Test Catalog

Test Id : RPR2

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Respiratory Profile, Region 2, Mid-Atlantic (DC, DE, MD, NC, VA), Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing sensitization to various inhalant allergens commonly found in the Mid-Atlantic region including the District of Columbia, Delaware, Maryland, North Carolina, and Virginia

 

Defining the allergen responsible for eliciting signs and symptoms

 

Identifying allergens:

-Responsible for allergic response and/or anaphylactic episode

-To confirm sensitization prior to beginning immunotherapy

-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
IGE Immunoglobulin E (IgE), S Yes Yes
DP House Dust Mites/D.P., IgE Yes Yes
DF House Dust Mites/D.F., IgE Yes Yes
CAT Cat Epithelium, IgE Yes Yes
DOGD Dog Dander, IgE Yes Yes
BERG Bermuda Grass, IgE Yes Yes
TIMG Timothy Grass, IgE Yes Yes
JOHN Johnson Grass, IgE Yes Yes
COCR Cockroach, IgE Yes Yes
PENL Penicillium, IgE Yes Yes
CLAD Cladosporium, IgE Yes Yes
ASP Aspergillus Fumigatus, IgE Yes Yes
ALTN Alternaria Tenuis, IgE Yes Yes
BXMPL Box Eld/Maple, S, IgE Yes Yes
BIR Silver Birch, IgE Yes Yes
CED Mountain Cedar, IgE Yes Yes
OAK Oak, IgE Yes Yes
ELM Elm, IgE Yes Yes
CTWD Cottonwood, IgE Yes Yes
PCANH Pecan Hickory, IgE Yes Yes
MULB Mulberry, IgE Yes Yes
SRW Short Ragweed, IgE Yes Yes
RRRP Rough Pigweed, IgE Yes Yes
SORR Red Sorrel, IgE Yes Yes

Method Name
A short description of the method used to perform the test

Fluorescence Enzyme Immunoassay (FEIA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Resp Profile, Reg 2, Mid-Atlantic

Aliases
Lists additional common names for a test, as an aid in searching

Refer to individual tests for lists of aliases

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1.7 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

1.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 90 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Assessing sensitization to various inhalant allergens commonly found in the Mid-Atlantic region including the District of Columbia, Delaware, Maryland, North Carolina, and Virginia

 

Defining the allergen responsible for eliciting signs and symptoms

 

Identifying allergens:

-Responsible for allergic response and/or anaphylactic episode

-To confirm sensitization prior to beginning immunotherapy

-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Immunoglobulin E (IgE) is one of the 5 classes of immunoglobulins and is defined by the presence of the epsilon heavy chain. It is the most recently described immunoglobulin, having first been identified in 1966. IgE exists as a monomer and is present in the circulation at very low concentrations, approximately 300-fold lower than that of IgG. The physiologic role of IgE is not well characterized, although it is thought to be involved in defense against parasites, specifically helminths.

 

The function of IgE is distinct from other immunoglobulins in that it induces activation of mast cells and basophils through the cell-surface receptor Fc epsilon RI. Fc epsilon RI is a high-affinity receptor specific for IgE present at a high density on tissue-resident mast cells and basophils. Because of this high-affinity interaction, almost all IgE produced by B cells is bound to mast cells or basophils, which explains the low concentration present in circulation. Cross-linking of the Fc epsilon RI-bound IgE leads to cellular activation, resulting in immediate release of preformed granular components (histamine and tryptase) and subsequent production of lipid mediators (prostaglandins and leukotrienes) and cytokines (interleukin-4 and interleukin-5).

 

Elevated concentrations of IgE may occur in the context of allergic disease. However, increases in the amount of circulating IgE can also be found in various other diseases, including primary immunodeficiencies, infections, inflammatory diseases, and malignancies. Total IgE measurements have limited utility for diagnostic evaluation of patients with suspected allergic disease. In this scenario, testing for the presence of allergen-specific IgE may provide more information.

 

Clinical manifestations of allergic disease result from activation of mast cells and basophils, which occurs when Fc epsilon RI-bound IgE antibodies interact with allergen.

