Laboratory Test Preparation

• IL-10
• Human cytokine synthesis inhibitory factor (CSIF)

Not applicable

IL-10 is a cytokine derived from helper T-cell lymphocytes that inhibits gamma-interferon and IL-2 secretion by T-cell lymphocytes and inhibits mononuclear cell inflammation.

Enzyme Immunoassay (EIA)

Special Test

No patient preparation necessary.

EDTA or Violet Tube

4 mL Plasma

Not Applicable

24 Hours

48 Hours

21 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Specimen

Batch Running

Friday 4:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Not applicable

IL-2

Not applicable

Interleukin-2 (IL-2) is an interleukin, a type of cytokine signaling molecule in the immune system. It is a protein that regulates the activities of white blood cells (often lymphocytes) that are responsible for immunity. In normal circumstances, IL-2 is undetectable but moderately high levels are found in the blood of patients with lymphoid malignancies and in the course of active graft rejection.

Enzyme Immunoassay (EIA)

Special Test

No patient preparation necessary.

EDTA or Violet Tube

4 mL Plasma

Not Applicable

24 Hours

48 Hours

21 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Specimen
• Over-filled or Under-filled tube

Batch Running

Monday, 12:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Not applicable

IL28B genotyping

Not applicable

Polymorphism (rs12979860) upstream of the IL28B gene is associated with a sustained response to treatment (interferon and ribavirin) in patients carrying genotype 1 of the hepatitis C virus.

Melting Curve Allelic Discrimination

Special Test

No patient preparation necessary.

EDTA or Violet Tube

2 pcs of 4 mL EDTA whole blood

Not Applicable

Not applicable

24 Hours

30 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Over-filled or Under-filled tube
• Clotted Specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Monday, 12:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified

Not applicable

Chronic Hepatitis C

IL-5

Not applicable

Interleukin 5 (IL-5) is secreted by lymphocytes and monocytes. It is a major chemoattractant of eosinophils, such as eotaxin.IL-5 is not assayed for diagnostic purposes but as part of major eosinophilia follow-up: haematological diseases, asthma (in the latter case, the IL-5 level can be measured in bronchoalveolar lavage fluid).

Enzyme Immunoassay (EIA)

Special Test

No patient preparation necessary.

EDTA or Violet Tube

4 mL Plasma

Not Applicable

24 Hours

48 Hours

21 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Specimen
• Over-filled or Under-filled tube

Batch Running

Friday 4:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Allergic rhinitis and asthma

IL-6

Not applicable

Interleukin 6 (IL-6) is a pleiotropic, proinflammatory cytokine. It increases during infection (viral, bacterial or parasitic), autoimmune disease and in certain tumors.

Enzyme Immunoassay (EIA)

Special Test

No patient preparation necessary.

RED or GOLD

4 mL serum 

Not Applicable

24 Hours

48 Hours

21 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Specimen
• Over-filled or Under-filled tube

Batch Running

Friday 4:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Pro-inflammatory cytokine, Anti-inflammatory myokine

• IF-Blocking Antibody
• Intrinsic Factor Blocking Antibody
• IF Antibody
• IF Antibody Type 1 or Type 2
• Intrinsic Factor Binding Antibody
• Anti-Intrinsic Factor

Not Applicable

Intrinsic factor antibodies are proteins produced by the immune system that are associated with pernicious anemia. This test detects intrinsic factor antibody (IF antibody) circulating in blood.

Immunoassay (IA)

Special Test

Samples should not be collected from a patient who has received Vitamin B12 injection therapy within the last week

Red tube or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 days

28 days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Specimen stored/transported outside the temperature range
• Quantity not sufficient
• Improperly labeled specimens

Batch Running

Monday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None Specified.

Q: Why get tested?

A:To help diagnose pernicious anemia. the most common cause of vitamin B12 deficiency.

Q: Why to get tested?

A:As part of an investigation, when you have anemia and/or neuropathy that may be due to a vitamin B12 deficiency; when you have red blood cells that are much larger than normal (macrocytic)

Q: Should everyone have an intrinsic factor antibody test?

A:It is not intended as a general screening test. It is only performed to help determine the cause of a demonstrated vitamin B12 deficiency.

