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There are currently 20 names in this directory beginning with the letter L.

Lactic Acid Dehydrogenase (LD)

Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum (preferred) or plasma Volume 1 mL Minimum Volume 0.5 mL Container Red-top tube, gel-barrier tube, or green-top (heparin) tube; do not use EDTA plasma. Collection Separate serum or plasma from cells within 45 minutes of collection. Storage Instructions Maintain specimen at room temperature.1 Stability Requirements Temperature Period Room temperature 14 days Refrigerated 7 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Plasma specimens collected in EDTA, oxalate, or citrated tubes; gross hemolysis; gross bacterial contamination; improper labeling Test Details Use Elevated serum levels of LDH have been observed in a variety of disease states. The highest levels are seen in patients with megaloblastic anemia, disseminated carcinoma, and shock. Moderate increases occur in muscular disorders, renal diseases, and cirrhosis. Mild increases in LDH activity have been reported in cases of myocardial or pulmonary infarction, leukemia, hemolytic anemia, and nonviral hepatitis.2 Limitations Hemolysis elevates LDH results, oxalate inhibits LDH, and ascorbic acid can decrease LDH values. Methodology Enzymatic, colorimetric, UV Reference Interval See table. Age Male (IU/L)1 Female (IU/L)1 0 to 7 d 123−237 123−237 8 to 30 d 126−331 130−275 1 to 11 m 143−381 128−376 1 to 3 y 195−361 192−352 4 to 6 y 180−313 180−311 7 to 9 y 166−291 166−290 10 to 12 y 155−280 135−260 13 to 15 y 126−244 118−215 16 to 17 y 118−222 114−209 >17 y 121−224 119−226 Additional Information In infectious mononucleosis, LD is usually more elevated than AST, and there is usually an isomorphic pattern of LD isoenzymes. In viral hepatitis, by contrast, AST and ALT (the transaminases) are much more increased than is LD, about three or more times higher than total LD, and LD5 is high. The differential diagnosis of acute infarct of myocardium includes pericarditis and angina, entities in which enzymes are usually not substantially increased. Bovine or porcine heparin therapy can cause increases of AST, ALT, and LD, with elevated LD hepatic fractions.2

Lactic Acid, Plasma

Lamellar Body Counts (LBC)

Lamellar Body Counts (LBC)

Lead, Blood, Filter Paper

Special Instructions This assay currently is not available in New York state. Expected Turnaround Time 4 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Two free-falling blood drops approximating size of imprinted circles (dime-sized) on supplied filter paper collector. Drop blood onto the paper. Do not touch paper to skin. Volume 2 free-falling blood drops Minimum Volume 1 free-falling blood drop Container Filter Paper Collection Card (PeopleSoft N° 107973 or 111742) Storage Instructions Maintain specimen at room temperature. Stable at room temperature for up to six months. Test Details Use Evaluate exposure to lead Methodology Inductively Coupled Plasma/Mass Spectrometry (ICP-MS)

Lead, Venous Blood Pediatric

Synonyms Pb, Blood Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Lead, Whole Blood (Adult) Related Documents Sample Report Specimen Requirements Specimen Whole blood Volume 3 mL (venous) Minimum Volume 0.5 mL (venous) Container Royal blue-top (EDTA) tube or tan-top lead-free tube; submit original tube. Collection Mix blood thoroughly to avoid clotting. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x2 Causes for Rejection Capillary specimen in Microtainer tubes; clotted specimen Test Details Use Monitor environmental lead exposure in children younger than 16 years. Limitations This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA). Methodology Atomic absorption spectrometry (AAS) or inductively coupled plasma/mass spectrometry (ICP/MS) Reference Interval Environmental exposure: 0 to 15 years: 0−4 μg/dL1 Additional Information The Centers for Disease Control and Prevention recommends the following testing schedule for children with elevated BLLs (blood lead levels) on a screening test.2 See table. Blood Lead Levels (CDC) Blood (μg/dL): Time to Confirmation Testing: *The higher the BLL on the screening test, the more urgent the need for confirmation testing. Reference value-9 1 to 3 m 10−45 1 wk to 1 m* 45−59 48 h 60−69 24 h ≥70 Urgently as emergency test

Lead, Whole Blood (Adult)

Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Plasma Volume 1 mL Minimum Volume 0.5 mL Container Gray-top (sodium fluoride/potassium oxalate or sodium fluoride/sodium heparin) tube Collection Keep gray-top tube on ice. Draw blood in gray-top tube. Mix well by gentle inversion at least six times. Return to ice bath to cool. Avoid hand-clenching and, if possible, avoid use of a tourniquet. A tourniquet with patient clenching and unclenching hand will lead to high potassium and lactic acid buildup from the hand muscles, and pH will decrease. It is best to avoid a tourniquet for electrolytes and lactic acid or to release it after blood begins to flow into the tube. If the tourniquet is released before blood is drawn, wait about a minute before drawing. Within 15 minutes of draw, separate the plasma from blood by centrifugation for 10 minutes. Immediately transfer the plasma portion of the sample to a labeled plastic transport tube. Avoid excessive forces that contribute to hemolysis. Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Patient Preparation Patient should not be on any intravenous infusion that would affect the acid-base balance. Patient should be in a fasting and resting state (should not exercise). Causes for Rejection Specimen not separated from cells within 15 minutes of draw; marked hemolysis; slight or moderate turbidity; perchloric acid supernatant; serum specimen Test Details Use Hypoperfusion is the most common cause of lactic acidosis and hyperlactacidemia may be the only marker of tissue hypoperfusion.1 Suspect lactic acidosis when unexplained anion gap metabolic acidosis is encountered, especially if azotemia or ketoacidosis are not present. Evaluate metabolic acidosis, regional or diffuse tissue hypoperfusion, hypoxia, shock,2 congestive heart failure, dehydration, complicated postoperative state, ketoacidosis or nonketotic acidosis in diabetes mellitus, patients with infections, inflammatory states, postictal state, certain myopathies, acute leukemia and other neoplasia, enzyme defects, glycogen storage disease (type I), thiamine deficiency, and hepatic failure. A spontaneous form of lactic acidosis occurs. It is a prognostic index in particular clinical settings, especially in critically ill patients in shock.3 A relationship to renal disease also exists. With skin rash, seizures, alopecia, ataxia, keratoconjunctivitis, and lactic acidosis in children, consider defective biotin metabolism.4 Phenformin, ethanol, methanol, and salicylate poisoning and ethylene glycol may cause lactic acidosis. Acetaminophen toxicity causes lactic acidosis, sometimes with hypoglycemia. Cyanide, isoniazid, and propylene glycol are among the causes of lactic acidosis.1 Lactic acidosis may be due to inborn errors of metabolism. Limitations Gross hemolysis elevates plasma results. Intravenous injections, or infusions which modify acid-base balance, may cause alterations in lactate levels. Epinephrine and exercise elevate lactate, as may IV sodium bicarbonate, glucose, or hyperventilation. False-low values may be found with a high LD (LDH) value. Methodology Lactate−pyruvate; spectrophotometry Reference Interval See table. Age Range (mg/dL) 0 to 7 d 4.5−19.2 8 to 30 d 9.6−35.0 1 to 6 m 8.4−41.3 7 m to 5 y 6.3−33.0 ≥6 y 4.8−25.7 Additional Information Expected Turnaround Time 2 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Heavy Metals Profile I, Whole Blood Heavy Metals Profile II, Whole Blood Lead, Urine Lead, Venous Blood Pediatric Related Documents Sample Report Specimen Requirements Specimen Whole blood Volume 1 mL Minimum Volume 0.5 mL Container Royal blue-top (EDTA) tube or tan-top lead-free tube; submit original tube. Collection Sampling time is not critical for industrial exposure monitoring. Metals with timing “not critical” have very long elimination half-lives and accumulate in the body over years, some for a lifetime. After a couple of weeks of exposure, specimens can be collected at any time. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Clotted specimen Test Details Use Monitor exposure to lead Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Atomic absorption spectrometry (AAS) or inductively coupled plasma/mass spectrometry (ICP/MS) Reference Interval 0 - 4 μg/dL • Environmental exposure (WHO): <20 μg/dL • Occupational exposure: BEI® (sampling time is not critical): 30 μg/dL;1 OSHA Lead Standard: 40 μg/dL Additional Information Hematologic consequences ascribed to lead toxicity may be basophilic stippling, mild anemia, and reticulocytosis. Other characteristics of toxicity may include increased urine δ-aminolevulinic acid, increased erythrocyte protoporphyrins, and decreased aminolevulinic acid dehydrase. Lead lines on gums or at the metaphyses of long bones in children may also be present.2 Early symptoms of lead poisoning include anorexia, apathy or irritability, fatigue, and anemia.3 Toxic effects include GI distress, joint pain, colic, headache, stupor, convulsions, and coma. Another test that may be used to evaluate lead intoxication is free erythrocyte protoporphyrin (FEP); however, a blood lead assay is the definitive test.4 Lead and organic lead compounds have numerous commercial and industrial applications, including paints, plastics, storage batteries, bearing alloys, insecticides, and ceramics. Exposure may also occur through the inhalation of dust containing lead emitted by automobile exhaust. A common source of lead exposure among children is through the mouthing of inanimate objects, specifically objects with paint and paint chips that contain lead. Acute lead exposure is rare; however, toxicity may occur through acute ingestion of a lead salt or acetate. Blood is the preferred specimen by which the extent of an acute or recent exposure to lead may be measured. BEI® are reference values intended as guidelines for evaluation of occupational exposure. BEI® represent biological levels of chemicals that correspond to workers with inhalation exposure equivalent to the threshold limit value (TLV®) of the chemicals. TLVs refer to the airborne concentrations of substances and represent conditions under which it is believed that nearly all workers may be repeatedly exposed, day after day, without adverse health effects.1

Leflunomide

Synonyms A77/1726 Arava® Teriflunomide Expected Turnaround Time 4 - 9 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 1 mL Minimum Volume 0.5 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Collection Serum must be separated from cells within 45 minutes of collection and transferred to a plastic transport tube. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested. Storage Instructions Freeze Stability Requirements Temperature Period Room temperature Unstable Refrigerated Unstable Frozen 6 months Causes for Rejection Serum separator tube; nonfrozen sample; gel-barrier tubes Test Details Use Leflunomide (Arava®) is a pyrimidine synthesis inhibitor used in the treatment of active rheumatoid arthritis. The drug is available in oral doses containing 10, 20, or 100 mg of active drug. Arava® is an isoxazole immunodulatory agent which inhibits dihydroorotate dehydrogenase (an enzyme involved in de novo pyrimidine synthesis) and has antiproliferative activity. Following oral administration, leflunomide is metabolized to an active metabolite, A77-1726 (teriflunomide), which is responsible for essentially all of its activity in vivo. Peak levels of this metabolite occurred 6 to 12 hours after dosing, with a long half-life (about two weeks). Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Leukemia/Lymphoma Immunophenotyping Profile

