Test Directory - Understand Your Tests.

Rabbit Meat

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Ragweed, Giant

Synonyms

Giant Ragweed

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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Ragweed, Western

Synonyms

Western Ragweed

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Rapidly-growing Mycobacterium Susceptibility−Broth Dilution

Synonyms

M abscessus Susceptibility Testing
M chelonae Susceptibility Testing
M fortuitum Complex Susceptibility Testing
AFB Susceptibility Testing
Rapid-grower Susceptibility Testing

Test Includes

Susceptibility testing for amikacin, cefoxitin, ciprofloxacin, clarithromycin, imipenem (M fortuitum, M immunogenum, M smegmatis only), linezolid, minocycline, sulfamethoxazole-trimethoprim, and tobramycin (M chelonae only). MIC values will be reported with CLSI interpretive comments.

Expected Turnaround Time

20 - 35 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

Specimen Requirements

Specimen

Rapidly-growing mycobacteria isolated from a primary clinical specimen, on a submitted AFB conventional solid medium, or an AFB broth medium

Volume

Pure culture isolate on an AFB conventional solid medium or a minimum of 1 mL of AFB broth medium

Container

Conventional or broth medium, tightly sealed, in etiologic agent packaging

Storage Instructions

Maintain media at room temperature.

Causes for Rejection

Specimen received in leaking or in broken transport tube or vial; specimen received in expired transport medium; mixed culture; unlabeled culture or name discrepancy between specimen and request label

Test Details

Use

Determine the susceptibility of rapidly-growing mycobacterial isolates to a profile of antimycobacterial agents. Interpretive categories include the following. Susceptible: This category implies that an infection due to the strain may be appropriately treated with the dosage of the recommended agent unless otherwise contraindicated. Intermediate: Susceptibility is not certain since the available data does not permit categorization as either susceptible or resistant. Resistant: Strains falling in this category are not inhibited by the usually achievable systemic concentration of the agent with normal dosage schedules and/or fall in the range where specific microbial resistance mechanisms are likely, and/or clinical efficacy has not been reliable in treatment studies.

Limitations

Susceptibilities cannot be reported if the organism fails to grow in the test medium. Susceptibilities cannot be performed on mixed cultures. An organism identification is required prior to reporting susceptibility results. Imipenem results will only be reported for M fortuitum group, M smegmatis group, and M mucogenicum isolates.¹ MICs for imipenem with other rapid growers (ie, M chelonae, M abscessus, M immunogenum) are problematic due to lack of reproducibility and, therefore, will not be reported. In vitro susceptibility studies reveal that tobramycin is the most active aminoglycoside for M chelonae. The recommendation is that tobramycin be reported for M chelonae only.¹ Results of this 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

Sensititre® broth microdilution (MIC)

Additional Information

Failure to take all drugs in a multidrug regimen can lead to a shift toward resistant organisms and treatment failure.² M fortuitum isolates are susceptible in vitro to multiple antimicrobial drugs and the clinical response to therapeutic agents appears to closely parallel the in vitro susceptibility patterns; however, this observation has not been evaluated by randomized controlled trials.³ M abscessus has limited in vitro susceptibility to any agent and clinical response in the treatment of pulmonary disease. There does appear, however, a correlation for M abscessus between in vitro susceptibility and clinical response for skin and soft tissue infections, although this has not been evaluated by randomized controlled trials.³ Few data are available to validate susceptibility testing as a guide for choosing antibiotics. Until the relationship between in vitro susceptibility testing and the clinical response to antimicrobial drugs is better understood and clarified, the clinician should use in vitro susceptibility data with an awareness of the limitations and that the disease may not be eradicated in a particular patient with therapy based on those results.³ Test results are not intended to be used as the sole means for patient management. Extended incubation for up to 14 days will occur to evaluate the organism for inducible macrolide resistance.

Rash Profile A

Test Includes

Detection of antibodies for adenovirus, rubella, rubeola

Special Instructions

Identify specimen as acute or convalescent. Acute and convalescent specimens must be submitted on separate request forms.

Expected Turnaround Time

3 - 5 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

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Hemolysis; lipemia; gross bacterial contamination

Rat Serum

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Rat Urine

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Red Beet

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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Red Blood Cell (RBC) Antigen Typing

Synonyms

Antigen Typing, RBC

Special Instructions

Tests are now available for each antigen pair; refer to the appropriate test number. If the antigen being requested does not have a test number, specify the antigen to be tested in the clinical comments section of the test request form. Red cell antigen typing is available for the following additional antigens: k(Cellano) and P1. For E/e Antigen, refer to 006018, C/c Antigen, refer to 006010, K Antigen, refer to 006068, Fya/Fyb Antigen, refer to 006025, Jka/Jkb Antigen, refer to 006030, M Antigen, refer to 006048, N Antigen, refer to 006060, S/s Antigen, refer to 006040, Lea/Leb Antigen, refer to 006034, A1 Antigen, refer to 006002. Note: This testing is usually ordered to test red cells from the partner of a prenatal patient who has developed atypical red cell antibodies. Red cell antigen typing may also be indicated for bone marrow, tissue, organ, or blood donors prior to donation. Testing a prenatal patient for red cell antigens is generally not indicated.

Expected Turnaround Time

1 - 5 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

Whole blood

Volume

1 mL

Minimum Volume

0.5 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Specimens should be tested as soon as possible or within 72 hours of collection. Samples that cannot be tested immediately should be stored at 2°C to 8°C. Do not freeze red cells.

Causes for Rejection

Gross hemolysis; bacterial or other contamination

Test Details

Use

Typing paternal RBCs for antigens that correspond to maternal antibody may aid in the prediction of hemolytic disease of the fetus and newborn.

Limitations

Presence of potent cold autoagglutinins, positive direct antiglobulin test, and, in some cases, bacteremia may interfere with test interpretation. Typing for high or low frequency antigens may not be possible due to the unavailability of appropriate antisera.

Methodology

Hemagglutination/antiglobulin test

Red Blood Cell (RBC) Antigen Typing: C/c

Special Instructions

For Rh phenotyping, refer to test 058008.

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.

Specimen Requirements

Specimen

Whole blood

Volume

1 mL

Minimum Volume

0.5 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Specimens should be tested as soon as possible or within 72 hours of collection. Samples that cannot be tested immediately should be stored at 2°C to 8°C. Do not freeze red cells.

Causes for Rejection

Gross hemolysis; bacterial or other contamination

Test Details

Use

Typing paternal RBCs for antigens that correspond to maternal antibody may aid in the prediction of hemolytic disease of the fetus and newborn. Red cell antigen typing may also be indicated for bone marrow, tissue, organ, or blood donors prior to donation. Testing a prenatal patient for red cell antigens is generally not indicated. The occurrence of the C antigen is 68% in Caucasians, 27% in Blacks, and 93% in Asians. Anti-C can cause mild hemolytic disease of the fetus and newborn. The occurrence of the c antigen is 80% in Caucasians, 98% in Blacks, and 47% in Asians. Anti-c can cause mild to severe hemolytic disease of the fetus and newborn.

Limitations

Presence of potent cold agglutinins, positive direct antiglobulin test, and (in some cases) bacteremia may interfere with test interpretation.

Methodology

Hemagglutination

Red Blood Cell (RBC) Antigen Typing: K (Kell)

Special Instructions

This test does not include little k (cellano). To order little k typing, refer to test 006096.

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.

Specimen Requirements

Specimen

Whole blood

Volume

1 mL

Minimum Volume

0.5 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Specimens should be tested as soon as possible or within 72 hours of collection. Samples that cannot be tested immediately should be stored at 2°C to 8°C. Do not freeze red cells.

