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Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date (Each component may be ordered separately) (see Complement Components) 3-hydroxy-3-methyl-glutaryl-CoA reductase (see HMG-CoA Reductase (HMGCR) IgG Antibodies, ) Anti-HMG-CoA Reductase (HMGCR) (see Comprehensive Myositis Panel, Serum) Autoimmune Encephalitis Antibodies (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Basic Myositis Panel (see Comprehensive Myositis Panel, Serum) Other (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Paraneoplastic Antibodies (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) ACCP (see Anti Cyclic Citrullinated Peptide, Serum) ADNA (see Anti double stranded DNA, IgG) AGAD (see Anti Glutamic Acid Decarboxylase, Serum/CSF) AILD-relevant antinuclear antibodies (ANA2) (see Autoimmune Liver Disease (AILD) Profile) Alkaline Phosphatase Fractionation (see Alkaline Phosphatase Isoenzymes, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Alkaline Phosphatase Clinical Adult: Monday - Friday ALP Isoenzyme 2010-01-11 If alkaline phosphatase Isoenzymes, Serum Immunology 5 mL Gold top 0800-1600 Fraction isoenzymes are Alkaline Phosphatase Vacutainer tube Reference ordered and it has Fractionation Interval been ≤ 15 days since ALP Isoenzymes (U/L)AgeLiver the collection date of Pediatric: 1BoneLiver the last sample run, the 0-2 years: 0.5 2Intestinal≤14 test will be cancelled. mL Red or Gold days≤77≤248≤17 Please monitor using top Microtainer ≤3515 days-<1 the total alkaline 2-10 years: 3 year≤145≤469≤ phosphatase result. mL Red top 33≤661-<10 Vacutainer tube years≤104≤335≤ 1. The reference values 23≤4710-<13 of the individual Light Green (Li- years≤129≤417≤ isoenzymes vary with Heparin) or 29≤58 age, sex, hormonal Lavender Male 13-<15 state (pregnancy, (EDTA) top years≤145≤468≤ menopause, puberty) tubes are NOT 33≤66Male 15- and medications. acceptable <17 years≤103≤ GENERAL 331≤23≤46Male 2. In children, ALP is LABORATORY 17-<19 years≤46 increased due to REQUISITION ≤149≤10≤ predominant bone 21Male ≥19 isoenzymes. years≤92≤97≤12 ≤18Female 13- 3. Intestinal <15 years≤79≤ isoenzymes are absent 254≤18≤36 in about 60% of normal Female 15-<17 subjects years≤36≤117≤8 ≤16Fema (more...) 4. Our method (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date ALP Isoenzymes (see Alkaline Phosphatase Isoenzymes, Serum) Alpha 1-Antitrypsin, Clinical Adult: Monday-Friday 0.90-2.00 g/L 2010-01-11 Serum/Plasma Immunology 5 mL Gold top 0800-1600 Alpha Protease Vacutainer tube Patients with Inhibitor homozygous deficiency of alpha 1-antitrypsin Pediatric: usually have levels less 0-2 years: 0.5 than 0.6 g/L. mL Red or Gold top Microtainer Levels rise in acute 2-10 years: 3 phase reaction. mL Red top Vacutainer tube

Light Green (Li- Heparin) or Lavender (EDTA) top tubes are also acceptable GENERAL LABORATORY REQUISITION Alpha Protease Inhibitor (see Alpha 1-Antitrypsin, Serum/Plasma) ANA (see Anti Nuclear Antibody) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date ANCA Clinical 5 mL Gold top Wednesday and Negative: ≤19 2010-12-09 A single P-ANCA / Anti-MPO Immunology Vacutainer tube Friday RU/mL test is not diagnostic (anti-myeloperoxidase or 6 mL Red top and should not be used antibody) EDTA, heparin For STAT to determine course of C-ANCA / Anti-PR3 or citrate samples: treatment. The test (anti-proteinase plasma tube Availability of result must be antibody) STAT testing is evaluated with Pediatric: 07:00-15:00 consideration of clinical 0-2 years: Red Monday to presentation, patient 1.0 pk. Friday. Saturday, history and other 2-10 years: 2 Sunday & laboratory tests. mL Red top holiday requests GENERAL will be processed Interpretive Comments: LABORATORY the next cANCA and pANCA REQUISITION business day. are two fluorescence STAT testing patterns that are must be pre- associated with a arranged with the number of antibodies. Immunology Lab Our current by calling methodology of ELISA x35541. See detects anti MPO (a Critical major antibody for Information pANCA) and anti PR3 Required section (a major antibody for prior to calling. cANCA) only.