 

In vitro serum testing for specific IgE antibodies may provide an indication of the immune response to an allergen that may be associated with allergic disease.

 

The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. Sensitization to inhalant allergens (dust mite, mold, and pollen inhalants) primarily occurs in older children, adolescents, and adults, and usually manifests as respiratory disease (rhinitis and asthma).

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Specific IgE:

Class

IgE kU/L

Interpretation

0 

<0.10 

Negative 

0/1 

0.10-0.34 

Borderline/equivocal 

1 

0.35-0.69 

Equivocal 

2 

0.70-3.49 

Positive 

3 

3.50-17.4 

Positive 

4 

17.5-49.9 

Strongly positive 

5 

50.0-99.9 

Strongly positive 

6 

> or =100 

Strongly positive 

 

Reference values apply to all ages.

 

Total IgE:

Age

Reference interval (in kU/L)

0-5 months

< or =13

6-11 months

< or =34

1 and 2 years

< or =97

3 years

< or =199

4-6 years

< or =307

7 and 8 years

< or =403

9-12 years

< or =696

13-15 years

< or =629

16 and 17 years

< or =537

18 years and older

< or =214

Interpretation
Provides information to assist in interpretation of the test results

Elevated concentrations of total IgE may be found in a variety of clinical diseases, including allergic disease, certain primary immunodeficiencies, infections, inflammatory diseases, and malignancies.

 

Detection of allergen-specific IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

An elevated concentration of total IgE is not diagnostic for allergic disease and must be interpreted in the clinical context of the patient, including age, sex, travel history, potential allergen exposure, and family history.

 

A normal concentration of total IgE does not eliminate the possibility of allergic disease. In patients with a high index of suspicion for allergic disease, testing for allergen-specific IgE may be warranted.

 

Testing for allergen-specific IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.

 

Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and test results must be interpreted in the clinical context.

 

False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Homburger HA, Hamilton RG: Chapter 55: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070

2. Bernstein IL, Li JT, Bernstein DI, et al: Allergy diagnostic testing: An updated practice parameter. Ann Allergy Asthma Immunol. 2008 Mar;100(3 Suppl 3):S1-148

Method Description
Describes how the test is performed and provides a method-specific reference

Specific IgE:

Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)

 

Total IgE:

Anti-IgE, covalently coupled to ImmunoCAP, reacts with the IgE in a serum specimen. After washing, enzyme-labeled anti-IgE antibodies are added to form a complex. After incubation, unbound enzyme-labeled anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, fluorescence of the eluate in the well is measured. The fluorescence is directly proportional to the concentration of IgE in the test specimen.(Package insert: Phadia CAP System IgE FEIA. Phadia; Rev 10/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82785-IgE

86003 x 23-Each individual allergen

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
RPR2 Resp Profile, Reg 2, Mid-Atlantic 48825-4
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
ALTN Alternaria Tenuis, IgE 6020-2
ASP Aspergillus Fumigatus, IgE 6025-1
BERG Bermuda Grass, IgE 6041-8
BIR Silver Birch, IgE 15283-5
BXMPL Box Eld/Maple, S, IgE 7155-5
CAT Cat Epithelium, IgE 6833-8
CED Mountain Cedar, IgE 6178-8
CLAD Cladosporium, IgE 53760-5
COCR Cockroach, IgE 6078-0
CTWD Cottonwood, IgE 6090-5
DF House Dust Mites/D.F., IgE 6095-4
DOGD Dog Dander, IgE 6098-8
DP House Dust Mites/D.P., IgE 6096-2
ELM Elm, IgE 6109-3
IGE Immunoglobulin E (IgE), S 19113-0
JOHN Johnson Grass, IgE 6152-3
MULB Mulberry, IgE 6281-0
OAK Oak, IgE 6189-5
PENL Penicillium, IgE 6212-5
RRRP Rough Pigweed, IgE 6233-1
SORR Red Sorrel, IgE 6244-8
SRW Short Ragweed, IgE 6085-5
TIMG Timothy Grass, IgE 6265-3
PCANH Pecan Hickory, IgE 6208-3

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports