A new anti-CD-38 mAb drug-daratumumab, was recently approved by the FDA for treatment of relapsed multiple myeloma. However, mAb therapy can result in specific antigen-antibody interactions on red blood cells that interfere with routine pre-transfusion testing.
Patients receiving anti-CD38 mAb therapy show false positive results on routing blood bank screening, preventing the
rapid provision of cross-matched compatible red blood cells to patients.
Clinicians can help by notifying blood bank that their patient is receiving this treatment when pre-transfusion testing is ordered, and by understanding that transfusion may be delayed while alternate testing strategies are employed. For further questions contact Dr. Craig McBride, 260-266-1637.
On Dec 3, 2015, Parkview Health Laboratories will begin reporting Creatinine results that are IDSM traceable.
The adult reference ranges will change to 0.8-1.4 mg/dl for Males, and 0.6-1.1 mg/dl for Females.
The eGFR calculation has been modified for the IDSM traceable results.
Please refer question to Dr. Yi Zhuang, Technical Consultant Chemistry, 266-1644 or Richard Brown, Chemistry Lead Technologist, 266-1521.
Amaranth (Red Dye #2) Allergen testing is no longer available
Beginning Sept 14, 2015, Parkview Health Laboratories will no longer accept urine culture (gray-top) tubes as alternate tube for urinalysis testing. New instrumentation does not recommend urine preservatives for urinalysis testing. The Yellow-cap tubes (no preservatives) within the CCMS collection kits are the designated tubes for urinalysis testing. The gray–top tubes are for urine cultures. Please refer to Laboratory Test Directory for acceptable specimens.
Tube type changes coming soon; the laboratory is changing test tube brands, these two tube types will be changing. As the labortory runs out of the current tubes, it will be replacing with the new tube tops.
Vitamin D tests available for ordering
Vitamin D originating from dietary and endogenous sources is converted to 25-hydroxyvitamin D in the liver, and subsequently to 1,25-dihydroxyvitamin D in the kidney.
The most reliable clinical indicator of vitamin D status is 25-hydroxyvitamin D because serum and plasma levels reflect the body’s storage levels of vitamin D, and 25-hydroxyvitamin D levels correlate with the clinical symptoms of vitamin D deficiency. This test is performed by the Parkview Health Laboratories by ordering test code VD251.
1,25-dihydroxyvitamin D is the most potent vitamin D metabolite. Elevations can be seen in primary hyperparathyroidism and in physiologic hyperparathyroidism secondary to low calcium or vitamin D intake. Levels are decreased in hypoparathyroidism and chronic renal failure. 1,25-dihydroxyvitamin D levels may be needed to adequately assess vitamin D status in the presence of renal disease. This test is performed by Quest Diagnostics by ordering test code VitD2.
For questions or additional information, please contact Dr. Yi Zhuang at 266-1644.
Beginning the week of October 6, Chlamydia trachomatis and Neisseria gonorrhoeae DNA probe testing will be performed on a new instrument. With this switch, acceptable specimen sources are changing. The test is approved for female cervical, female urine, and male urine only. As your current stock of red-top M4RT collection kits is depleted and more kits are ordered, you will receive pink-top Xpert CT/NG Endocervical Specimen Collection Kits. These are for female cervical use only and should not be used for male urethral collection. First-catch urine should be collected for all male testing. For questions related to this change in testing, please contact Dr. X. Karen Wan, Pathologist, at 260-266-1639.
Beginning October 21, the laboratory at PRMC will be offering these three tests:
Influenza A/B RNA testing with H1N1 reflex. Acceptable specimens include nasopharyngeal swab, nasal aspirate, or nasal wash placed into Universal Transport Medium for the Collection and Preservation of Influenza Viruses. The nasopharyngeal swab used for rapid flu testing is not an acceptable specimen.
Enterovirus, RNA testing. This test is available on CSF only. This test is not intended for the detection of Enterovirus-068 on nasopharyngeal or throat specimens.
MRSA, DNA testing for pre-surgical screening. Acceptable specimen collection includes nasal swab using a Liquid Stuart or Liquid Amies collection kit. This test is not intended for non-nasal sources.
For questions related to this new test, please contact the Richard Brown at 260-266-1521 or Dr. X. Karen Wan, Pathologist, at 260-266-1639.
As of January 24,2014 Parkview Regional Medical Center will no longer perform the Leukocyte Alkaline Phosphatase (LAP) stain, used primarily in association with Chronic Myelogenous Leukemia (CML) and Polycythemia Vera. Due to nonspecific information provided and non-diagnostic result, Parkview has determined this test is passed its clinical usefulness and provides no added clinical value for patient care.
Please consider other testing for diagnosing or excluding CML or other myeloproliferative neoplasms. For any questions please contact Dr. S. Kim at 260-266-1643.
