Immunodeficiency Evaluation
Clinical Significance:
Immunodeficiency states can be acquired or
congenital.
1.
The
pathogenesis of acquired immunodeficiency syndrome (AIDS) is largely due
to the decrease in number of T-cells that bear the CD4 receptor. Progressive depletion of CD4+ T-cells is
associated with increased likelihood of severe HIV disease and an unfavorable
prognosis. It has been recommended that
CD4+ T-cell levels be monitored every 3-6 months in all HIV infected
persons.
2.
Flow
cytometry can also be useful in the diagnosis of congenital immunodeficiency,
as many of these patients have decreased production of T-cells, B-cells and/or
NK cells, which are easily quantitated by flow cytometry.
3.
Chronic Lyme infections are known to suppress the immune
system and it typically impacts a specific subset of the natural killer cells,
the CD57 subset. When lyme disease is
active, the CD57 count is typically suppressed.
Who should be tested?
Patients with suspected acquired or
congenital immunodeficiency
Antibody Panels:
- Acquired
panel: CD45, CD3, CD4, CD8, CD4/CD8
ratio
- Congenital
panel: CD45, CD3, CD4, CD8, CD4/CD8
ratio, CD19, CD56
- Lyme
Disease panel: CD45, CD3, CD8, CD57
- Other
antibodies available per request
Specimens:
1-2 ml peripheral blood in EDTA (20°C)
Forms:
Dahl-Chase Flow Cytometry requisition form
along with demographic sheet
CBC results obtained from the same tube
Transport:
Specimens need to be delivered within 24
hours.
Flow Cytometry lab should be notified of
coming specimen (call 207-941-8282)
Uniship courier pick-up available.
CPT codes:
86360 for CD4/CD8 Count (Acquired
Immunodeficiency)
86355, 86357, 86359, 86360 for T, B, and NK
(Congenital Immunodeficiency)
86356, 86357, 86359 for Lyme Disease (CD57
evaluation)
Test performed:
Monday through Saturday
Test reported:
Faxed or mailed with 24 hours after sample is
received.
