B Cell Subset Analysis

Overview

  • EPIC Code:
  • MISC
  • Soft Test Code:
  • MSOT
  • Send Out Test Code:
  • 3002216
Alternate Names
  • B Subsets
  • CVID
  • Memory B Cell
  • Memory B-cells
Clinical Significance

This panel identifies B cell dysregulation.  B cells start development in the bone marrow (stem-cell, pro-B, pre-B), then transition to the spleen and lymph nodes where some mature by acquiring CD27 and switching immunoglobulin class from IgD and IgM to IgG or IgA. Class-switched B cells may further progress to plasmablasts and finally plasma cells.  Different disorders may block different parts of this pathway, disrupting immunoglobulin production.
This panel can also be used to monitor B cell reconstitution after bone marrow transplantation or targeted B cell depletion therapy.
This panel can assist in the diagnosis and subclassification of Common Variable Immune Deficiency (CVID). CVID is a heterogeneous group of disorders characterized by low antibody production, defective antibody responses, and recurrent infections. Most cases of CVID have a severe reduction in class switched memory B cells (CD27+, IgD-, IgM-) that correlates with granulomatous disease.  Many also have an expanded population of CD21low, CD38low B cells that correlates with splenomegaly. Increased transitional B cells (CD38+, IgM+) in CVID correlates with lymphadenopathy. Most CVID patients have a low percentage of plasmablasts (CD38+, IgM-) that has a correlation with autoimmune cytopenia.
Class switched memory B cells are also low in ALPS, but are typically increased in SLE and infection.
Please note, reference intervals for CD20+ B cells were not established for patients less than 16 years of age. For all other B cell subsets, reference intervals for populations younger than 16 years are adopted from literature. Piatosa B, Wolska-Kusnierz B, Pac M, Siewiera K, Galkowska E, Bernatowska E. B cell subsets in healthy children: Reference values for evaluation of B cell maturation process in peripheral blood. Cytometry Part B 2010; 78B: 372381.


Specimen Collection & Preparation

Specimen Requirements


Alternate Specimen




TransportAndStorage


Collection Instructions


Minimum Volume


Neonatal Volumne

Clinical Interpretation

Reference Range:

Refer to Interpretive Results


Methodology:
  • Flow Cytometry (FC)

Clinical Significance

This panel identifies B cell dysregulation.  B cells start development in the bone marrow (stem-cell, pro-B, pre-B), then transition to the spleen and lymph nodes where some mature by acquiring CD27 and switching immunoglobulin class from IgD and IgM to IgG or IgA. Class-switched B cells may further progress to plasmablasts and finally plasma cells.  Different disorders may block different parts of this pathway, disrupting immunoglobulin production.
This panel can also be used to monitor B cell reconstitution after bone marrow transplantation or targeted B cell depletion therapy.
This panel can assist in the diagnosis and subclassification of Common Variable Immune Deficiency (CVID). CVID is a heterogeneous group of disorders characterized by low antibody production, defective antibody responses, and recurrent infections. Most cases of CVID have a severe reduction in class switched memory B cells (CD27+, IgD-, IgM-) that correlates with granulomatous disease.  Many also have an expanded population of CD21low, CD38low B cells that correlates with splenomegaly. Increased transitional B cells (CD38+, IgM+) in CVID correlates with lymphadenopathy. Most CVID patients have a low percentage of plasmablasts (CD38+, IgM-) that has a correlation with autoimmune cytopenia.
Class switched memory B cells are also low in ALPS, but are typically increased in SLE and infection.
Please note, reference intervals for CD20+ B cells were not established for patients less than 16 years of age. For all other B cell subsets, reference intervals for populations younger than 16 years are adopted from literature. Piatosa B, Wolska-Kusnierz B, Pac M, Siewiera K, Galkowska E, Bernatowska E. B cell subsets in healthy children: Reference values for evaluation of B cell maturation process in peripheral blood. Cytometry Part B 2010; 78B: 372381.


Production Schedule

Sites Performed
  • ARUP Lab
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Sendouts - Miscellaneous
Turn Around Time

1 to 3 days


Coding & Compliance

CDM

00913333


CPT Coding

86355; 86356 x6