Vitamin B12 and Folate, Methylmalonic Acid, Gastrin, Parietal Cell Antibody, Homocysteine, Complete Blood Count

Genetic Testing for Hereditary Cancers

Not applicable

The Invitae Hereditary Multi-Cancer Panel analyzes 84 genes associated with hereditary breast and gynecologic (ovarian and uterine), gastrointestinal (colorectal, gastric, pancreatic), genitourinary (renal/urinary tract, prostate), endocrine (thyroid, paraganglioma/pheochromocytoma, parathyroid, pituitary), skin (melanoma, basal cell carcinoma), brain and nervous system, sarcoma, and hematologic (myelodysplastic syndrome, leukemia).

This type of genetic testing may confirm a diagnosis and help guide treatment and management decisions.

Identification of a disease-causing genetic variant can also guide testing and diagnosis of at-risk relatives.

This test is specifically designed for heritable germline mutations and is not appropriate for the detection of somatic mutations in tumor tissue.

Next Generation Sequencing (NGS)

Special Test

• No patient preparation necessary.
• Test collection container (violet top) will be provided by HPD. Branch to coordinate with Special Test (HPD Main) 2-3 days before specimen collection.
• Collect samples using one violet top tube.
• Mix by inverting 5 – 6 times.
• Do not centrifuge or freeze the specimen.
• Label the blood collection tube with the patient's first and last name, patient's date of birth (MM-DD-YYYY) and specimen collection date (MM-DD-YYYY)
• Send sample immediately to HPD Del Monte for ship out within the day.

PLEASE LET THE PATIENT ANSWER THE FOLLOWING QUESTION:

1. PRIMARY INDICTATION: (CHOOSE ONLY ONE FOR THE FOLLOWING ANSWERS BELOW)

• Cardiology: Aortopathy
• Cardiology: Arrythmia
• Cardiology: Cardiomyopathy
• Cardiology: Other
• Hereditary Breast and Ovarian Cancer (HBOC)
• Lynch Syndrome
• Neurology
• Other Cancer: (please note)
• Pancreatic Cancer
• Polyposis (FAP)
• Prostate Cancer
• Other: (please note)

2. IS / WAS PATIENT AFFECTED OR SYMPTOMATIC?

• Yes (If yes, what kind of symptoms)
• No

3. IS THERE A FAMILY HISTORY OF DISEASE FOR WHICH THE PATIENT IS BEING TESTED?

• Yes (if yes, what kind of disease)
• No

4. HAS THE PATIENT HAD GENETIC TESTING BEFORE?

• Yes (If yes, what kind ofgenetic testing, when the testing happened and provide us copy of results)
• No

5. IS THERE KNOWN FAMILY VARIANT IN A GENE BEING TESTED FOR THIS PATIENT?

• Yes (if yes, what particular gene)
• No

NOTE:Double check completeness of information in the required documents prior to sending to HPD Main Laboratory to avoid delay in processing of sample.

Invitae Collection Kit will be provided by HPD Special Test Section.

6mL whole blood Edta provided by HPD Special Test Section.

Not Applicable

5 Days

Not Applicable

Not Applicable

• Transport specimen at 15°C ~25 °C (room temperature)
• Place samples in the provided Specimen Bag with gel packs and store at room temperature.
• Send sample immediately to HPD Del Monte for ship out within the day.
• Sample must reach Referral Laboratory within 5 days of sample collection.

• Incorrect storage and transport temperature of specimen 
• Improperly labeled specimen
• Incomplete documentation requirement or incompletely filled out Requisition Quantity not sufficient 
• Specimen collection kit stored/transported outside the temperature range.

Batch running

Monday, 12:00 noon

3 weeks after cut-off (excluding Saturdays, Sundays and Holidays) (Excluding Saturdays, Sundays and Holidays

Not Applicable

Not Applicable

Q: What is the INVITAE Hereditary Multi-Cancer Panel?

A: The Invitae Hereditary Multi-Cancer Panel is a genetic test employing Next Generation Sequencing technology to analyze 84 genes associated withcancers across major organ systems including:

• Breast and gynecologic (breast, ovarian, uterine)
• Gastrointestinal (colorectal, gastric, pancreatic)
• Endocrine (thyroid, paraganglioma/pheochromocytoma, parathyroid, pituitary)
• Genitourinary (kidney, bladder, urinary tract, prostate)
• Skin (melanoma, basal cell carcinoma)
• Brain and nervous system (pituitary adenoma, CNS and PNS tumors)
• Sarcoma
• Hematologic (myelodysplastic syndrome, leukemia)

Q:  What are the benefits of genetic testing?

A: Knowing if you have an inherited risk empowers you to be more proactive about your health.  Increased surveillance can identify a cancer at its earliest, most treatable stage.  Identification of a disease-causing genetic variant can also guide testing and diagnosis of at-risk relatives.  Genetic information can qualify you for participation in clinical trials or research studies.

