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Test Code LAB2797 Anti Neutrophil Ab by Flow <4 months old

Important Note

ORDERING PROVIDER INSTRUCTIONS

This test needs to be scheduled with the Send Out department at (206) 987-2563 prior to specimen collection. Both the mother and father need to be drawn, the patient DOES NOT need to be drawn.

The provider should place a Future (On Hold) order for "Anti Neutrophil Ab by Flow <4 months old" in Epic under the child only. The Laboratory will place orders for the parents once their specimens have been collected.

This test is for the detection of allo antibodies in patients <4 months of age.

 

CHILDREN'S OUTPATIENT BLOOD DRAW AREAS AND COMM SERVICE ORDERING

Specimen Collection at Seattle Childrens' Outpatient Blood Draw: Anti Neutrophil Ab by Flow <4 months old (LAB2797) is ordered on child only. Both the mother and father need to be drawn.  Have each parent register for the day and use their separate accounts to order the appropriate test, either Anti Neutrophil Ab Mother (LAB2800) or Anti Neutrophil Ab Father (LAB2799). Label each of the two sets of samples with the correct Epic label (mother or father) and submit to CPA. Note: If child is INPATIENT, parents may be drawn at Outpatient Blood Draw.

 

Community Services Ordering: Anti Neutrophil Ab by Flow <4 months old (LAB2797) is ordered on child only.  Both the mother and father samples are required, but for Community Services samples collected elsewhere, register the child only.  Note: If specimens on parents not received, CONTACT SEND OUTS.  Parent tubes should arrive labeled with the parent name and DOB; no additional labeling is necessary.  Notify Send Outs at ext. 7-2563 right away - billing/ordering questions should not delay delivery to lab.  

 

Other Assays with Similar Test Name

Additional Codes

ANEUT<4MO

Clinical System Name

Anti Neutrophil Ab by Flow <4 months old

Synonyms

Granulocyte Antibody Screen <4 months old

Granulocyte Ab Screen <4 months old

Anti Neutrophil Antibodies - Allo

Neutrophil Alloantibodies

Neutrophil Antibodies - Allo

Anti Neutrophil AB by Flow <4 months old

Neonatal Alloimmune Neutropenia

 

Sample Requirements

Specimen:  See Notes below

Container(s):  See Notes below

Preferred Vol:  See Notes below

Minimum Vol:  See Notes below

Notes:  Specimens from Mother and Father are required for patient <4 months, and all samples must be tested together.

 

  Specimen Requirements
   
MOTHER 5 mL in Lavender/EDTA and 5 mL in Gold SST
FATHER 5 mL in Lavender/EDTA

 

Processing Instructions

Reject due to:  n/a - send to lab

Spin:  see Notes below

Aliquot:  see Notes below

Temp:  see Notes below

Storage location:  Notify Send Outs at x72563 right away - billing/ordering questions should not delay delivery to lab.  Transport specimens, (copy of community services requisition, if applicable), and labels to Send Outs. Eves/nights:  Store serum and EDTA in CPA refrigerator Send Outs rack.

 

Notes:  Do not spin Lavender/EDTA tubes (mother and father) and refrigerate; spin Gold SST tube (mother) and transport refrigerated (after hours, see note above).

 

Off-site collection:  Specimen collection at Seattle Children's preferred - otherwise specimens must be received before noon at Seattle Children's Lab M-F to allow testing within 24 hours of draw.  Both the mother and father need to be drawn and must be tested together (see detailed requirements in Sample Requirements table above).  Label each of the two sets of samples with the correct name and DOB.  Record names & DOB for mother and father, as requested, on child's requisition form. 

Notes:  Do not spin Lavender/EDTA tubes (mother and father) and refrigerate; spin Gold SST tube (mother).  Transport all tubes refrigerated to Seattle Children's Hospital address on requisition: Laboratory OC.8.720., 4800 Sand Point Way NE, Seattle, WA  98105.  Notify Send Out Lab at (206)987-2563.

Stability

Temperature Time
Room temp 24 hours; see Processing below
Refrigerated Y  (7 days)
Frozen N

 

Availability

STAT Performed TAT
N processed before noon M-F; no weekends or holidays <2 weeks

 

Performing Laboratory

Versiti Wisconsin

Platelet and Neutrophil Immunology Laboratory

638 North 18th Street

Milwaukee, WI 53233-2121

 

Phone Number: (800) 245-3117 x6250

Department

Department: Send Outs

Phone Number: (206) 987-2563

CPT Codes

86021

Methodology

Method:  Flow Cytometry

Analytical Volume:  see notes

Limitations:

Reference Range

Negative

 

Send Out Instructions

Reference Test Name: Neonatal Alloimmune Neutropenia
Reference Test Number: 5125 (Mother) / 5126 (Father)
Instructions: Send refrigerated sample(s) on ice pack(s) via FedEx Priority overnight shipping. Saturday deliveries are acceptable.

 

Description

Anti-neutrophil antibody <4 months testing is used to identify the presence of anti-neutrophil antibodies in patients who are <4 months of age, with suspected allo-immune neutropenia.

Clinical Utility

Alloimmune neutropenia, found in patients less than 4 months of age, is seen when the patient's neutrophils are destroyed by maternally-derived alloantibodies.  These antibodies arise in the mother as the direct result of a neutrophil incompatibility between the mother and the fetus, as when an HNA-1b negative mother carries an HNA-1b positive fetus.  The mother becomes sensitized to HNA-1b positive neutrophils when variable amounts of fetal cells pass through the placental barrier and gain entrance into the maternal circulation.  The presence of these "foreign" fetal neutrophils initiates the formation of anti HNA-1b antibodies in the mother, which are then capable of crossing the placenta and causing neutropenia in the infant during the fetal and/or neonatal period.

 

The anti-neutrophil alloantibodies destroy neutrophils which may lead to neutropenia in the infant and subsequent increased risk of infection.

 

Alloimmune neutropenia usually resolves on its own as the levels of maternal antibody naturally decrease.  Alloimmune antibodies are typically gone by 4 months of age.

 

Identification of anti-neutrophl antibodies can help to exclude other inherited forms of neutropenia.