Peanut Component Reflex, S

Centralized Core Laboratory : 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. Peanut Component Reflex, S
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

PEANT MAYO

Specimen Type:

Blood

Tube Type:

Red top (no anticoagulant) tube

Collection Volume:

5.0 mL (minimum 4.0 mL)

Storage:

Refrigerated

Availability:

Sent to Mayo Medical Laboratory

Methodology:

Fluorescent Enzyme Immunoassay (FEIA)

Lab/Phone:

330-543-8418

TAT:

1-3 days

Additional Info:

Reference range is available on patient report.

If Peanut IgE is detectable (> or = 0.10 kU/L), then the 5 peanut components (Ara h 1, Ara h 3, Ara h 8, and Ara h 9) are performed at an additional charge.

CPT Code:

86003

Synonyms:

Ground Nut, Monkey Nut, Glycinin (h 1 and h 3), Conglutin (h 2), A bet v 1-homologous allergen (h 8), Group 1 Fagales-related protein (h 8), PR-10 Protein (h 8), Non-specific Lipid Transfer Protein (ns- LTP) (h 9), PR-14 Protein (h 9), Bet v2, Profilin