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Transglutaminase IgA

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. Transglutaminase IgA
2.
3.
4.
5.
6.

SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID/Workstation :

TRGLA VIR5

Specimen Type:

Blood

Tube Type:

Red Top (no anticoagulant) tube

Collection Volume:

1.5 mL (minimum 1.0 mL)

Cause for Rejection:

Grossly hemolyzed, hyperlipemic, hemolytic, heat-treated or contaminated serum.

Storage:

Refrigerated

Availability:

Tuesday and Thursday

Methodology:

Enzyme immunoassay

Lab/Phone:

330-543-8576

TAT:

1-4 days

Additional Info:

Reference Range:

< Negative: <9.0 AU/mL

Equivocal: 9.0-16.0 AU/mL

>Positive: > 16.0 AU/mL

CPT Code:

83516

Synonyms:

Tissue Transglutaminase IgA

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