Sign in →

Test Code DTABS Diphtheria/Tetanus Antibody Panel, Serum

Useful For

Assessment of an antibody response to tetanus and diphtheria toxoid vaccines

 

An aid to diagnose immunodeficiency

Profile Information

Test ID Reporting Name Available Separately Always Performed
DIPGS Diphtheria Toxoid IgG Ab, S Yes Yes
TTIGS Tetanus Toxoid IgG Ab, S Yes Yes

Method Name

Enzyme Immunoassay (EIA)

Reporting Name

Diphtheria/Tetanus Ab Panel, S

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 30 days
  Frozen  30 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross reject

Other

NA

Clinical Information

Diphtheria is an acute, contagious, febrile illness caused by the bacterium Corynebacterium diphtheriae. The disease is classically characterized by a combination of localized inflammation in the upper respiratory tract with the formation of a diphtheric pseudomembrane over the oropharynx, including the tonsils, pharynx, larynx and posterior nasal passages. Corynebacterium diphtheriae produces a potent diphtheria exotoxin which is absorbed systemically and can lead to cardiac failure and paralysis of the diaphragm.

 

The disease is preventable by vaccination with diphtheria toxoid, which stimulates anti-diphtheria toxoid antibodies. In the United States, diphtheria toxoid is administered to children as part of the combined diphtheria, tetanus, acellular pertussis (TDaP) vaccine. A patient’s immunological response to diphtheria toxoid vaccination can be determined by measuring anti-diphtheria toxoid IgG antibody using this enzyme immunoassay technique. An absence of antibody formation postvaccination may relate to immune deficiency disorders, either congenital or acquired, or iatrogenic due to immunosuppressive drugs.

 

Tetanus results from contamination of wounds or lacerations with Clostridium tetani spores from the environment. The spores germinate to actively replicating bacterial cells localized within the wound and produce the heat-labile toxin, tetanospasmin. Tetanospasmin attaches to peripheral nerve endings and travels to the central nervous system (CNS) where it blocks inhibitory impulses to motor neurons and leads to severe, spastic muscle contractions, a classic characteristic of tetanus.

 

The disease is preventable by vaccination with tetanus toxoid (formaldehyde-treated tetanospasmin), which stimulates development of anti-tetanus toxoid antibodies. In the United States, tetanus toxoid is administered to children as part of the combined diphtheria, tetanus, acellular pertussis (TDaP) vaccine.

 

Two to three weeks following vaccination, a patient's immunological response may be assessed by measuring the total anti-tetanus toxoid IgG antibody level in serum. An absence of antibody formation post-vaccination may relate to immune deficiency disorders, either congenital or acquired, or iatrogenic due to immunosuppressive drugs.

Reference Values

DIPHTHERIA TOXOID IgG ANTIBODY

Vaccinated: Positive (≥0.01 IU/mL)

Unvaccinated: Negative (<0.01 IU/mL)

 

TETANUS TOXOID IgG ANTIBODY

Vaccinated: Positive (≥0.01 IU/mL)

Unvaccinated: Negative (<0.01 IU/mL)

Interpretation

Diphtheria:

Results ≥0.01 IU/mL suggest a vaccine response.

 

A diphtheria toxoid booster should be considered for patients with anti-diphtheria toxoid IgG values between 0.01 and <0.1 IU/mL

 

Tetanus:

Results ≥0.01 IU/mL suggest a vaccine response.

 

A tetanus toxoid booster should strongly be considered for patients with anti-tetanus toxoid IgG values between 0.01 and 0.5 IU/mL.

 

Some cases of tetanus, usually mild, have occasionally been observed in patients who have a measurable serum level of 0.01 to 1.0 IU/mL.

Clinical Reference

1. Booy R, Aitken SJ, Taylor S, et al: Immunogenicity of combined diphtheria, tetanus, and pertussis vaccine given at 2, 3, and 4 months versus 3, 5, and 9 months of age. Lancet 1992;339(8792):507-510

2. Maple PA, Efstratiou A, George RC, et al: Diphtheria immunity in UK blood donors. Lancet 1995;345(8955):963-965

3. Bleck TP: Clostridium tetani (tetanus). In Principals and Practice of Infectious Disease. Fifth edition. Edited by GL Mandell, JE Bennett, R Dolin. Churchill Livingstone, Philadelphia, 2000, pp 2537-2543

4. Gergen PJ, McQuillan GM, Kiely M, et al: A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med 1995;332:761-766

5. Bjorkholm B, Wahl M, Granstrom M, Hagberg L: Immune status and booster effects of low doses of tetanus toxoid in Swedish medical personnel. Scand J Infect Dis 1994;26:471-475

6. Ramsay ME, Corbel MJ, Redhead K, et al: Persistence of antibody after accelerated immunization with diptheria/tetanus/pertussis vaccine. Br Med J 1991;302:1489-1491

Day(s) and Time(s) Performed

Monday through Friday; 9 a.m.

Analytic Time

Same day/1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

Diphtheria This test has been cleared or approved by the U.S. 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. Tetanus This test uses a reagent or kit labeled by the manufacturer as "Research Use Only". Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

86317 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DTABS Diphtheria/Tetanus Ab Panel, S In Process

 

Result ID Test Result Name Result LOINC Value
TETG Tetanus IgG Ab 33469-8
DIPG Diphtheria IgG Ab 45166-6
DEXDP Diphtheria IgG Value 48654-8
DEXTG Tetanus IgG Value 53935-3