Entamoeba histolytica, IgG

Infectious Disease Laboratories : Immunology

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. Entamoeba histolytica, IgG
2.
3.
4.
5.
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SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

EHIST CLEVE

Specimen Type:

Blood

Tube Type:

Gold top SST (serum separator tube, no anticoagulant)

Collection Volume:

2.5 mL (minimum 0.5 mL)

Cause for Rejection:

Contaminated, heat inactivated or severely lipemic specimens.

Storage:

Refrigerated

Availability:

Sent to reference lab

Methodology:

Enzyme-Linked Immunosorbent Assay (ELISA)

Special Instructions:

For Outpatients, send specimen by courier STAT to Hospital lab. Serum must be separated from cells within 2 hours of collection. Acute and convalescent specimens must be labeled as such; parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.

Lab/Phone:

330-543-8418

TAT:

3-7 days

Additional Info:

Clinical information: Aid in the detection of amebic liver abscess. Test is not useful for intestinal infection. In case of extra-intestinal complications, a positive antibody can indicate amebiasis even though stool findings are negative. Seroconversion between acute and convalescent sera is considered strong evidence of recent infection.

Reference Range:

Negative: No significant level of detectable E. histolytica IgG Antibody: 8 U or less.

Equivocal: (repeat testing in 10-14 days may be helpful) 9-11 U

Positive: (current or past infection) 12 U or greater

CPT Code:

86753