ANCA testing is mainly indicated in patients with a tentative or a definite diagn (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date ANNA-3 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti AQP4 antibody (see Neuromyelitis Spectrum Profile) Anti CENP A (see Systemic Sclerosis Profile) Anti CENP B (see Systemic Sclerosis Profile) Anti Cyclic Citrullinated Peptide (see Anti Cyclic Citrullinated Peptide, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Cyclic Clinical 5 mL Gold top Batch Analysis Negative ≤ 5 2010-01-11 Anti-CCP antibodies Citrullinated Peptide, Immunology Vacutainer tube RU/mL are potentially Serum or 6 mL Red top important surrogate ACCP EDTA, heparin markers for diagnosis Anti Cyclic or citrated and prognosis in Citrullinated Peptide plasma tube rheumatoid arthritis (RA) because they: Pediatric: 0-2 yrs: Red - are as sensitive as, 0.5pk. and more specific than, 2-10 yrs: 2 mL IgM Rheumatoid Factor Red top (RF) in early and fully GENERAL established disease LABORATORY - may predict the REQUISITION eventual development into RA when found in undifferentiated arthritis - may be detected in healthy individuals years before onset of clinical RA

Reports above the top standard are reported as ">200" RU/mL Anti DNA (see Anti double stranded DNA, IgG) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti double stranded Clinical 5 mL Gold top Weekdays Negative: ≤ 99 2009-10-26 DNA, IgG Immunology Vacutainer tube IU/ml Anti DNA or 6 mL Red top Positive: >99 Anti native DNA Vacutainer tube IU/ml IgG Antibodies to as well as double stranded DNA EDTA, heparin ADNA or citrated Anti dsDNA plasma

Pediatric: 0-2 years: Red 0.5 pk. 2-10 years: 2 mL Red top GENERAL LABORATORY REQUISITION Anti dsDNA (see Anti double stranded DNA, IgG) Anti EJ (see Myositis Antibodies Profile) Anti ENA Clinical 2010-01-11 Identification, Serum-- Immunology SEE ANA Anti Fibrillarin (see Systemic Sclerosis Profile) Anti GAD (see Anti Glutamic Acid Decarboxylase, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Gangliosides Clinical Adult: Batch analysis Negative 2019-11-27 Immunoblot results will Profile IgG and IgM, Immunology 6 mL Red top be reported as either Serum Vacutainer tube negative or positive for Anti GM1 IgG specific antibodies as Anti GM2 IgG Pediatric: the following: Anti GM3 IgG 0-2 years: Red Anti GD1a IgG 0.5 mL 1+ Weak Positive Anti GD1b IgG Microtainer 2+ Positive Anti GT1b IgG 2-10 years: 3 3+ Strong Positive Anti GQ1b IgG mL Red top Anti GM1 IgM tube Anti GM2 IgM Antibodies AgainstIg Anti GM3 IgM EDTA, Heparin ClassAssociated Anti GD1a IgM or Citrate NeuropathiesGM1, Anti GD1b IgM plasma are also GD1a, GD1b and Anti GT1b IgM acceptable GT1bIgMMultifocal Anti GQ1b IgM GENERAL motor neuropathy LABORATORY (MMN)GM2 and REQUISITION GM3IgM, IgGMultifocal motor neuropathy (MMN)GM3, GD1a and GT1bIgMGuillain-Barre syndrome (GBS)GM1, GM2, GD1b and GQ1bIgM, IgGGuillain- Barre syndrome (GBS)GM2, GD1a and GD1bIgMChronic inflammatory demyelinating (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti GBM (see Anti Glomerular Basement Membrane, Serum) Anti GD1a IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GD1a IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GD1b IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GD1b IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Glomerular Clinical 5 mL Gold top Routine: Negative: ≤19 2010-01-11 A single autoantibody Basement Membrane, Immunology Vacutainer tube Wednesdays and RU/mL test is not diagnostic Serum or 6 mL Red top Fridays and should not be used Anti GBM Vacutainer to determine course of Glomerular Basement tube. EDTA, For STAT treatment. The test Membrane, IgG heparin or samples: result must be antibody citrated plasma Availability of evaluated with are also STAT testing is consideration of clinical acceptable. 0700-1500 hrs, presentation, patient seven days a history and other Pediatric: week. ** Sample laboratory tests. 0-2 years: Red must be in 0.5 pk. Immunology by For the detection of IgG 2-10 years: 2 noon to insure class antibodies to NC1 mL Red top testing is domain of Type 4 GENERAL completed by collagen found in LABORATORY 15:00** STAT glomerular basement REQUISITION testing must be membrane. Increases pre-arranged may occur in with the Goodpasture's Immunology Lab Syndrome. by calling ext. 35541. See "Critical Information Required" section prior to calling. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Glutamic Acid Clinical Adult: Batch analysis <5.0 IU/mL 2010-06-01 Decarboxylase, Immunology 5 mL Gold top Serum/CSF Vacutainer tube AGAD or 6 mL Red top Anti-GAD65 Vacutainer tube Anti GAD Glutamic Acid Decarboxylase-65 Pediatric: Antibodies 0-2 years: 0.5 mL Red top Microtainer 2-10 years: 2 mL Red top Vacutainer tube

CSF collected in a standard CSF tube. GENERAL LABORATORY REQUISITION Anti GM1 IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GM1 IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti GM1, IgM serum Clinical 6 mL Red top Batch Analysis Ratio 2010-12-14 IgM antibodies to Immunology Vacutainer tube %NegativeLess Ganglioside than or equal to Monosialic Acid Pediatric: 29Borderline IgM antibodies to 0-2 yrs: Red 1.0 Positive30-50 AGM1 pk. Positive>50- 2-10 yrs: 2 mL 100Strong Red top Positive>100 GENERAL LABORATORY Borderline REQUISITION positive result should be retested after a subsequent blood draw. Anti GM2 IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GM2 IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GM3 IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GM3 IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GQ1b IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GQ1b IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GT1b IgG (see Anti Gangliosides Profile IgG and IgM, Serum) Anti GT1b IgM (see Anti Gangliosides Profile IgG and IgM, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Histone Clinical 5 mL Gold top Batch Analysis Negative: ≤ 0.9 2010-04-07 A single autoantibody Group,Serum Immunology Vacutainer tube Positive: > 0.9 test is not diagnostic Anti-Histones or 6 mL Red top and should not be used HIST Vacutainer tube to determine course of as well as treatment. The test EDTA, heparin result must be or citrate evaluated with plasma consideration of clinical presentation, patient Pediatric: history and other 0-2 yrs: Red 1.0 laboratory tests. pk. 2-10 yrs: 2 mL Histone antibodies are Red top the major antibodies GENERAL found in 50-90% drug- LABORATORY induced lupus REQUISITION erythematosus. As well, histone antibodies are found along with other antibodies in 20- 50% of Systemic Lupus Erythematosus and 10- 15% of Rheumatoid Arthritis, Mixed Connective Tissue Disease and Progressive Scleroderma.

This test does (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti JO1 (see Myositis Antibodies Profile) Anti Ku (see Myositis Antibodies Profile, Systemic Sclerosis Profile) Anti Liver/Kidney Microsome Antibody (Anti LKM) (see Autoimmune Liver Disease (AILD) Profile) Anti MAG, Serum (see Myelin-Associated Glycoprotein IgM, Serum) Anti MDA5 (see Myositis Antibodies Profile) Anti Mi-2 alpha (see Myositis Antibodies Profile) Anti Mi-2 beta (see Myositis Antibodies Profile) Anti Mitochondrial Antibody (AMA) (see Autoimmune Liver Disease (AILD) Profile) Anti MOG antibody (see Neuromyelitis Spectrum Profile) Anti Myelin Oligodendrocyte Glycoprotein and Anti Aquaporin4, IgG (see Neuromyelitis Spectrum Profile) Anti Myelin-Associated Glycoprotein IgM (see Myelin-Associated Glycoprotein IgM, Serum) Anti native DNA (see Anti double stranded DNA, IgG) Anti NMO antibody (see Neuromyelitis Spectrum Profile) Anti NOR90 (see Systemic Sclerosis Profile) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti Nuclear Antibody Clinical Serum Batch Analysis Negative <1:80 2010-01-11 ANA should not be ANA Immunology (preferred) used to monitor from a 5 mL disease activity. Gold top Positive ANA other Vacutainer tube than anti-dsDNA or 6 mL Red top should not be repeated. Vacutainer tube If ANA was tested positive previously, Pediatric: repeat testing will not 0-2 years: Red be processed. 0.5pk. 2-10 years: 2 Anti-dsDNA may mL Red top correlate with disease activity and positive EDTA, heparin results can be repeated or citrated 1-3 months for active plasma will also disease and 6-12 be accepted. months for less active Other fluids will disease. Repeat testing not be for Anti-dsDNA within 1 accepted. month will not be GENERAL processed. LABORATORY REQUISITION If ANA is negative or borderline positive (1:80), repeat testing is allowed only if the patient has developed new symptoms of SARD and the (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti NXP2 (see Myositis Antibodies Profile) Anti OJ (see Myositis Antibodies Profile) Anti PDGFR (see Systemic Sclerosis Profile) Anti PL-12 (see Myositis Antibodies Profile) Anti PL-7 (see Myositis Antibodies Profile) Anti PM-Scl 100 (see Myositis Antibodies Profile) Anti PM-Scl 75 (see Myositis Antibodies Profile) Anti PM-Scl100 (see Systemic Sclerosis Profile) Anti PM-Scl75 (see Systemic Sclerosis Profile) Anti Ro-52 (see Myositis Antibodies Profile, Systemic Sclerosis Profile) Anti RP11 (see Systemic Sclerosis Profile) Anti RP155 (see Systemic Sclerosis Profile) Anti SAE1 (see Myositis Antibodies Profile) Anti Scl-70 (see Systemic Sclerosis Profile) Anti Smooth Muscle Antibody (ASMA) (see Autoimmune Liver Disease (AILD) Profile) Anti SRP (see Myositis Antibodies Profile) Anti Th/To (see Systemic Sclerosis Profile) Anti TIF1 gamma (see Myositis Antibodies Profile) Anti-AMPAR1/R2 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-Amphiphysin (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-AP3B2 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti-CASPR2 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-cN1A (see Comprehensive Myositis Panel, Serum) Anti-CV2 (CRMP5) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-DPPX (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-EJ (see Comprehensive Myositis Panel, Serum) Anti-GABARB1/B2 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-GAD65 (see Anti Glutamic Acid Decarboxylase, Serum/CSF, Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-GFAP (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-GRAF (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-Histones (see Anti Histone Group,Serum) Anti-HMGCR antibodies (see HMG-CoA Reductase (HMGCR) IgG Antibodies, Serum) Anti-Hu (ANNA-1) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti-IgLON5 Antibody, Clinical Adult: Batch analysis Negative 2019-02-26 This test is available to Serum/CSF Immunology 5 mL Gold or 6 neurologists at mL Red top LHSC/SJHC and Vacutainer tube accepted from referred in locations. EDTA, heparin A single autoantibody or citrated test is not diagnostic plasma are also and should not be used acceptable. to determine course of treatment. Pediatric: The test result must be 0-2 years: 0.5 evaluated with mL Red consideration of clinical Microtainer presentation, patient 2-10 years: 2 history and other mL Red top laboratory tests. Vacutainer tube