Synonyms Chronic Leukemia/Lymphoma Flow Cytometry Flow Immunophenotyping Leukemia Leukemia Profile Lymphoma Special Instructions If both tissue flow cytometry and histology are required, submit one portion of fresh specimen in transport medium or saline for flow cytometry and one portion in 10% formalin for histologic analysis. Please direct any questions regarding this test to oncology customer service at 800-345-4363. Pathologist consultation is available Monday through Friday. Indicate differential diagnosis on test request form. Submit recent CBC results for consideration in report. Billing will be performed back end. Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Chromosome Analysis, Leukemia/Lymphoma Leukemia & Lymphoma Management Test Selection Table T-Cell Receptor γ-Chain Gene Rearrangements Related Documents For more information, please view the literature below. Leukemia & Lymphoma Management Test Selection Table Sample Report Specimen Requirements Specimen Whole blood, bone marrow aspirate, body fluids, fresh lymph node, spleen, extranodal solid tissue, biopsy, or needle aspirate Volume 3 mL whole blood or 2 mL bone marrow aspirate, 2 mL body fluid tube. Large volumes of body fluids should be concentrated to <5 mL; 0.5 to 1.0 cm3 fresh tissue. Minimum Volume 1 mL whole blood or bone marrow (Note: This volume does not allow for repeat testing.) Container Green-top (sodium heparin) tube (preferred), lavender-top (EDTA) tube, or yellow-top (ACD) tube for whole blood or bone marrow (acceptable, not preferred); lavender-top (EDTA body fluids) tube; fresh tissue in lymph node transport bottle containing RPMI Collection Note: In an attempt to maintain specimen at room temperature, • In hot weather, enclose a refrigerated (not frozen) gel pack in shipper kit. • In cold weather, run hot water over gel pack for three to five minutes and enclose in shipper kit. • Ship specimens in a timely manner based on the specific requirements of the test. Submit blood or bone marrow at room temperature. Collect the specimen so it will arrive in the laboratory Monday through Saturday and within 24 hours of collection. Please state on the test request form the date and time of collection and the name and phone number of the pathologist responsible for the histologic or cytologic diagnosis. For fresh tissue, aseptically cut tissue in pieces and place in lymph node transport bottle. If aspirate is submitted, rinse needle in transport medium. Submit at room temperature using Lymph Node Transport Kit (supplied by LabCorp). If transport kit is not available, place specimen in sterile container with saline. Submit specimen so it will arrive in the laboratory Monday through Saturday and within 24 hours of surgical removal. To avoid transportation delays, submit specimen on the day of collection. Storage Instructions Maintain specimen at room temperature. Causes for Rejection Hemolysis; specimen clotted; specimen frozen; specimen in formalin or other fixative; blood more than 72 hours old; bone marrow aspirates more than five days old; bags or bottles of body fluid or bronchial washing; tissue in formalin or other fixative; contaminated transport medium Test Details Use Identify and characterize the following: • Reactive lymphocytosis vs chronic lymphocytic leukemia (CLL) • CLL vs mantle cell lymphoma • Prolymphocytic leukemia vs lymphoblastic leukemia large granular lymphocyte proliferations, T-γ lymphoproliferative disease, natural killer cell proliferations, T-cell CLL, T-cell γ/δ proliferations • Sézary syndrome • Non-Hodgkin lymphoma • Adult T-cell leukemia/lymphoma Neoplastic B-cell proliferations (chronic leukemias and lymphomas) are clonal expansions of cells that express either κ or λ immunoglobulin light chains. Methodology Immunophenotyping by flow cytometry Additional Information In normal or reactive processes, a bimodal distribution of κ- and λ-positive B cells is present in a ratio of approximately 1.5:1. Immunophenotyping using multiparameter analysis (simultaneous staining with a pan B-cell marker and anti-immunoglobulin light chain antibodies) is a rapid and specific method for detecting and confirming the presence of neoplastic B-cell disorders. Chronic lymphocytic leukemia (CLL) is a clonal lymphoproliferative disorder usually of B-cell origin (95%), that has been traditionally diagnosed using clinical and morphologic criteria. Incorporation of immunophenotypic features into the diagnostic criteria is helpful in separating common B-cell CLL from other lymphoproliferative disorders. Detection of karyotypic abnormalities is useful in assessing prognosis. Lymphocytes in B-CLL coexpress CD19, CD20, and CD23 pan B-cell antigens, CD5, pan T-cell antigen, and a single immunoglobulin light chain, κ or λ. CD10 (CALLA) expression is usually absent. Mantle cell lymphoma is distinguished from CLL by absent or very dim expression of CD23. Lymphomas are biologically complex neoplasms of the immune system. Numerous classification schemes have been developed based on morphologic features. This limited