PARKVIEW GENETICS LABORATORY CLOSING - SPECIMENS TO BE SENT TO AMERIPATH Beginning December 1, 2013, specimens for Cytogenetic Tests will be sent to Quest Laboratories and Ameripath Laboratory.. Genetic tests include, but are not be limited to, Chromosome Analysis, Microarray, Subtelomeres, FISH Tests, Marfan’s Tests, and Ehrler’s-Danlos Tests, PLEASE NOTE: Many Cytogenetic tests require pre-authorization from various insurance companies for outpatient orders. Many Indiana Medicaid plans require preauthorization.
Orders for Cytogenetic Tests must be accompanied by the Preauthorization documentation, including Pre-Auth number and the Date range for Dates or Service. If not required, a document from the insurance company stating that pre-authorization is not required must be provided. The Patient cannot be drawn without the preauthorization documentation. PLEASE NOTE: Preauthorization by insurance companies is not required for inpatient testing at this time. Physicians are encouraged to consult with our Parkview Genetics Counselors concerning appropriateness of Genetic test orders. Contact Melissa Dempsey or Jessica Chowns at 266-9225 PPG Physicians requiring assistance with the preauthorization process may contact 373-8270. Non-PPG Physicians may contact 373-8900 for assistance.
Effective immediately, the specimen requirement for a Total Testosterone has been changed to a red top tube. Serum separator tubes (SST) are no longer acceptable. This change is due to a national shortage of reagents. Testing is temporarily being performed at Quest Laboratories, until reagent is available. If in need of the proper specimen collection tube please contact Parkview Labs at 260-266-1500 (Option 4). Questions to Dr. Cobanov at 260-266-1641.
On 11-7-13, the laboratories will change the test names for the molecular Chlamydia and Gonorrhea tests in EPIC. There will be separate tests for male and female.
The new test names are:
Chlamydia Amplified Probe Male - Test Code CTM
Chlamydia Amplified Probe Female - Test Code CTF
Gonorrhea Amplified Probe Male - Test Code GCM
Gonorrhea Amplified Probe Female - Test Code GCF
These tests may also be ordered together. The new panel names are:
GC and Chlamydia Probe Female - Test Code GCCTF
GC and Chlamydia Probe Male - Test Code GCCTM
As of Tuesday, November 12 2013 Parkview Health Laboratories- Hematology Department will revise the reference range for WBC and differential parameters for adult male and females.
- The current normal WBC range is 4.5-11.0 TH/UL.
- The revised normal WBC range will be 3.4-10.5 TH/UL for adult male and female.
The differential reference range changes include:
- Lymph 20-50% changed to Lymph 17-43 %
- Neut 42-80% changed to Neut 45-75 %
- Lymph (ABS) 0.9-5.0 TH/UL changed to Lymph (ABS) 0.9-3.0 TH/UL.
Please contact Lisa Daniel, PRMC Lab Manager at 266-1505 with questions.
The following platelet function tests are available 24 hrs. / 7days at PRMC:
The Bleeding Time and Aspirin Response Assays screen for platelet dysfunction using PFA-100 technology. PFA-100 test method aids in differentiating platelet dysfunction from aspirin therapy vs. other platelet dysfunctions such as vonWillebrand’s disease.
The P2Y12 Platelet Assay, using VerifyNow instrumentation, measures platelet P2Y12 receptor blockage. Thienopyridines such as Clopidogrel (Plavix) and Prasugrel are known to specifically block platelet P2Y12 receptors. Contact the Lab Client Response Center at 266-1500 for special collection kits for P2Y12.
All samples for platelet function testing must be received at PRMC laboratory within 3 hours of collection. Refer to Parkview Health Laboratories Test Directory for additional information.
Due to a reagent shortage, the laboratories are unable to perform prealbumin testing in-house. Beginning 9-26-13, the test will be sent to Quest until the reagent is available. Please be aware that the specimen requirements will change from plasma to serum during this time. Please refer to the Laboratory Test Directory for the correct specimen requirements.
Parkview Genetics Laboratory Closing:
Parkview Health Laboratories will cease to perform Chromosome Analysis, and Molecular Cytogenetic testing including Chromosome Microarray Analysis. Parkview will continue to meet your cytogenetic testing needs by referring your tests to the most appropriate laboratory. We are in the process of developing those referral options. Genetic counseling will also still be available locally through Dr. Bader and other Parkview genetic counselors.
Blood Culture Bottle Supply
Parkview Health Laboratories supply of blood culture bottles is dangerously low. Local and Nationwide Laboratories are experiencing the same blood culture bottle shortages. It is very important that blood cultures are ordered judiciously. We are working with the vendor to get supply in; however, we have been notified that the low supplies are to be expected for at least the next month.
Annual Physician Review
Discontinuation of Leukocyte Alkaline Phosphatase (LAP) Stain