Epic Test Code LAB101011 Anaplasma phagocytophilum (Human Granulocytic Ehrlichiosis) Antibody, Serum
Additional Codes
MML:ANAP
Reporting Name
Anaplasma phagocytophilum Ab, IgG,SUseful For
As an adjunct in the diagnosis of human granulocytic ehrlichiosis (anaplasmosis)
Seroepidemiological surveys of the prevalence of the infection in certain populations
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Reference Values
<1:64
Reference values apply to all ages.
Day(s) Performed
Monday through Friday
CPT Code Information
86666
Testing Algorithm
For more information see Acute Tick-Borne Disease Testing Algorithm.
Special Instructions
Clinical Information
Anaplasma phagocytophilum is an intracellular rickettsia-like bacterium that preferentially infects granulocytes and forms inclusion bodies, referred to as morulae. A phagocytophilum is transmitted by Ixodes species ticks, which also transmit Borrelia burgdorferi and Babesia species. Infection with A phagocytophilum is also referred to as human granulocytic anaplasmosis (HGA) or human granulocytic ehrlichiosis, and symptoms in otherwise healthy individuals are often mild and nonspecific, including fever, myalgia, arthralgia, and nausea. Clues to the diagnosis of anaplasmosis in a patient with an acute febrile illness after tick exposure include laboratory findings of leukopenia or thrombocytopenia and elevated liver enzymes. HGA is most prevalent in the upper Midwest and in other areas of the United States that are endemic for Lyme disease.
Interpretation
A positive result of an immunofluorescence assay (IFA) test (titer ≥1:64) suggests current or previous infection with human granulocytic ehrlichiosis (anaplasmosis). In general, the higher the titer, the more likely it is that the patient has an active infection.
Seroconversion may also be demonstrated by a significant increase in IFA titers.
During the acute phase of the infection, serologic tests are often nonreactive, polymerase chain reaction (PCR) testing is available to aid in the diagnosis of these cases (see EPCRB / Ehrlichia/Anaplasma, Molecular Detection, PCR, Blood).
Cautions
Previous episodes of human granulocytic ehrlichiosis (anaplasmosis) may produce a positive serologic result.
In rare instances, clinical evidence of infection may also be derived by direct microscopic examination of Giemsa- or Diff-Quik-stained peripheral blood buffy coat smears, which may reveal clusters of round, dark-purple stained, small dots (morulae) in the cytoplasm of polymorphonuclear cells. However, this is a very insensitive method.
Performance characteristics have not been established for hemolyzed or lipemic specimens.
Report Available
1 to 3 daysSpecimen Retention Time
14 daysReject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Heat-inactivated specimen | Reject |
NY State Approved
YesMethod Name
Immunofluorescence Assay (IFA)
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.