Causes for Rejection

Gross hemolysis; bacterial or other contamination

Test Details

Use

Typing paternal RBCs for antigens that correspond to maternal antibody may aid in the prediction of hemolytic disease of the fetus and newborn. Red cell antigen typing may also be indicated for bone marrow, tissue, organ, or blood donors prior to donation. Testing a prenatal patient for red cell antigens is generally not indicated. The occurrence of the K antigen is 9% in Caucasians, 2% in Blacks, and rare in Asians. Anti-K can cause mild to severe (rare) hemolytic disease of the fetus and newborn (often with anemia), which is sometimes delayed.

Limitations

Presence of potent cold agglutinins, positive direct antiglobulin test, and (in some cases) bacteremia may interfere with test interpretation.

Methodology

Hemagglutination

Red Snapper

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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Red Top, Bentgrass

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP®

Respiratory Infection Profile B (Pneumonia)

Test Includes

Detection of antibodies for adenovirus; Mycoplasma pneumoniae; parainfluenza virus 1, 2, 3

Special Instructions

Identify specimen as acute or convalescent. Acute and convalescent specimens must be submitted on separate request forms.

Expected Turnaround Time

2 - 5 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

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Hemolysis; lipemia; gross bacterial contamination

Test Details

Methodology

See individual tests.

Respiratory Pathogen Profile, PCR

Test Includes

Adenovirus; Bordetella pertussis; Chlamydophila pneumoniae; coronavirus 229E; coronavirus HKU1; coronavirus NL63; coronavirus OC43; human metapneumovirus; human rhinovirus/enterovirus; influenza A; influenza A subtype H1; influenza A subtype H3; influenza A subtype H1-2009; influenza B; Mycoplasma pneumoniae; parainfluenza virus 1; parainfluenza virus 2; parainfluenza virus 3; parainfluenza virus 4; respiratory syncytial virus

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.

Specimen Requirements

Specimen

Nasopharyngeal swab

Volume

One swab in viral transport

Minimum Volume

0.3 mL

Container

Viral Transport System

Storage Instructions

Freeze. Per the package insert: Swabs in viral transport media are stable for 30 days at -15°C or below. Swabs in viral transport media are also stable for 4 hours at room temperature and 3 days refrigerated (2º to 8º C).

Causes for Rejection

Improper collection; inadequate specimen; improper labeling; specimen leaked in transit; quantity not sufficient for analysis; name discrepancies; specimen exceeding storage requirements; specimen types other than nasopharyngeal swab in viral transport media

Test Details

Use

This test provides simultaneous qualitative detection and identification of multiple respiratory viral and bacterial nucleic acids in nasopharyngeal swabs obtained from individuals suspected of respiratory tract infections.

Limitations

The performance of this test has not been established for patients without signs and symptoms of respiratory infection. Results from this test must be correlated with the clinical history, epidemiological data, and other data available to the clinician evaluating the patient. Viral and bacterial nucleic acids may persist in vivo independent of organism viability. Detection of organism target(s) does not imply that the corresponding organisms are infectious or are the causative agents for clinical symptoms. The detection of viral and bacterial nucleic acid is dependent upon proper specimen collection, handling, transportation, storage and preparation. Failure to observe proper procedures in any one of these steps can lead to incorrect results. There is a risk of false positive or false negative values resulting from improperly collected, transported or handled specimens.

Methodology

Polymerase chain reaction (PCR)

Respiratory Syncytial Virus (RSV), Immunoassay

Special Instructions

Submit one specimen per test requested. Specify the exact specimen source/origin (eg, nasopharyngeal aspirate). Indicate a specific test number on the test request form.

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

Specimen Requirements

Specimen

Nasopharyngeal (NP) washes or aspirates (preferred), NP swabs; refrigerated or frozen

Volume

2 to 3 mL washes or 0.5 to 1 mL aspirates

Container

Viral, Chlamydia, or Mycoplasma culture transport provided by LabCorp, or other appropriate transport medium; sterile leakproof container for washes or aspirates

Collection

Nasopharyngeal wash or aspirate using routine collection and transport procedure. Nasal swabs are not considered as sensitive for RSV detection. Avoid using collection containers with preservatives or transport that may contain interfering substances. Do not use calcium alginate swabs. Obtain sample during acute phase of illness when greatest amount of viral shedding occurs. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.