CSF: Suggest Associated disease: CSF be parasomnia, tauopathy submitted with serum for testing. CLINICAL IMMUNOLOGY REQUISITION Anti-ITPR1 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-JO1 (see Comprehensive Myositis Panel, Serum) Anti-KLHL11 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti-Ku (see Comprehensive Myositis Panel, Serum) Anti-LGI1 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-Ma2/Ta (see Paraneoplastic Antibody Panel, Serum/CSF) Anti-Ma2/Ta (PNMA2) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-MAG, IgM (see Myelin-Associated Glycoprotein IgM, Serum) Anti-MDA5 (see Comprehensive Myositis Panel, Serum) Anti-mGluR1 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-Mi-2 alpha (see Comprehensive Myositis Panel, Serum) Anti-Mi-2 beta (see Comprehensive Myositis Panel, Serum) Anti-Neurochondrin (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-NIF (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-NMDAR (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-NXP2 (see Comprehensive Myositis Panel, Serum) Anti-OJ (see Comprehensive Myositis Panel, Serum) Anti-PDE10A (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) Anti-PL-12 (see Comprehensive Myositis Panel, Serum) Anti-PL-7 (see Comprehensive Myositis Panel, Serum) Anti-PM-Scl 100 (see Comprehensive Myositis Panel, Serum) Anti-PM-Scl 75 (see Comprehensive Myositis Panel, Serum) Anti-Recoverin (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-Ri (ANNA-2) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Anti-Ro-52 (see Comprehensive Myositis Panel, Serum) Anti-SAE1 (see Comprehensive Myositis Panel, Serum) Anti-SOX1 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-SRP (see Comprehensive Myositis Panel, Serum) Anti-TIF1 gamma (see Comprehensive Myositis Panel, Serum) Anti-Titin (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-Tr (DNER) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-Yo (PCA-1) (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Anti-Zic4 (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Paraneoplastic Antibody Panel, Serum/CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Autoimmune Liver Clinical Serum Batch Analysis Negative 2018-06-11 ANA2 will only screen Disease (AILD) Profile Immunology (preferred) from and report for AILD- Anti Mitochondrial a 5 mL Gold top related ANA patterns Antibody (AMA) Vacutainer tube (Multiple Nuclear Dot, Anti Smooth Muscle or 6 mL Red top Nuclear Membrane and Antibody (ASMA) Vacutainer tube F-Actin). Anti Liver/Kidney Microsome Antibody Pediatric: To screen for other (Anti LKM) 0-2 years: Red ANA patterns, the AILD-relevant 0.5 Microtainer regular ANA is tested antinuclear antibodies tube together with AILDP (ANA2) 2-10 years: 2 testing initially. mL Red top tube Repeat testing: For EDTA, heparin adults ANA repeat or citrated testing will not be done; plasma will also AILDP can be repeated be accepted. every 6 months. For Other fluids will children AILDP/ANA not be testing can be repeated accepted. every 3 months. GENERAL LABORATORY REQUISITION The following IFA patterns are reported: AMA ASMA Anti LKM Multiple Nuclear dots Nuclear membrane (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Autoimmune Myositis Panel (see Myositis Antibodies Profile)

