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Test Code RPR11 Respiratory Profile, Region 11, Rocky Mountain (AZ [Mt]; CO; ID [Mt]; NM, UT [Mt]; WY)

Useful For

Assessing sensitization to various inhalant allergens commonly found in the Rocky Mountain region including Arizona, Colorado, Idaho, New Mexico, Utah and Wyoming

Profile Information

Test ID Reporting Name Available Separately Always Performed
IGE Immunoglobulin E (IgE), S Yes Yes
DP House Dust Mites/D.P., IgE Yes Yes
DF House Dust Mites/D.F., IgE Yes Yes
CAT Cat Epithelium, IgE Yes Yes
DOGD Dog Dander, IgE Yes Yes
BERG Bermuda Grass, IgE Yes Yes
TIMG Timothy Grass, IgE Yes Yes
COCR Cockroach, IgE Yes Yes
PENL Penicillium, IgE Yes Yes
CLAD Cladosporium, IgE Yes Yes
ASP Aspergillus Fumigatus, IgE Yes Yes
ALTN Alternaria Tenuis, IgE Yes Yes
BXMPL Box Eld/Maple, S, IgE Yes Yes
ALDR Grey Alder, IgE Yes Yes
CED Mountain Cedar, IgE Yes Yes
OAK Oak, IgE Yes Yes
ELM Elm, IgE Yes Yes
OLIV Olive-Tree, IgE Yes Yes
CTWD Cottonwood, IgE Yes Yes
MULB Mulberry, IgE Yes Yes
SRW Short Ragweed, IgE Yes Yes
MUG Mugwort, IgE Yes Yes
RUSS Russian Thistle, IgE Yes Yes
RRRP Rough Pigweed, IgE Yes Yes
SORR Red Sorrel, IgE Yes Yes

Reporting Name

Resp Profile, Reg 11, Rocky Mt

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1.7 mL

Additional Information: See Allergens-IgE Antibodies in Special Instructions.


Specimen Minimum Volume

1.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  90 days

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

NA

Other

NA

Clinical Information

Immunoglobulin E (IgE) is one of the 5 classes of immunoglobulins, and is defined by the presence of the epsilon heavy chain. It is the most recently described immunoglobulin, having first been identified in 1966. IgE exists as a monomer, and is present in circulation at very low concentrations, approximately 300-fold lower than that of IgG. The physiologic role of IgE is not well characterized, although it is thought to be involved in defense against parasites, specifically helminthes.

 

The function of IgE is also distinct from other immunoglobulins in that it induces activation of mast cells and basophils through the cell-surface receptor Fc epsilon RI. Fc epsilon RI is a high-affinity receptor specific for IgE present at a high density on tissue-resident mast cells and basophils. Because of this high-affinity interaction, almost all IgE produced by B cells is bound to mast cells or basophils, which explains the low concentration present in circulation. Cross-linking of the Fc epsilon RI -bound IgE leads to cellular activation, resulting in immediate release of preformed granular components (histamine and tryptase) and subsequent production of lipid mediators (prostaglandins and leukotrienes) and cytokines (interleukin-4 and interleukin-5).

 

Elevated concentrations of IgE may occur in the context of allergic disease. However, increases in the amount of circulating IgE can also be found in various other diseases, including primary immunodeficiencies, infections, inflammatory diseases, and malignancies. Total IgE measurements have limited utility for diagnostic evaluation of patients with suspected allergic disease. In this scenario, testing for the presence of allergen-specific IgEs may provide more information.

 

Clinical manifestations of allergic disease result from activation of mast cells and basophils, which occurs when Fc epsilon RI -bound IgE antibodies interact with allergen.

 

In vitro serum testing for specific IgE antibodies may provide an indication of the immune response to an allergen that may be associated with allergic disease.

 

The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. Sensitization to inhalant allergens (dust mite, mold, and pollen inhalants) primarily occurs in older children, adolescents, and adults, and usually manifests as respiratory disease (rhinitis and asthma).

Reference Values

Specific IgE:

Class

IgE kU/L

Interpretation

0

<0.35

Negative

1

0.35-0.69

Equivocal

2

0.70-3.49

Positive

3

3.50-17.4

Positive

4

17.5-49.9

Strongly positive

5

50.0-99.9

Strongly positive

6

≥100

Strongly positive

Reference values apply to all ages.

 

Total IgE:

Results Reported in kU/L

Age

Reference interval

0-5 months

≤13

6-11 months

≤34

1 and 2 years

≤97

3 years

≤199

4-6 years

≤307

7 and 8 years

≤403

9-12 years

≤696

13-15 years

≤629

16 and 17 years

≤537

18 years and older

≤214

Interpretation

Elevated concentrations of total IgE may be found in a variety of clinical diseases, including allergic disease, certain primary immunodeficiencies, infections, inflammatory diseases, and malignancies.

 

Detection of allergen-specific IgE antibodies in serum (Class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.

Clinical Reference

1. Homburger HA: Allergic diseases. In Clinical Diagnosis and Management by Laboratory Methods. 21st edition. New York, WB Saunders Company, 2007, pp 961-971

2. Bernstein IL, Li JT, Bernstein DI, et al: Allergy diagnostic testing: An updated practice parameter. Ann Allergy Asthma Immunol 2008 Mar;100(3 Suppl 3):S1-148

Day(s) and Time(s) Performed

Monday through Friday; 9 a.m.-8 p.m.

Saturday; 8 a.m.-3 p.m.

Analytic Time

Same day/1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

82785-IgE

86003 x 24-Each individual allergen

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RPR11 Resp Profile, Reg 11, Rocky Mt In Process

 

Result ID Test Result Name Result LOINC Value
ALDR Grey Alder, IgE 15284-3
ALTN Alternaria Tenuis, IgE 6020-2
ASP Aspergillus Fumigatus, IgE 6025-1
BERG Bermuda Grass, IgE 6041-8
BXMPL Box Eld/Maple, S, IgE 7155-5
CAT Cat Epithelium, IgE 6833-8
CED Mountain Cedar, IgE 6178-8
CLAD Cladosporium, IgE 53760-5
COCR Cockroach, IgE 30170-5
CTWD Cottonwood, IgE 6090-5
DF House Dust Mites/D.F., IgE 6095-4
DOGD Dog Dander, IgE 6098-8
DP House Dust Mites/D.P., IgE 6096-2
ELM Elm, IgE 6109-3
IGE Immunoglobulin E (IgE), S 19113-0
MUG Mugwort, IgE 6183-8
MULB Mulberry, IgE 6281-0
OAK Oak, IgE 6189-5
OLIV Olive-Tree, IgE 6192-9
PENL Penicillium, IgE 6212-5
RRRP Rough Pigweed, IgE 6233-1
RUSS Russian Thistle, IgE 6234-9
SORR Red Sorrel, IgE 6244-8
SRW Short Ragweed, IgE 6085-5
TIMG Timothy Grass, IgE 6265-3

Method Name

Fluorescence Enzyme Immunoassay (FEIA)