Storage Instructions

Refrigerate for 72 hours or freeze if held longer.

Causes for Rejection

Bacterial swab specimen; specimen received in grossly leaking transport container; dry specimen; specimen submitted in fixative or additives; specimen excessively bloody; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions; specimen received after prolonged delay in transport (usually more than 72 hours); wooden shaft swab or calcium alginate swab in transport device; unlabeled specimen or name discrepancy between specimen and request label

Test Details

Use

Evaluate lower respiratory tract infections in young children. Severe life-threatening infections due to respiratory syncytial virus can occur during the first few years. Acquired immunity is incomplete and reinfection can occur later.

Limitations

A positive result may occur in the absence of viable virus. In the event of a negative result, infection due to RSV cannot be ruled out because the antigen present may be below the detection limit of the test. A negative test is presumptive, and it is recommended by the assay manufacturer that these results be confirmed by another method. Freezing of the sample may also diminish detection of the antigen.

Methodology

Immunoassay (IA)

Reference Interval

Negative

Additional Information

This test allows rapid diagnosis of the presence of respiratory syncytial virus. It avoids the necessity of obtaining acute and convalescent specimens over a two-week period. It may be particularly useful in children younger than six months old, whose antibody response to infection may not be diagnostic.

RET Oncology FISH

Synonyms

Adenocarcinoma
Non−Small-cell Lung Cancer

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 Information

Specimen Requirements

Specimen

FNA; formalin-fixed paraffin-embedded blocks are acceptable.

Volume

Five slides (4- to 5-micron thick sections)

Minimum Volume

Two slides (4- to 5-micron thick sections)

Container

Paraffin block

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Broken or dirty slides; excessive cellular debris or stained slides; decalcified bone cores; absence of tumor or quantity not sufficient for analysis

Test Details

Use

Confirmation/identification of cancer-related alterations in non−small-cell lung cancer

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

Fluorescence in situ hybridization (FISH)

Reticulocyte Count

Test Includes

Reticulocytes are expressed as a percentage in a total of 1000 RBCs.

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.

Specimen Requirements

Specimen

Whole blood

Volume

Tube fill capacity

Minimum Volume

500 μL for Microtainer™ (capillary) specimens

Container

Lavender-top (EDTA) tube

Collection

Invert tube immediately 8 to 10 times once tube is filled at time of collection.

Storage Instructions

Refrigerate

Stability Requirements

Temperature	Period
Room temperature	1 day
Refrigerated	3 days
Frozen	Unstable
Freeze/thaw cycles	Unstable

Causes for Rejection

Hemolysis; specimen more than 72 hours old; clotted specimen; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen diluted or contaminated with I.V. fluid; specimen drawn in any anticoagulant other than EDTA; specimen received with plasma removed

Test Details

Use

Evaluate erythropoietic activity which is increased in acute and chronic hemorrhage, and hemolytic anemias; evaluate erythropoietic response to antianemic therapy

Limitations

Caution should be exercised with recently transfused patients (reticulocytes may decrease on a dilutional basis due to transfusion).

Methodology

Automated cell counter

Contraindications

Patients receiving a large number of blood transfusions

Additional Information

Reticulocytes stained with a fluorescent reagent can be differentiated from mature red cells and other cell populations by light scatter, direct measurements, and opacity characteristics when

Rh-hr Genotype With ABO Grouping

Synonyms

Rh Genotype
Rh-hr Genotype

Test Includes

Tests for ABO blood grouping and the the Rh antigens D, C, E, c, and e (including test for “weak D,” if applicable)

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

Specimen Requirements

Specimen

Whole blood

Volume

4 mL

Minimum Volume

1 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Specimens should be tested as soon as possible or within 72 hours of collection. Samples that cannot be tested immediately should be stored at 2°C to 8°C. Do not freeze red cells.