B2 (see Beta2 Microglobulin, Urine, Beta2Microglobulin, Plasma) Bence Jones (see Immunofixation Electrophoresis, Urine) Bence Jones Protein Screen (see Protein Electrophoresis, Urine) Beta 2 (see Beta-2 Transferrin) Beta Transferrin (see Beta-2 Transferrin) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Beta-2 Transferrin Clinical Collect 500 L Monday - Friday Negative 2012-04-12 Based on consultation Beta-2 Transferrin Immunology nasal or ear 0800-1600 with Dr. Rotenberg, it Beta 2 Transferrin fluid into a has been decided to Beta Transferrin clean limit the collection CSF Specific specimen frequency to ≥ 4 weeks Transferrin container. for repeat testing. If Tau Protein Also need to beta-2 transferrin collect blood testing is ordered and it as follows: has been ≤ 30 days since the collection Adult: 5 mL date of the last sample Gold top run, the test will be Vacutainer tube cancelled.

Both fluid and serum Pediatric: are required for 0-2 years: 0.5 testing. Failure to mL Red or Gold collect a serum top Microtainer specimen may result 2-10 years: 3 in an inconclusive mL Red top result. Vacutainer tube

Light Green (Li- Heparin) or Lavender (EDTA) top tubes are NOT acceptable GENE (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date

Beta2 Microglobulin, Clinical Random urine Monday - Friday B2MU: 35-202 2010-02-03 Beta2 microglobulin is Urine Immunology GENERAL 0800-1600 g/L unstable in acidic urine. B2 Microglobulin LABORATORY B2MU/creatinine REQUISITION ratio: 0-23 B2MU is increased in g/mmol proximal tube dysfunction and some forms of cancer.

Testing includes urine creatinine.

Prepare an aliquot of the urine and freeze immediately. C-ANCA / Anti-PR3 (anti-proteinase antibody) (see ANCA) C1 complement component group test (see C1qrs, Serum) C1 Esterase Inhibitor (see C1 Inhibitor Protein, Serum/Plasma) C1 Inactivator (see C1 Inhibitor Protein, Serum/Plasma) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C1 Inhibitor Protein, Clinical Adult: Monday Friday 0.21 - 0.38 g/L 2010-03-12 This is a quantitative Serum/Plasma Immunology 5 mL Gold top 0800-1600 assay; it does not C1 Esterase Inhibitor Vacutainer tube assess the function of C1 Inactivator C1 inhibitor. Pediatric: 0-2 years: 0.5 C1 inhibitor protein is mL Red or Gold decreased in hereditary top Microtainer angioneurotic edema, a 2-10 years: 3 genetic disease mL Red top characterized by acute Vacutainer tube edema of subcutaneous tissue, Light Green (Li- the GI tract, or the Heparin) or upper respiratory tract. Lavender (EDTA) top tubes are also acceptable GENERAL LABORATORY REQUISITION C1q (see C1qrs, Serum) C1qrs components (see C1qrs, Serum) C1qrs levels (see C1qrs, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C1qrs, Serum Clinical Both plasma Referred out C1q level: 83- 2010-01-11 This test is available C1qrs components Immunology and serum are monthly. 125 mg/L exclusively to C1q required Total C1r level: 61-162 SJHC/LHSC C1r 5 mL Gold top complement % of STD physicians. C1s Vacutainer tube CH50 is C1s level: 59- C1 complement or 6 mL Red top performed as a 297 % of STD C1QRS is a group test component group test Vacutainer tube screen to that includes C1q, C1r, C1qrs levels and a 5 mL determine if the and C1s. Lavender top component Also order TCOM (EDTA plasma) assay is (CH50). required. Pediatric: Total complement is 0-2 yrs: Red assayed first to 0.5pk. and determine if the Purple 0.5pk components evaluation 2-10 yrs: 2 mL is necessary. If the total Red and Purple complement is within top the normal range, the GENERAL component(s) is LABORATORY resulted as "not REQUISITION indicated".

The group test C1qrs includes C1q, C1r, C1s protein quantitation. It does not evaluate function.

This test does NOT include C1 est (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C1r (see C1qrs, Serum) C1s (see C1qrs, Serum) C2,Serum Clinical 6 mL Red top Batch analysis 14 33 mg/L; no 2010-01-11 Complement C2 Immunology Vacutainer tube pediatric range quantitation or 5 mL Gold top Vacutainer tube

