Sweat Chloride

Centralized Core Laboratory : Special Chemistry

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. Sweat Chloride
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Test ID/Workstation :

SWEAT MCHM

Specimen Type:

Sweat

Tube Type:

Sweat container

Collection Volume:

0.03 mL sweat by iontophoresis

Cause for Rejection:

Insufficient sample for testing

Storage:

Ambient

Availability:

Mon-Fri

Methodology:

Pilocarpine Iontophoresis assayed by Elitech Group Wescor Chlorochek

Special Instructions:

See information under Iontophoresis" for collection instructions. Lab will order this test if a sufficient amount of sweat is collected." For Outpatients, test should only be drawn in outpatient locations within the Hospital at the Akron campus.

Lab/Phone:

330-543-8417

TAT:

Next business day.

Additional Info:

The Cystic Fibrosis Foundation Reference intervals for chloride:
< or = 29 mEq/L, CF unlikely
30-59 mEq/L, Intermediate
> or = 60 mEq/L, Indicative of CF
A result of >30 mEq/L is considered abnormal and should prompt further investigation.
NOTE: Sweat chloride values less than 30 mEq/L have been documented in genetically proven CF patients. Clinical correlation is necessary.

CPT Code:

82438

Synonyms:

Cystic Fibrosis Sweat Test; Pilocarpine Ionto

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Sweat Chloride

Centralized Core Laboratory : Special Chemistry

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