Causes for Rejection

Gross hemolysis; bacterial or other contamination

Test Details

Use

Determine ABO blood grouping and most probable zygosity for D(Rh_o) antigen. Zygosity for C, E, c, and e antigens is also determined. Paternal typing may aid in the prediction of Rh hemolytic disease of the newborn.

Limitations

Abnormal plasma proteins, potent cold autoagglutinins, positive direct antiglobulin test, and in some cases bacteremia may interfere with test interpretation. Variable testing results may be observed with partial antigens which are rare variants of the Rh_o(D) antigen.

Methodology

Hemagglutination

Additional Information

When a woman of childbearing age has anti-D, it is important for prognostic purposes to determine the probability that her husband is homozygous or heterozygous for the gene determining the D antigen. If a prenatal patient is Rh-negative and the father of her fetus is homozygous for D, the child will always be Rh positive. Approximately 50% of the children of a heterozygous father will be Rh-negative. Testing to determine zygosity involves testing the subject's red blood cells for D, C, E, c, and e antigens. The results of this testing are referred to as the Rh phenotype. The Rh phenotype is used to determine a “most probable” zygosity for D based upon correlation of these results with a frequency chart detailing most probable Rh genotypes. In the case of D, this must be done indirectly since there is no detectable allele for this gene. In the case of the alleles C and c and the alleles E and e, the zygosity of these genes may be directly determined from the phenotyping results. Rh phenotyping of the father may also be helpful for evaluating the potential for hemolytic disease of the newborn in the presence of maternal antibodies to C, c, E, or e antigens. See table.

**Interpretation of Rh Phenotype Results in the Rh-positive Population¹**
Red Cell Antigen Typing					Most Probable Genotype			% Likelihood of Being Homozygous for D
D	C	E	c	e	Caucasian	Black	Mestizo*	White	Black	Mestizo*
For further information, please contact LabCorp or consult the source for this chart.
From American Association of Blood Banks. Technical Manual. 15th ed. Bethesda, Md: AABB Press; 2005.
*Mestizo frequencies were derived from a study of Mexican and Mexican-American population studies. The term “Mestizo” is commonly used in Hispanic countries to describe persons of mixed European and American Indian ancestry.
+	+	O	+	+	CDe/cde	CDe/cDe	CDe/cde	10	59	15
+	+	O	O	+	CDe/CDe	CDe/CDe	CDe/CDe	91	81	96
+	O	+	+	+	cDE/cde	cDE/cDe	cDE/cde	10	63	15
+	O	+	+	O	cDE/cDE	cDE/cDE	cDE/cDE	87	99	98
+	+	+	+	+	CDe/cDE	CDe/cDE	CDe/cDE	89	90	97
+	O	O	+	+	cDe/cde	cDe/cde	cDe/cde	6	46	8

Rheumatoid Arthritis HLA Association

Special Instructions

If you have questions, please call 800-533-1037 (HLA customer service) for assistance selecting the proper HLA test for the patient.

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.

Specimen Requirements

Specimen

Whole blood

Volume

7 mL

Minimum Volume

3 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Maintain specimen at ambient temperature; protect from extreme heat or cold. Do not freeze.

Causes for Rejection

Hemolyzed; clotted specimen

Test Details

Use

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints. Worldwide, the pervalence ranges between 0.5 to 1 percent and genetic factors play a role in RA risk, severity, and progression. The most important gene conferring risk for Anti-Citrullinated Protein Antibody positive (ACPA+) RA resides in the class II major histocompatibility complex (MHC) at the HLA-DRB1 locus. The HLA-DRB1 alleles that predispose to RA are the DRB1*04:01, *04:04, *04:05, *04:08, *01:01, *01:02, *09:01, *10:01 and *14:02 alleles, most of which possess a shared epitope (SE). These alleles increase the risk of RA in all populations, but the degree of predisposition may vary with different populations.