Pediatric: 0-2 yrs: Gold 0.5pk. 2-10 yrs: 2 mL Gold top GENERAL LABORATORY REQUISITION Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C3 Nephritic Factor Clinical 6 mL Red top Referred out Normal Ratio 2010-01-11 This test is available C3NF Immunology Vacutainer monthly 0.00 to 0.26 exclusively to tube. Gel Equivocal Ratio SJHC/LHSC barrier tubes 0.27 to 0.33 physicians. are not Positive Ratio acceptable. greater than or C3 Nephritic Factor is equal to 0.34 an autoantibody that Pediatric: binds to the alternative 0-2 yrs: Red pathway C3 convertase 0.5pk. and prolongs its activity 2-10 yrs: 2 mL in vivo. Red top Allow the filled red top GENERAL tube to clot at 22-37oC LABORATORY for 30-60 minutes. REQUISITION Centrifuge at room temperature. Aliquot into 2 storage tubes and freeze as soon as possible. Store at - 20oC (preferably - 70oC). C3NF (see C3 Nephritic Factor) C5 complement component level (see C5, Serum) C5 Level (see C5, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C5, Serum Clinical 5 mL Gold top Referred out 55-113 mg/L 2010-01-11 This test is available C5 complement Immunology Vacutainer tube monthly. exclusively to component level or 6 mL Red top Total SJHC/LHSC C5 Level Vacutainer tube complement physicians. C5L and a 5 mL CH50 is Lavender top performed as a Total complement is (EDTA plasma) screen to assayed first to determine the determine if the Pediatric: component components evaluation 0-2 yrs: Red assay is is necessary. Only if 0.5pk. and required. the total complement is Purple 0.5 pk. less than the lower limit 2-10 yrs: 2 mL of normal will the Red and Purple complement top component be GENERAL processed. Otherwise LABORATORY the component(s) is REQUISITION cancelled with the Comment: "Test not indicated."

Also included in group test CCOMPG (includes, C1qrs, C5, C6, C7, C8, C9).

Total complement (TCOM, CH50) is a screen for cla (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C5L (see C5, Serum) C6 complement component level (see C6, Serum) C6 Level (see C6, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C6, Serum Clinical 5 mL Gold top Referred out 28-69 mg/L 2010-01-11 This test is available C6 complement Immunology Vacutainer tube monthly. exclusively to component level or 6 mL Red top Total SJHC/LHSC C6 Level Vacutainer tube complement physicians. C6L and a 5 mL CH50 is Lavender top performed as a Total complement is (EDTA plasma) screen to assayed first to determine if the determine if the Pediatric: component components evaluation 0-2 yrs: Red assay is is necessary. Only if 0.5pk. and required. the total complement is Purple 0.5 pk. less than the lower limit 2-10 yrs: 2 mL of normal will the Red and Purple complement top component be GENERAL processed. Otherwise LABORATORY the component(s) is REQUISITION cancelled with the Comment: "Test not indicated."

Also included in group test CCOMPG (includes, C1qrs, C5, C6, C7, C8, C9).

Total complement (TCOM, CH50) is a screen for classical pathway function. (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C6L (see C6, Serum) C7 complement component level (see C7,Serum) C7 Level (see C7,Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C7,Serum Clinical 5 mL Gold top Referred out 35.3-96.5 mg/L 2010-01-11 This test is available C7 complement Immunology Vacutainer tube monthly. exclusively to component level or 6 mL Red top Total SJHC/LHSC C7 Level Vacutainer tube complement physicians. C7L and a 5 mL CH50 is Lavender top performed as a Total complement is (EDTA plasma) screen to assayed first to determine the determine if the Pediatric: component components evaluation 0-2 yrs: Red assay is is necessary. Only if 0.5pk. and required. the total complement is Purple 0.5 pk. less than the lower limit 2-10 yrs: 2 mL of normal will the Red and Purple complement top component be GENERAL processed. Otherwise LABORATORY the component(s) is REQUISITION cancelled with the Comment: "Test not indicated."

Also included in group test CCOMPG (includes, C1qrs, C5, C6, C7, C8, C9).

Total complement (TCOM, CH50) is a screen for classical pathway function. (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C7L (see C7,Serum) C8 complement component level (see C8, Serum) C8 Level (see C8, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C8, Serum Clinical 5 mL Gold top Referred out 49-106 mg/L 2010-01-11 This test is available C8 complement Immunology Vacutainer tube monthly. exclusively to component level or 6 mL Red top Total SJHC/LHSC C8 Level Vacutainer tube complement physicians. C8L and a 5 mL CH50 is Lavender top performed as a Total complement is (EDTA plasma) screen to assayed first to determine the determine if the Pediatric: component components evaluation 0-2 yrs: Red assay is is necessary. Only if 0.5pk. and required. the total complement is Purple 0.5 pk. less than the lower limit 2-10 yrs: 2 mL of normal will the Red and Purple complement top component be GENERAL processed. Otherwise LABORATORY the component(s) is REQUISITION cancelled with the Comment: "Test not indicated."

Also included in group test CCOMPG (includes, C1qrs, C5, C6, C7, C8, C9).

