Diagnosis for Anaplasmosis. Centers for Disease Control and Prevention. Last updated May 15, 2024. https://www.cdc.gov/anaplasmosis/hcp/diagnosis-testing/index.html
3. Miller, MJ, et al. Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5:ciae104.doi: 10.1093/cid/ciae104.
4. Biggs, HM, et al. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. MMWR Recomm Rep. 2016 May 13;65(2):1-44.
5. Clinical Testing and Diagnosis for Ehrlichiosis. Centers for Disease Control and Prevention. Last updated May 15, 2024. https://www.cdc.gov/ehrlichiosis/hcp/diagnosis-testing/index.html
Testing for tickborne disease is based on a clinical evaluation and risk of tick exposure with consideration to the geographic region. Symptoms may be nonspecific, including headache, fever/chills, malaise, myalgia, gastrointestinal symptoms, and rash. Infection can have similarities with other tickborne illnesses with overlapping vectors, geographic endemicity, and similar clinical signs and symptoms, including Borrelia burgdorferi (Lyme disease) and Babesia microti.
Negative results can occur early in infection. Nucleic acid amplification tests are the preferred method for diagnosis during acute infection. Seroconversion or a four-fold increase between acute and convalescent sera can be used to support a diagnosis. The presence of IgG alone may indicate past infection, and IgM may persist for many months after infection has resolved. Antibody levels may remain elevated for several years after acute illness. Cross-reactivity between Anaplasma and Ehrlichia spp can occur. Therefore, interpretation of serologic results is done in the context of pertinent clinical picture, including timing from symptom onset.
References:
1. Tickborne Diseases of the United States. A Reference Manual for Healthcare Providers, Sixth Edition, 2022. Centers for Disease Control and Prevention.
2. Clinical Testing and Diagnosis for Anaplasmosis. Centers for Disease Control and Prevention. Last updated May 15, 2024. https://www.cdc.gov/anaplasmosis/hcp/diagnosis-testing/index.html
3. Miller, MJ, et al. Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5:ciae104.doi: 10.1093/cid/ciae104.
4. Biggs, HM, et al. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. MMWR Recomm Rep. 2016 May 13;65(2):1-44.
5. Clinical Testing and Diagnosis for Ehrlichiosis. Centers for Disease Control and Prevention. Last updated May 15, 2024. https://www.cdc.gov/ehrlichiosis/hcp/diagnosis-testing/index.html