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

HLA results were obtained using massively parallel sequencing (also called Next Generation Sequencing). Supplemental procedures based on sequence-based typing (SBT), sequence-specific oligonucleotide probes (SSOP), and sequence-specific primers (SSP) may be used as needed to obtain the required resolution. If you have questions, please call 800-533-1037 (HLA customer service) for assistance.

Rifampin, Serum or Plasma

Synonyms

Rifadin®
Rimactane®

Expected Turnaround Time

10 - 14 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.

Causes for Rejection

Gel-barrier tubes

Test Details

Use

Therapeutic drug management

Methodology

High-pressure liquid chromatography with ultraviolet detection (HPLC/UV)

Risperidone

Synonyms

Risperdal®
Risperdal® Consta®

Expected Turnaround Time

3 - 5 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

Volume

3 mL

Minimum Volume

1.1 mL

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

Collect specimen just prior to the next dose (trough level).

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

Gel-barrier tube

Test Details

Use

Monitor drug levels for optimal therapy

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)

Reference Interval

20−60 ng/mL

Additional Information

Risperidone is an antipsychotic agent belonging to the benzisoxazole derivatives class. The mechanism of action is unknown; however, antipsychotic activity may be mediated through a combination of dopamine (D2) and serotonic (5HT2) antagonism. Risperidone is well absorbed by the gut. It is extensively metabolized in the liver to a major active metabolite, 9-hydroxyrisperidone, which appears approximately equieffective with risperidone with respect to receptor binding activity. Consequently, the clinical effect of the drug likely results from the combined concentrations of risperidone and 9-OH-risperidone. The pharmacokinetics for the sum of the two, after single and multiple doses, were similar in both rapid and slow metabolizers, with an overall mean elimination half-life of about 20 hours. Steady-state concentrations are reached in five to six days. The plasma protein binding of risperidone and 9-OH-risperidone is about 90% and 77%, respectively. It has been reported that dosing with long-acting risperidone every two weeks produced lower peak levels than oral dosing, while trough concentrations did not differ between the two routes of administration.¹ Chronic administration of carbamazepine with risperidone may increase the clearance of risperidone; whereas, chronic administration of clozapine with risperidone may decrease the clearance of risperidone. The primary side effects noted with risperidone are the extrapyramidal symptoms, such as spasmodic, intermittent contraction of facial, neck, or back muscles, but the incidence of these side effects is lower compared with other neuroleptic agents.

ROS1 Oncology FISH

Synonyms

Adenocarcinoma, ROS1
Non−Small-cell Lung Cancer, ROS1

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 Information

Specimen Requirements

Specimen

FNA; formalin-fixed paraffin-embedded blocks are acceptable.

Volume

Five slides (4- to 5-micron thick sections)

Minimum Volume

Two slides (4- to 5-micron thick sections)

Container

Paraffin block

Storage Instructions

Maintain specimen at room temperature.

Causes for Rejection

Broken or dirty slides; excessive cellular debris or stained slides; decalcified bone cores; absence of tumor or quantity not sufficient for analysis

Test Details

Use

Confirmation/identification of cancer-related alterations in non−small-cell lung cancer

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

Fluorescence in situ hybridization (FISH)

Rough Marshelder

Synonyms

Rough Marsh Elder

Expected Turnaround Time

3 - 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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Test Details

Methodology

Thermo Fisher ImmunoCAP

Rye Grass

Synonyms

Cultivated Rye Grass

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

Individual Allergens

Specimen Requirements

Specimen

Serum

Volume

0.2 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Stability Requirements

Temperature	Period
Room temperature	14 days
Refrigerated	14 days
Frozen	3 months
Freeze/thaw cycles	Stable x3

Expected Turnaround Time

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