approach is often unreliable. Immunophenotyping, by flow cytometry and/or immunohistochemistry, has emerged as a valuable adjunct to conventional morphologic diagnosis and classification. Flow cytometry offers the advantage of rapid multiparameter analysis. Combining light scatter characteristics with patterns of antigen expression and DNA content provides biological information that is useful in making a diagnosis and assessing prognosis. Various gating strategies can be employed to enhance the detection of minor populations, thus providing a level of sensitivity comparable to molecular methods (gene rearrangement studies). T-cell CLL, unlike B-CLL, is associated with rapid onset, an aggressive clinical course poorly responsive to therapy and decreased survival. Immunophenotyping, in the majority of cases, demonstrates expression of CD3 (a pan T-cell antigen), and CD4 (the helper cell antigen). CD8 (the suppressor/cytotoxic cell antigen) is usually not expressed. Genotyping demonstrates a clonal rearrangement of the T-cell receptor gene. Large granular lymphocyte (LGL) proliferations can be divided into T-cell and natural killer (NK) cell subsets by immunophenotyping. The more common T-cell type expresses CD3, a pan T-cell antigen and CD8, the suppressor/cytotoxic cell antigen. Genotyping demonstrates a rearrangement of the T-cell receptor gene. The NK cell type is relatively rare and expresses CD2 and CD16 and/or CD56. CD3 expression is absent. Genotyping demonstrates a germline configuration of the T-cell receptor gene. In Sézary syndrome, the neoplastic lymphocytes are T cells with a helper cell phenotype. Expression of CD7, a pan T-cell antigen, is absent and is useful in distinguishing the neoplastic cells from normal T-helper cells. Genotyping demonstrates a clonal rearrangement of the T-cell receptor gene. In adult T-cell leukemia/lymphoma, the neoplastic lymphocytes are T-cells with a helper cell phenotype. Expression of CD3, CD4, and CD25 is present. Expression of CD7 is absent. Genotyping demonstrates a clonal rearrangement of the T-cell receptor gene. Detection of a B-cell population coexpressing CD22, CD11c, and CD25 is useful in establishing a diagnosis of hairy cell leukemia when used in conjunction with morphology and cytochemistry. Immunophenotyping by flow cytometry is a sensitive method for detecting residual or recurrent disease in the peripheral blood of patients with an established diagnosis. Detection of a population of cells expressing CD38 and CD138 in the peripheral blood is useful in establishing a diagnosis of plasma cell leukemia when used in conjunction with morphology. Lineage assignment in acute leukemia is necessary for selecting appropriate therapy and is useful in assessing prognosis. Multiparameter analysis using four-color immunophenotyping techniques is a rapid and specific method of assigning lineage in acute leukemia. This profile is also useful in distinguishing lymphoid from myeloid blast crisis in CML and immunophenotyping lymphoblastic lymphoma in blood or bone marrow. Immunophenotyping and cytogenetic analysis are increasingly being used to supplement the traditional methods (morphology and cytochemistry) of classifying acute leukemias and to provide prognostic information. Acute lymphoblastic leukemia (ALL) can be classified into undifferentiated null T- and B-cell lineages. In all of B-cell lineage, expression of CD10 (CALLA) is a favorable prognostic factor. Acute myelogenous leukemias (AML) are a heterogeneous group. In cases where morphology and cytochemical staining is equivocal, immunophenotyping can be useful. Immunophenotyping is particularly useful in classifying megakaryoblastic leukemia (FABM7). A combination of characteristic light scattering properties and myeloid phenotype can suggest a diagnosis of acute promyelocytic leukemia (FABM3). Confirmation of the retinoic acid receptor gene rearrangement by cytogenetic or molecular methods is recommended. See tests listed under Related Information and related FISH tests (eg, 510669). References Bitter MA. Hairy cell leukemia. In: Knowles DM, ed. Neoplastic Hematopathology. Baltimore, Md: Williams and Wilkins;1992. Braylan RC. Lymphomas. In: Bauer KD, Duque RE, Shankey TV, eds. Clinical Flow Cytometry: Principles and Applications. Baltimore, Md: Williams and Wilkins;1993. Foucar K. B-Cell chronic lymphocytic and prolymphocytic leukemia. In: Knowles DM, ed.Neoplastic Hematopathology. Baltimore, Md: Williams and Wilkins;1992. Knowles DM II. The human T-cell leukemias: Clinical, cytomorphologic, immunophenotypic, and genotypic characteristics. Hum Pathol. 1986; 17(1):14-33. PubMed 3002948 McDaniel HL, MacPherson BR, Tindle BH, et al. Lymphoproliferative disorder of granular lymphocytes: A heterogeneous disease. Arch Pathol Lab Med. 1992; 116(3):242-248. PubMed 1371379 Miller ML, Fishleder AJ, Tubbs RR. The expression of CD22 (leu 14) and CD11c (leu M5) in chronic lymphoproliferative disorders using two-color flow cytometric analysis. Am J Clin Pathol. 1991; 96(1):100-108. PubMed 2069128