Q: Who should consider genetic testing?

A: Genetic testing may be appropriate if you or a close family member has:

• a personal or family history presenting with multiple cancer types that could fit the features of more than one hereditary cancer syndrome
• a clinical history indicative of a hereditary cancer syndrome but a limited pedigree due to small family size or adoption.
• cancer diagnosed at an unusually young age
• different types of cancer that have occurred independently in the same person.
• cancer in both of a set of paired organs, e.g., both kidneys, both breasts
• several close blood relatives that have the same type of cancer
•           unusual cases of a specific cancer type, e.g., male breast cancer

Q:  What can genetic testing tell me?

A: A positive result can pinpoint your risk of developing cancer, enabling you to make informed medical decisions to reduce risk.  It can also help identify other at-risk relatives for whom genetic testing is recommended.

     A negative result means that you do not have an alteration in the genes tested.  Your overall cancer risk will depend on your medical history, family history and environment.

     An uncertain variant test result means that an alteration was identified, but is currently not known if the alteration increases risk.  Invitae will update your doctor if new information becomes available.

Q:  What can genetic testing do for my family?

A: Identifying at-risk family members is one of the most important benefits of genetic testing.  If you have a genetic alteration, your immediate family members have a 50% chance of having the same alteration.  Other relatives may also be at risk.

Not applicable

• Free calcium
• Dialyzable calcium

Not applicable

Used to screen, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth.

Direct ISE

Chemistry

• 4 hours fasting
• Patient must be relaxed and normally breathing for at least 10 minutes before extraction. Do not exercise the forearm (i.e. make a fist) before or during the blood collection.
• Patient must sit or lie down at least 5 minutes before extraction

Gold tube

1-3 mL Serum

Not applicable

4 hours

70 hours if sample is in a full (<1cm air space), gel separator tube

Not specified

• Refrigerated Temperature (2 – 8 °C) (with cold packs)

Sample must be centrifuged within two hours to separate serum from red cells. IMPORTANT: DO NOT OPEN THE SAMPLE TUBE"

• Improper collection tube used
• Specimen stored/transported outside the temperature range
• Quantity not sufficient
• Hemolyzed specimen
• Lipemic specimen
• Improperly labeled specimen

•Tube not sealed

Daily

Monday to Saturday:6:00 PM

Sunday:4:00PM

ROUTINE (on running days only)
• 4 hours after receipt of specimen/ arrival of messenger
RELEASING TIME: STAT (on running days only)
• After 2½ hours from extraction/messenger arrival

1.10 – 1.35 mmol/L

None identified

Not applicable

Electrolytes, Total Calcium, Sodium, Potassium, Magnesium

• P
• PO4
• Phosphate
• Inorganic Phosphate

Not applicable

• Often measured along with other tests (e.g. Calcium, PTH and/or Vitamin D) to help diagnose and/or monitor treatment of various conditions that cause calcium and phosphorus imbalances.

Phosphomolybdate

Chemistry

• 8-12 hours fasting.
Note:
• Prolonged fasting is highly discouraged since various metabolic changes associated with starvation may begin to develop. Water intake is acceptable.
• Note in clinical info if patient drank more than 4 glasses of water during fasting period, ask patient for medical history as this is rather unusual.
• Note in clinical info in case patient overfasts and insists on proceeding test.

Red or Gold tube

1-3 mL Serum

1-3 mL Plasma (Li-Heparin)

1 Day

4 Days

1 Year

Transport specimen at 2 – 8 °C (with cold packs)

1. Failed serum index samples
2. Specimen stored/transported outside the temperature range
3. Quantity not sufficient
4. Improperly labeled specimen
5. Improper collection tube used

Daily

Monday to Saturday: 6 PM

Sunday: 4PM

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
 STAT
• After 2½ hours from extraction/messenger arrival

• In very rare cases, gammopathy, in particular type lgM (Waldenstrom‘s macroglobulinemia). May cause unreliable results.
• Phospholipids contained in liposomal drug formulations (eg: AmBisome) may be hydrolyzed in the test due to the acidic reaction pH and thus lead to elevated phosphate results.
• Interferences from medications or endogenous substances may affect results.

Not applicable

Calcium, Electrolytes, Vitamin D, PTH, Magnesium

• Serum Iron
• Serum Fe

Not applicable

The serum measurement of iron is useful in the differential diagnosis of anemia, iron deficiency anemia, thalassemia, possible sideroblastic anemia, and iron poisoning.