Total complement (TCOM, CH50) is a screen for cla (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C8L (see C8, Serum) C9 complement component level (see C9, Serum) C9 Level (see C9, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C9, Serum Clinical 5 mL Gold top Referred out 33-95 mg/L 2010-01-11 This test is available C9 complement Immunology Vacutainer tube monthly. exclusively to component level or 6 mL Red top Total SJHC/LHSC C9 Level Vacutainer tube complement physicians. C9L and a 5 mL CH50 is Lavender top performed as a Total complement is (EDTA plasma) screen to assayed first to determine the determine if the Pediatric: component components evaluation 0-2 yrs: Red assay is is necessary. Only if 0.5pk. and required. the total complement is Purple 0.5 pk. less than the lower limit 2-10 yrs: 2 mL of normal will the Red and Purple complement top component be GENERAL processed. Otherwise LABORATORY the component(s) is REQUISITION cancelled with the Comment: "Test not indicated."

Also included in group test CCOMPG (includes, C1qrs, C5, C6, C7, C8, C9).

Total complement (TCOM, CH50) is a screen for cla (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date C9L (see C9, Serum) CCOMPG (see Complement Components) CH50 (see Complement Total, Serum) CIC (see Immune Complexes) Circulating immune complexes (see Immune Complexes) Complement C2 quantitation (see C2,Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Complement Clinical Age 10-Adult: Referred out 2010-01-11 This test is available Components Immunology 6 mL Red top monthly. C1q 83 to 125 exclusively to CCOMPG Vacutainer tube Total mg/L SJHC/LHSC Complement and 5 mL complement C1r 61 to 162 physicians. components group Lavender top (K CH50 is % of standard test: C1qrs, C5, C6, 3EDTA) tube performed as a C1s 59 to 297 CCOMPG is a group C7, C8, C9 Require 2 x 1 screen to % of standard test that includes (Each component mL aliquots determine the C5 55 to 113 C1qrs, C5, C6, C7, C8, may be ordered each of serum component mg/L C9. The components separately) and plasma for assay is C6 28 to 69 can be ordered send out required. mg/L individually. C7 35.3 to Pediatric: 96.5 mg/L Total complement is 0-2 yrs: 2 x 0.5 C8 49 to 106 assayed first to Red micropick mg/L determine if the and 2 x 0.5 C9 33 to 95 components evaluation Lavender mg/L is necessary. Only if micropick the total complement is Require 2 x 0.5 less than the lower limit mL aliquots of normal will the each of serum complement and plasma for component be send out processed. Otherwise the component(s) is 2-10 yrs: 2 x 4 cancelled with the mL Red top and Comment: "Test not 2 x 4 mL indicated." Lavender top Require 2 x 1 mL ali (more...) Group test tha (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Complement components group test: C1qrs, C5, C6, C7, C8, C9 (see Complement Components) Complement Total, Clinical Adult: Batch analysis 42 95 U/mL 2010-01-11 Serum Immunology 5 mL Gold top CH50 Vacutainer tube TCOM Total Complement Pediatric: Function Assay 0-2 years: 2 x 0.5 mL Red or Gold top Microtainer 2-10 years: 3 mL Red top Vacutainer tube

Light Green (Li- Heparin) or Lavender (EDTA) top tubes are NOT acceptable GENERAL LABORATORY REQUISITION Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Comprehensive Clinical Adult: Batch analysis Negative 2019-02-26 This test is available to Autoimmune Immunology 5 mL Gold or 6 neurologists at Encephalitis Panel, mL Red top LHSC/SJHC and Serum/CSF Vacutainer tube accepted from referred Panel includes: in locations. Autoimmune Pediatric: A single autoantibody Encephalitis 0-2 years: 0.5 test is not diagnostic Antibodies mL Red and should not be used Anti-NMDAR Microtainer to determine course of Anti-LGI1 2-10 years: 2 treatment. Anti-CASPR2 mL Red top The test result must be Anti-AMPAR1/R2 Vacutainer tube evaluated with Anti-GABARB1/B2 consideration of clinical Anti-DPPX CSF sample: presentation, patient Suggest CSF history and other be submitted laboratory tests. Paraneoplastic with serum for Antibodies testing. Anti-Hu (ANNA-1) CLINICAL Antibodies against Anti-Ri (ANNA-2) IMMUNOLOGY Associated Anti-Yo (PCA-1) REQUISITION Neurological Anti-Amphiphysin DisordersFrequently Anti-CV2 (CRMP5) Associated Tumors Anti-Ma2/Ta (PNMA2) NMDARAnti-NMDAR Anti-Tr (DNER) encephalitisOvarian Anti-Zic4 teratoma, testicular Anti-Recoverin teratomaLGI1Limbic Anti-Titin encephalitisThyroid Anti-SOX1 carcinoma, small cell (more...) lung cancer, ki (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Comprehensive Clinical Adult: Batch analysis Antibodies by 2021-07-28 Accepted from referred Myositis Panel, Serum Immunology 5 mL Gold top immunoblot in locations. Panel includes: Vacutainer tube Negative or 6 mL Red top Immunoblot results will Basic Myositis Panel Vacutainer tube Anti-HMGCR by be reported as either Anti-Mi-2 alpha as well as ELISA negative or positive for Anti-Mi-2 beta EDTA, heparin Negative: <20 U specific antibodies as Anti-TIF1 gamma or citrate Positive: ≥20 U the following. Anti-MDA5 plasma 1+ Weak Positive Anti-NXP2 2+ Positive Anti-SAE1 Pediatric: 3+ Strong Positive Anti-Ku 0-2 years: 0.5 Anti-PM-Scl 100 mL Red top Anti-PM-Scl 75 Microtainer Anti-JO1 2-10 years: 2 Anti-PL-7 mL Red top Anti-PL-12 tube Anti-EJ CLINICAL Anti-OJ IMMUNOLOGY Anti-Ro-52 REQUISITION Anti-cN1A Anti-SRP