Leukemia/Lymphoma Monitor Profile

Test Includes β2 microglobulin, serial monitor report; lipid-associated sialic acid (LASA), serial monitor report Special Instructions The account must submit the patient's Social Security number to monitor. Expected Turnaround Time 4 - 6 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Leukemia & Lymphoma Management Test Selection Table Related Documents Sample Report Specimen Requirements Specimen Serum Volume 2 mL Minimum Volume 1 mL Container Red-top tube or gel-barrier tube Collection If a red-top tube is used, transfer separated serum to a plastic transport tube. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 7 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Hemolysis; whole blood specimen Test Details Use β2-microglobulin is increased nonspecifically in active chronic lymphocytic leukemia (CLL) due to increased lymphocyte turnover. Limitations This profile is not useful as a screening or diagnostic test for leukemia or lymphoma. The LASA test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology See individual tests. Additional Information β2-microglobulin is a cell membrane associated 100 amino acid peptide, a component of the lymphocyte HLA complex. It is increased nonspecifically in inflammatory reactions and in active chronic lymphocytic leukemia in which there is increased lymphocyte turnover.

Lipase

Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum (preferred) or plasma Volume 1 mL Minimum Volume 0.5 mL Container Red-top tube, gel-barrier tube, or green-top (heparin) tube Collection Separate serum or plasma from cells within 45 minutes of collection. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Improper labeling Test Details Use Diagnose pancreatitis, more specific for pancreatitis than is serum amylase; diagnose peritonitis, strangulated or infarcted bowel, pancreatic cyst Methodology Colorimetric Contraindications Urine specimens are inappropriate for lipase. Lipase activity is usually absent in urine, possibly from inactivation of the enzyme. Reference Interval See table. Age Range (U/L) Male 0 to 6 m 8−37 7 m to 1 y 11−34 2 to 17 y 11−38 ≥18 y 13−78 Female 0 to 6 m 9−50 7 m to 1 y 10−37 2 to 17 y 12−45 18 to 70 y 14−72 ≥71 y 14−85 Additional Information Serum lipase is usually normal in patients with elevated serum amylase, without pancreatitis, who have peptic ulcer, salivary adenitis, inflammatory bowel disease, intestinal obstruction, and macroamylasemia. Coexistence of increased serum amylase with normal lipase may be a helpful clue to the presence of macroamylasemia.1 Lipase is elevated with amylase in acute pancreatitis, but the elevation of lipase is more prolonged. In work-up of pancreatitis, in addition to serum lipase and amylase, the 2-hour urine amylase is of value. Electrolytes, serum calcium, glucose, and acetone are also often needed. Immunoreactive trypsin is technically more difficult than lipase and probably no better.2 The serum lipase:amylase ratio may help distinguish alcoholic from nonalcoholic pancreatitis. Ratios >2 (expressed as multiples of the upper limits of normal) suggest an alcoholic etiology.3 Lipase isoform or isoenzymes have been studied.4

Lipid Panel

Test Includes Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein ( VLDL) cholesterol (calculation) Special Instructions State patient's age and sex on the request form. Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Clinical Utility Test List High-density Lipoprotein Cholesterol (HDL-C) Low-density Lipoprotein Cholesterol (Direct) Related Documents For more information, please view the literature below. Spanning the Continuum of Cardiovascular Care AMA-Recognized Organ and Disease Panels Sample Report Specimen Requirements Specimen Serum (preferred) or plasma Volume 1 mL Minimum Volume 0.5 mL Container Gel-barrier transport, green-top (heparin) tube, or lavender-top (EDTA) tube Collection Separate serum or plasma from cells within 45 minutes of collection. Lipid panels are best avoided for three months following acute myocardial infarction, although cholesterol can be measured in the first 24 hours. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 3 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x2 Patient Preparation Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Causes for Rejection Hemolysis Test Details Use Evaluate hyperlipidemia as an index to coronary artery disease Limitations Patients with obstructive liver disease may develop lipoprotein abnormalities. Serum lipid factors have not been demonstrated to have a strong influence on recurrent stenosis following coronary angioplasty, the pathogenesis of which is presently not well understood. LDL cholesterol cannot be calculated if triglyceride is >400 mg/dL. Methodology See individual tests. Additional Information Investigation of serum lipids is indicated in those with coronary and other arterial disease, especially when it is premature, and in those with family history of atherosclerosis or of hyperlipidemia. In this sense, the expression “premature” is mostly used to include those younger than 40 years of age. Patients with xanthomas should be worked up with lipid panels but not those with xanthelasmas or xanthofibromas in the sense of dermatofibromas. Those whose fasting serum is lipemic should have a lipid panel, but the serum of a subject with high cholesterol (but normal triglyceride) is not milky in appearance. The patient with high cholesterol (>240 mg/dL) should have a lipid panel. Patients with cholesterol levels between 200−240 mg/dL plus two other coronary heart disease risk factors should also have a lipid panel.1 In addition to application in screening programs for evaluation of risk factors for coronary arterial disease, lipid profiling may lead to detection of some cases of hypothyroidism. Primary hyperlipoproteinemia includes hypercholesterolemia, a direct risk factor for coronary heart disease. Secondary hyperlipoproteinemia includes increases of lipoproteins secondary to hypothyroidism, nephrosis, renal failure, obesity, diabetes mellitus, alcoholism, primary biliary cirrhosis, and other types of cholestasis. Decreased lipids are found with some cases of malabsorption, malnutrition, and advanced liver disease. In abetalipoproteinemia, cholesterol is <70 mg/dL.