Ferene

Chemistry

• Sample should be taken in the morning before patient is given therapeutic iron or blood transfusion.
• Iron determinations on patients who have had blood transfusions should be delayed several days.

Red or Gold tube

1-3 mL Serum

1-3 mL (Lithium Heparin or Sodium Heparin)

7 Days

3 Weeks

1 Year

NOTE:Serum must be separated from gel separator.

• Uncentrifuged sample: Room temperature (15°C–25°C)
• Refrigerated Temperature (2°C– 8°C) (with cold packs)

NOTE: Sample must be separated from serum within 2 hours of specimen collection.

• Specimens with any sign of hemolysis
• Improper collection tube used
• Specimen stored/transported outside the temperature range
• Quantity not sufficient
• Lipemic specimen
• Improperly labeled specimen plasma
• EDTA plasma

Monday, Wednesday, Friday

Monday to Saturday:6:00 PM

Sunday:4:00PM

ROUTINE

• 4 hours after receipt of specimen/ arrival of messenger

STAT

• After 2½ HOURS from extraction/messenger arrival

MALE: 11.60~31.30 umol/L (64.81 - 174.87 ug/dL)
FEMALE: 9.00~30.40 umol/L (50.28 – 169.85 ug/dL)

 Not applicable

Ferritin, TIBC, UIBC and Transferrin, Hemoglobin, Hematocrit, Complete Blood Count, Reticulocyte Count, Zinc Protoporphyrin, Iron Tests, Soluble Transferrin Receptor

Fe

Not applicable

An element which plays a key role in hemoglobin, myoglobin and various respiratory enzyme systems. Very high levels are found in hemochromatosis, both primary (due to excess intestinal absorption) and secondary to over-consumption (alcoholism, repeated blood transfusions, etc.). Low iron levels are due to insufficient intake, poor absorption, increased requirement (e.g. during pregnancy) or heavy losses (bleeding).

Inductively Coupled Plasma/Optical Emission Spectrometry

Special Test

• Blood sample will be drawn every friday from 6am to 4pm
• (Request Container to Special test section)
• Carefully clean skin prior to venipuncture. Avoid worksite collection.

Royal Blue Top -(Request Container to Special test section)

3pcs of  wholeblood Royal Blue Top

Not Applicable

6 Days

6 Days

Not applicable

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Sample
• Over-filled or Under-filled tube

Batch Running

Monday, 12:00 PM

3 weeks after cut off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Not applicable

• ICA (Islet Cell Cytoplasmic Autoantibodies)
• Anti endocrin pancreas antibodies

Not applicable

An early indicator of insulin-dependent diabetes (IDD) which is useful in screening for nascent diabetes. To be combined with Anti-GAD and Anti-IA2 testing.

Chemiluminescence

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Friday, 4:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Islet Autoantibodies, Diabetes Mellitus Autoantibody Panel, Islet Cell Cytoplasmic Autoantibodies, ICA, Insulin Autoantibodies, IAA, Glutamic Acid Decarboxylase Autoantibodies, GADA, GAD65 Autoantibodies, Insulinoma-Associated-2 Autoantibodies, IA-2A, ICA512 Autoantibodies, Protein Tyrosine Phosphatase-like Autoantibodies

IVANT TEST

Janus Q Kinase 2 (Qualitative)

Not Applicable

JAK2 is a regulating protein present in myeloid precursor cells. The mutation V617F that effects the JH2 domain or pseudo kinase of JAK2, causes a permanent activation of the signalling pathway for erythropoietin and thrombopoietin without these growth factors being receptor bound. Causing an unprepared myeloproliferation.

• Detects the presence of JAK2 point mutation in granulocytes of peripheral blood from patient with non-CML Myeloproliferative Disorder (MPD)

Polymerase Chain Reaction (PCR)

Special Test

• No patient preparation necessary.
• Call Special Test Section (By Appointment/Schedule.

NOTE: Do not collect specimen without approval of Special Test Section

EDTA or Violet Tube

6 Pcs. of 4 mL whole blood

Not Applicable

24 Hours

Not Applicable

Not Applicable

Transport specimen at 15°C ~25 °C (room temperature)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used
• Clotted Sample
• Over-filled or Under-filled tube

Monday to Friday

Monday to Friday, 7:00 AM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None Specified.

Not Applicable

Janus Kinase 2, JAK2 V617F; JAK2 Exon 12 Mutation