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Test Code DNJB9 DNAJB9 Immunostain, Technical Component Only


Advisory Information


This test includes only technical performance of the stain (no pathologist interpretation is performed). If diagnostic consultation by a pathologist is required order PATHC / Pathology Consultation.



Shipping Instructions


Attach the green pathology address label and the pink Immunostain Technical Only label included in the kit to the outside of the transport container.



Specimen Required


Supplies: Immunostain Technical Only Envelope (T693)

Specimen Type: Tissue

Preferred: 2 Unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections 4-microns thick

Acceptable: Formalin-fixed, paraffin-embedded (FFPE) tissue block


Secondary ID

71739

Useful For

Diagnosis of fibrillary glomerulonephritis

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
IHTOI IHC Initial, Tech Only No No
IHTOA IHC Additional, Tech Only No No

Method Name

Immunohistochemistry

Reporting Name

DNAJB9 IHC, Tech Only

Specimen Type

TECHONLY

Specimen Stability Information

Specimen Type Temperature Time Special Container
TECHONLY Ambient (preferred)
  Refrigerated 

Reject Due To

Wet/frozen tissue Cytology smears Nonformalin fixed tissue Nonparaffin embedded tissue Noncharged slides ProbeOn slides Reject

Clinical Information

DNAJB9 (Dnaj (hsp40) homolog, subfamily b, member 9) is a cochaperone that is upregulated in response to endoplasmic reticulum (ER) stress and plays a role in protein folding or ER-associated protein degradation. Proteomic analysis using microdissection of glomeruli, protease digestion, and mass spectrometry indicates that the DNAJB9 protein is specifically identified in glomeruli of patients with fibrillary glomerulonephritis.(Mayo Clinic unpublished observations) By immunohistochemistry there is an intense smudgy staining of extracellular glomerular deposits for DNAJB9 that is not present in glomeruli from healthy individuals, patients with amyloidosis, or patients with other glomerular diseases. The presence of DNAJB9, in the appropriate clinical and pathological context, can be helpful in diagnosis of this disease.

Interpretation

This test includes only technical performance of the stain (no pathologist interpretation is performed). Mayo Clinic cannot provide an interpretation of tech only stains outside the context of a pathology consultation. If an interpretation is needed, refer to PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case. All material associated with the case is required. Additional specific stains may be requested as part of the pathology consultation, and will be performed as necessary at the discretion of the Mayo pathologist.

 

The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request. Contact 855-516-8404.

 

Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.

Clinical Reference

1. Rosenmann E, Eliakim M: Nephrotic syndrome associated with amyloid-like glomerular deposits. Nephron 1977;18:301-308

2. Casanova S, Donini U, Zucchelli P, et al: Immunohistochemical distinction between amyloidosis and fibrillar glomerulopathy. Am J Clin Pathol 1992;97:787-795

3. Berger BJ1, Muller TS, Buschmann IR, et al: High levels of the molecular chaperone Mdg1/ERdj4 reflect the activation state of endothelial cells. Exp Cell Res. 2003;290(1):82-92

4. Rosenstock JL, Markowitz GS, Valeri AM, et al: Fibrillary and immunotactoid glomerulonephritis: Distinct entities with different clinical and pathologic features. Kidney Int 2003;63:1450-1461

5. Nasr SH, Vrana JA, Dasari S, Bridoux F, et al: DNAJB9 is a Specific Immunohistochemical Marker for Fibrillary Glomerulonephritis. Kidney Int Rep 2017;3(1):56-64

6. Dasari S, Alexander MP, Vrana JA, Theis JD, et al: DnaJ Heat Shock Protein Family B Member 9 is a Novel Biomarker for Fibrillary GN. J Am Soc Nephrol 2018;29(1):51-56

Day(s) and Time(s) Performed

Monday through Friday

Analytic Time

1 day

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved or is exempt 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.

CPT Code Information

88342-TC, primary

88341-TC, if additional IHC

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DNJB9 DNAJB9 IHC, Tech Only Order only;no result

 

Result ID Test Result Name Result LOINC Value
71740 DNAJB9 IHC, Tech Only Bill only; no result

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Renal Diagnostics Test Request (T830)

-Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763)

Testing Algorithm

For the initial technical component only immunohistochemical (IHC) stain performed, the appropriate bill-only test ID will be reflexed and charged (IHTOI). For each additional technical component only IHC stain performed, an additional bill-only test ID will be reflexed and charged (IHTOA).