A-Z of immunology tests

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Here is an A-Z list of immunology tests, together with a brief summary of the clinical applications of each. This is intended purely as a guide.

A

  • Acetyl Choline Receptor Antibodies – Myasthenia Gravis
  • Acute Leukaemia panel – CD2, CD10, CD13, CD14, CD19, CD33, CD34, CD79a, CD117, TdT, MPO
  • Adrenal antibody – The results are positive in 60-7-% of patients with idiopathic Addison’s disease. Antiadrenal antibodies are also present in 28% of patients with idiopathic hypothyroidism and 7% of patients with Hashimoto’s disease.
  • Allergy specific IgE (ImmunoCAP) – Measurement of allergens specific IgE is of value where skin testing is difficult for any reason. Over 100 specific allergens (request panel) are routinely available and can be viewed by selecting the link below. Any requests for allergens that are not on the list should be discussed with a clinician.
  • Amphiphysin
  • Anti-Basal Ganglia Abs (referred test)
  • Anti C1q (referred test)
  • Anti Myelin oligodendrocyte glycoprotein (MOG) Antibodies (referred test)
  • Anti-neutrophil cytoplasmic antibody (ANCA) – Anti-neutrophil cytoplasmic antibodies (ANCA) are found in several types of vasculitis. Samples for ANCA are initially tested by immunofluorescence on neutrophils. Positive samples are then further tested by Multiplex assay for specific antibodies to either proteinase 3 (PR3) or myeloperoxidase (MPO). In general, a classical cANCA pattern corresponds to PR3 reactivity whilst a perinuclear pANCA pattern corresponds to MPO reactivity. Atypical ANCA patterns do not usually correlate with either antigen. These tests are used to diagnose vasculitis and to monitor disease activity. Infections and autoimmunity can produce positive tests reducing the specificity of ANCA testing.
  • Antinuclear antibody (ANA), includes anticentromere – Indicated in the investigation of suspected “connective tissue disorders”. The absence of ANA almost excludes a diagnosis of SLE. Antinuclear antibodies are detected in other clinical conditions including: Sjögren’s syndrome, systemic sclerosis (CREST), chronic active hepatitis, fibrosing alveolitis, juvenile chronic arthritis and infections.
  • AP100 Alternative Pathway Haemolytic Complement
  • Aquaporin 4 (referred test)
  • Aspergillus fumigatus precipitins – These tests detect presence of IgG antibodies to Aspergillus fumigatus. Aspergillus precipitins. See also: – Farmer’s lung and Avian precipitins.
  • Avian precipitins – As for Aspergillus precipitins.

 

B

C

D

  • Double stranded DNA antibodies (IgG) – The presence of autoantibodies to double-stranded DNA is strongly suggestive of SLE although they are detected in 40-60% of patients with this disease.

 

E

  • EMA Binding Assay (HS Screen) – A flow cytometric method is used which is useful in the diagnosis of Hereditary Spherocytosis (HS).
  • ENA antibodies includes: Ro (SS-A 52, SSA-60), La (SS-B), Sm, Sm/RNP, RNP (RNP A, RNP 68), Ribo P, Chromatin and Jo-1, and Scl-70 – Antibodies to extractable nuclear antigens are of use in the classification of clinical subsets of connective tissue disorders and in providing prognostic information.

 

F

 

G

 

 

H

 

 

I

L

M

 

 

N

 

 

O

  • Ovary antibodies – Autoantibodies to the ovary may interfere with fertility by masking functional proteins on the cell surface of ovaries and interfering with intracellular protein functions.

 

 

P

 

 

R

 

 

S

  • Serum Free Light Chains
  • Serum Paraprotein identification/quantification – Additional information is provided under Serum Protein Electrophoresis and Bence Jones protein (urine immunofixation).
  • Serum Protein Electrophoresis – (see IgG, IgA, IgM electrophoresis)
  • Skin antibodies – Two types of skin autoantibodies that detect different skin components are recognised: Intercellular cement substance (Pemphigus antibodies). Basement membrane antibodies (Pemphigoid antibodies)
  • Smooth muscle mitochondrial antibodies – (Including liver kidney microsomal (LKM), gastric parietal cell (GPC) and ribosomal). Smooth muscle antibodies at a high titre are associated with chronic active hepatitis, and at low titres are more likely to be triggered by infection. Mitochondrial antibodies are associated with primary biliary cirrhosis.

 

 

T

 

 

V

 

 

(Last reviewed January 2020)