Lipid Profile, Fasting, Pediatric

Test Includes Cholesterol, total; high-density lipoprotein (HDL); non-HDL cholesterol (calculated as total cholesterol minus HDL); LDL cholesterol (calculated); triglycerides Special Instructions State patient's age and sex on the test request form. Expected Turnaround Time Within 1 day Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Clinical Conditions Associated With Cardiovascular Disease Clinical Utility Test List High-density Lipoprotein Cholesterol (HDL-C) Low-density Lipoprotein Cholesterol (Direct) Related Documents Sample Report Specimen Requirements Specimen Serum (preferred) or plasma Volume 2 mL Minimum Volume 0.5 mL Container Gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube Collection Separate serum or plasma or from cells within 45 minutes of collection. Storage Instructions Maintain specimen at room temperature. Stable at room temperature, refrigerated or frozen for seven days. Patient Preparation Patient should be on a stable diet, ideally for two or three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen. Causes for Rejection Hemolysis Test Details Use Assessment of cardiovascular health and risk stratification in pediatric, adolescent, and young adult populations Limitations Patients with obstructive liver disease may develop lipoprotein abnormalities. Methodology Enzymatic Additional Information Atherosclerosis begins in youth, and this process, from its earliest phases, is related to the presence and intensity of the known cardiovascular risk factors. Clinical events such as myocardial infarction, stroke, peripheral arterial disease, and ruptured aortic aneurysm are the culmination of the lifelong vascular process of atherosclerosis. The most important evidence relating risk in youth to clinical CVD is the observed association of risk factors for atherosclerosis to clinically manifest cardiovascular conditions. Genetic disorders related to high cholesterol are the biological model for risk-factor impact on the atherosclerotic process. Combined evidence from autopsy studies, vascular studies, and cohort studies strongly indicates that abnormal lipid levels in childhood are associated with increased evidence of atherosclerosis. The evidence review supports the concept that early identification and control of dyslipidemia throughout youth and into adulthood will substantially reduce clinical CVD risk beginning in young adult life. Significant evidence exists to indicate that using family history of premature CVD or cholesterol disorders as the primary factor in determining lipid screening for children misses ~30% to 60% of children with dyslipidemias, and accurate and reliable measures of family history are not available. In the absence of a clinical or historic marker, identification of children with lipid disorders that predispose them to accelerated atherosclerosis requires universal lipid assessment. Non-HDL cholesterol level has been identified as a significant predictor of the presence of atherosclerosis, as powerful as any other lipoprotein cholesterol measure in children and adolescents. For both children and adults, non-HDL cholesterol level seems to be more predictive of persistent dyslipidemia and, therefore, atherosclerosis and future events than TC, LDL cholesterol, or HDL cholesterol levels alone. A major advantage of non-HDL cholesterol is that it can be accurately calculated in a nonfasting state and is, therefore, practical to obtain in clinical practice.1

Lithium

Synonyms Eskalith® Lithobid® Expected Turnaround Time 1 - 2 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 1 mL Minimum Volume 0.3 mL Container Red-top tube or gel-barrier tube; if a red-top tube is used, transfer separated serum to a plastic transport tube. Collection Collect trough level (just prior to next dose); at least 6 to 12 hours after the last dose. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 3 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Hemolysis; specimen collected in tube containing lithium heparin Test Details Use Lithium as lithium carbonate is used as a psychoactive agent in the treatment of manic depressive disorders. Lithium therapy demands daily monitoring of serum lithium levels until the proper dose schedule is determined. Serum elimination half-life ranges from 20 to 60 hours. Insomnia in a low-range group is described. Tremor, gastrointestinal symptoms, urinary frequency, and weight gain were less frequent at lower levels.1 Intoxication never occurs suddenly. Several days to a week before full-blown symptoms develop, a patient will experience lethargy, drowsiness, tremor, muscle twitching, dysarthria, anorexia and vomiting or diarrhea. A fully developed case of intoxication shows coma to semicoma, rigidity, hyperactive reflexes and seizures at times. There is a high incidence of pulmonary complications. It is advisable to perform periodic plasma sodium determinations. Low plasma sodium levels are associated with lithium retention; high levels with lithium elimination. Varying degrees of nephrogenic diabetes insipidus have been reported to occur in 33% of lithium treated patients. Lithium significantly inhibits antidiuretic hormone induced water transport in kidney. Lithium interferes with solute and water absorption from the gastrointestinal system producing nausea, vomiting, diarrhea, and abdominal pain. These symptoms may occur at any time, at any serum level. They most commonly occur during early treatment stages and usually clear spontaneously or by adjustment of dosage. Chronic lithium administration has a goitrogenic effect on 4% of lithium treated patients, with or without hypothyroidism. In general, lithium administration results in slightly decreased serum T4 levels and transiently elevated levels of TSH in nearly 33% of these patients. Lithium affects the cardiac conduction system by incomplete substitution for other cations, especially sodium and potassium. These electrolyte changes account for the usually unimportant and reversible T-wave depressions observed in 10% to 20% of patients on lithium therapy. Methodology Ion-selective electrode (ISE) Reference Interval Therapeutic: 0.6−1.2 mmol/L Critical Value Potentially toxic: >1.5 mmol/L Additional Information Lithium is completely absorbed six to eight hours after oral administration. Since the onset of action is slow (5 to 10 days), parenteral administration is of no advantage. The plasma half-life is 17 to 36 hours, and this drug is eliminated almost entirely by the kidneys. Lithium clearance averages approximately 20% of creatinine clearance, but significant variability exists among patients. Lithium ion is not protein bound, is distributed in total body water, and is concentrated in various tissues to different degrees. After a steady-state has been achieved, the lithium level in cerebrospinal fluid is about 40% of that in serum, and renal clearance for an individual remains relatively constant. In general, a good correlation exists between the serum concentration of lithium ion and therapeutic efficacy and toxicity; however, some patients who show no therapeutic benefit have adequate serum concentrations of lithium but low erythrocyte concentrations. Since lithium works intracellularly, the erythrocyte concentration of the drug may be more relevant than levels in serum; therefore, in unresponsive patients, doses that produce higher than usual serum concentrations can be used if erythrocyte concentrations are lower.

Liver Cancer Monitor Profile

Test Includes α-Fetoprotein (AFP), serial monitor report; CA 19-9, serial monitor report; lipid-associated sialic acid (LASA), serial monitor report Special Instructions The account must submit the patient's Social Security number to monitor. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample. Expected Turnaround Time 3 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum (preferred) or plasma Volume 4 mL Minimum Volume 2 mL Container Red-top tube, gel-barrier tube, lavender-top (EDTA) tube, or green-top (heparin) tube Collection If a red-top tube or plasma is used, transfer separated serum or plasma to a plastic transport tube. Storage Instructions Refrigerate Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Gross hemolysis; whole blood specimen Test Details Use Monitor the course of liver cancer, patient response to treatment, and disease recurrence Limitations This profile should not be used as a diagnostic or screening test for cancer. The LASA test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology See individual tests.

Lorazepam, Serum or Plasma

Synonyms Ativan® Expected Turnaround Time 7 - 10 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Serum or plasma Volume 2 mL Minimum Volume 0.5 mL Container Red-top tube or green-top (heparin) tube. Gel-barrier tubes are not recommended. Collection Serum or plasma should be separated from cells within two hours of venipuncture. Submit serum or plasma in a plastic transport tube. Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Patient Preparation Trough levels are most reproducible. Causes for Rejection Gel-barrier tubes Test Details Use Therapeutic drug management Methodology Liquid chromatography/tandem mass spectrometry (LC/MS-MS) Reference Interval 50.0−240.0 ng/mL

Lung, Small-cell Cancer Monitor Profile

Test Includes Carcinoembryonic antigen (CEA), serial monitor report; lipid-associated sialic acid (LASA), serial monitor report; neuron-specific enolase (NSE), serial monitor report Special Instructions The account must submit the patient's Social Security number to monitor. State on the request form whether the patient is a smoker or nonsmoker. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Expected Turnaround Time 5 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 4 mL Minimum Volume 2 mL Container Red-top tube or gel-barrier tube Collection If a red-top tube is used, transfer separated serum to a plastic transport tube. Storage Instructions Refrigerate Causes for Rejection Hemolysis; whole blood specimen; recently administered isotopes Test Details Use Monitor the course of small-cell lung cancer, patient response to treatment, and disease recurrence Limitations This profile should not be used as a diagnostic or screening test for cancer. The LASA test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. The results of the NSE test are labeled for research purposes only by the assay's manufacturer. The performance characteristics of this assay have not been established by the manufacturer. The result should not be used for treatment or for diagnostic purposes without confirmation of the diagnosis by another medically established diagnostic product or procedure. The performance characteristics were determined by LabCorp. Methodology See individual tests.

Lupus Anticoagulant Comprehensive

Test Includes LA-sensitive activated partial thromboplastin time (aPTT); dilute prothrombin time (dPT); thrombin time. If any of these three screening tests is extended, reflex testing is performed and additional charges/CPT code(s) will apply. Special Instructions This test will reflex immediately to aPTT Mixing Studies [117199] if aPTT is five or more seconds above the upper end of the reference interval. Expected Turnaround Time 2 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Abnormal Screening Results Anticardiolipin Antibodies Antiphospholipid Syndrome Dilute Prothrombin Time Genetic Thrombophilia Lupus Anticoagulant With Reflex Lupus Anticoagulants Thrombin Mixing Study β2-Glycoprotein 1 Antibodies Related Documents For more information, please view the literature below. Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium Sample Report Specimen Requirements Specimen Plasma, frozen Volume 3 mL Minimum Volume 2 mL Container Blue-top (sodium citrate) tube Collection Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp No. 49482). Freeze immediately and maintain frozen until tested. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume. Storage Instructions Freeze. Patient Preparation Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa, and thrombin inhibitor therapies for about three days prior to testing. Causes for Rejection Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability Test Details Use Qualitative detection of lupus anticoagulants in plasma6 Methodology Lupus-sensitive aPTT and dPT screening tests; mixing study if screening test are prolonged; confirmation if the mixing studies do not correct Additional Information Lupus anticoagulants are antibodies that inhibit one or more of the in vitro phospholipid-dependent tests of coagulation.6-10 Recently, the SCC Subcommittee for the Standardization of Lupus Anticoagulants provided guidelines for the laboratory diagnosis of LA.6 No single screening test can detect all LA-positive patients. The ISTH recommends that any sample suspected of having LA be tested using two or more LA screening tests.6,7 The screening tests commonly used to detect LA assess inhibitors of the intrinsic pathway (aPTT) and the common pathways (dRVVT). The dPT assay screens for phospholipid-dependent inhibitors of a different part of the coagulation cascade, the extrinsic pathway.11 The thrombin time is included to rule out heparin and other thrombin inhibitors.

Lupus Anticoagulant With Reflex

Synonyms Lupus Anticoagulant Lupus Anticoagulant Screen Expected Turnaround Time 2 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Abnormal Screening Results Anticardiolipin Antibodies Antiphospholipid Syndrome Genetic Thrombophilia Lupus Anticoagulants β2-Glycoprotein 1 Antibodies Related Documents For more information, please view the literature below. Procedures for Hemostasis and Thrombosis: A Clinical Test Compendium Sample Report Specimen Requirements Specimen Plasma, frozen Volume 2 mL Minimum Volume 1 mL (Note: This volume does not allow for repeat testing.) Container Blue-top (sodium citrate) tube Collection Citrated plasma samples should be collected by double centrifugation. Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate.1 Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio.2,3 The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples.4,5 When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge for 10 minutes and carefully remove 2/3 of the plasma using a plastic transfer pipette, being careful not to disturb the cells. Deliver to a plastic transport tube, cap, and recentrifuge for 10 minutes. Use a second plastic pipette to remove the plasma, staying clear of the platelets at the bottom of the tube. Transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp No. 49482). Freeze immediately and maintain frozen until tested. Please print and use the Volume Guide for Coagulation Testing to ensure proper draw volume. Storage Instructions Freeze Patient Preparation Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa, and thrombin inhibitor therapies for about three days prior to testing. Causes for Rejection Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability Test Details Use Qualitative detection of lupus anticoagulants in plasma6 Methodology PTT-LA (lupus-sensitive aPTT) and dRVVT screen; mixing study if screening tests are prolonged; confirmation if the mixing studies do not correct Additional Information Lupus anticoagulants are nonspecific antibodies that extend the clotting time of phospholipid-dependent clotting assays such as the aPTT.6,7 Unlike specific factor antibodies, LA are usually associated with venous thrombosis, pulmonary embolism, arterial thrombosis, and recurrent fetal loss.8 LA do not specifically inhibit individual coagulation factors; rather they neutralize anionic phospholipid-protein complexes that are involved in the coagulation process. Prolongation of clot-based assays is highly dependent on the sensitivity of the reagent employed. Reagents with reduced amounts of phospholipid, such as the aPTT-LA and dilute Russell viper venom time (dRVVT), have enhanced sensitivity for LA.6 Due to the heterogeneity of LA antibodies, no single assay will identify all cases.8 The International Society on Thrombosis and Haemostasis (ISTH) has established criteria for the diagnosis of lupus anticoagulants.6-8 Testing for lupus anticoagulant (LA) and the antiphospholipid syndrome that is associated with these antibodies is described in more detail in the online Coagulation Appendices: Lupus Anticoagulants and Antiphospholipid Syndrome.

Lyme Disease Antibodies, Total and IgM, With Reflex to Line Blot

Synonyms Borrelia Antibodies Test Includes ISR (immune status ratio) results for total antibodies; index results for IgM positives; Line blot analysis; result interpretation Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 2 mL Minimum Volume 1 mL Container Red-top tube or gel-barrier tube Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Hemolysis; lipemia; gross bacterial contamination Test Details Use Most analytical approach available for detecting antibodies specific for lyme disease Methodology Enzyme immunoassay (EIA); Line Blot

Lyme Disease, Antibody Total With Reflex

Test Includes Lyme disease total antibodies, EIA; supplementary Line blots for all positives from antibody test Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 2 mL Minimum Volume 1 mL Container Red-top tube or gel-barrier tube Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Hemolysis; lipemia; gross bacterial contamination Test Details Use Aid in the diagnosis of acute and later stages of infection with B burgdorferi Methodology Enzyme immunoassay (EIA); Line blot

Common Lab Tests

Complete Blood Count

This test, also known as a CBC, is the most common blood test performed. It measures the types and numbers of cells in the blood, including red and white blood cells and platelets. This test is used to determine general health status, screen for disorders and evaluate nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising, and can help diagnose conditions such as anemia, leukemia, malaria and infection.

Prothrombin Time

Also known as PT and Pro Time, this test measures how long it takes blood to clot. This coagulation test measures the presence and activity of five different blood clotting factors. This test can screen for bleeding abnormalities, and may also be used to monitor medication treatments that prevent the formation of blood clots.

Basic Metabolic Panel

This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor monitor the effects of medications you are taking, such as high blood pressure medicines, can help diagnose certain conditions, or can be part of a routine health screening. You may need to fast for up to 12 hours before this test.

Lipid

Panel

The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol and triglyceride levels.

Liver Panel

The liver panel is a combination of tests used to assess liver function and establish the possible presence of liver tumors.

Hemoglobin A1C

This test is used to diagnose and monitor diabetes.

Urinalysis

Often the first lab test performed, this is a general screening test used to check for early signs of disease. It may also be used to monitor diabetes or kidney disease.

Cultures

Cultures are used to test for diagnosis and treatment of infections. Illnesses such as urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be detected and tested for appropriate antibiotic treatment.

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