Anti-HMG-CoA Reductase (HMGCR) Cryofibrinogen, Plasma (see Cryoglobulin Serum and Cryofibrinogen Plasma Panel) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Cryoglobulin Serum Clinical 3 x 6 mL Red Monday- Negative 2020-10-28 Immunofixation for and Cryofibrinogen Immunology Top Vacutainer Thursday. No identification of Plasma Panel tubes STAT holidays. cryoprecipitate will only Cryoglobulin, Serum be performed on new Cryofibrinogen, 2 x 4 mL cryoglobulin and Plasma Lavender Top cryofibrinogen positive Vacutainer samples, once per tubes patient.

1 x 4.5 ml The final report for Green Top positive cryoglobulins Vacutainer tube will include: (Note: this 1)Cryoglobulin type: tube does not Type I - Monoclonal need to be immunoglobulins. May placed in be associated with thermos) Waldenstrms GENERAL macroglobulinemia, LABORATORY , REQUISITION monoclonal gammopathy of undetermined significance, and other lymphoproliferative diseases. Type II - A mixture of immunoglobulins (usually monoclonal IgM kappa rheumatoid factor comple (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Cryoglobulin, Serum (see Cryoglobulin Serum and Cryofibrinogen Plasma Panel) CSF Specific Transferrin (see Beta-2 Transferrin) Ferritin Level (see Hemoglobinopathy Screen) Free Kappa Light Chains (see Free Light Chains, Serum/Plasma) Free Lambda Light Chains (see Free Light Chains, Serum/Plasma) Free Light Chains, Clinical Adult: Monday - Friday Free Kappa 2009-02-13 Note: Serial free light Serum/Plasma Immunology 5 mL Gold top 0800-1600 Chains: 3.3-19.4 chain analysis should Free Kappa Light Vacutainer tube mg/L only be performed for Chains Free Lambda patients with AL Free Lambda Light Red, Light Chains: 5.7-26.3 amyloidosis, light chain Chains Green (Li- mg/L myeloma, or non- Serum Free Light Heparin), or Kappa:Lambda secretory myeloma. If Chains Lavender ratio: 0.26-1.65 free light chain testing (EDTA) top Adjusted is ordered and it has tubes are also Kappa:Lambda been <20 days since acceptable ratio for chronic the collection date of GENERAL kidney disease: the last sample run, the LABORATORY 0.37-3.10 test will be cancelled. REQUISITION A persistent and aberrant Kappa:Lambda ratio supports a diagnosis of monoclonal gammopathy. GALACTOM (Serum) (see Galactomannan Aspergillus , Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Galactomannan Clinical Bronchoalveola Batched twice Index: <0.5 Non- 2013-11-25 Test limited to Aspergillus Antigen, Immunology r lavage (BAL) weekly Reactive Infectious disease, Fluid fluid Monday/Tuesday Hematologists, GALTCTOMF ( BAL GENERAL and Respirologists and Fluid) LABORATORY Wednesday/Thur Microbiologists REQUISITION sdays routinely NOTE: Outside clients Note: must have pre- Samples to be in authorization by the lab no later than LHSC microbiologist noon Monday before sending. and Wednesday to be pretreated Piperacillin/Tazobacta for set up the m have been following day. associated with false positive results, if deemed a false positive result please contact the microbiologist.

Refer to template associated with the report. Send samples directly to the lab unopened. It is imperative that samples have minimal exposure to air before testing. Store at 2oC- 8oC after hours. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Galactomannan Clinical 5 mL Gold top Batched twice Index: <0.5 Non- 2013-11-25 Test limited to Aspergillus Antigen, Immunology Vacutainer tube weekly Reactive Infectious disease, Serum GENERAL Monday/Tuesday Hematologists, GALACTOM (Serum) LABORATORY and Respirologists, REQUISITION Wednesday/Thur Microbiologists sdays routinely NOTE: NOTE: Outside clients Samples to be in must have pre- lab no later than authorization by the noonMonday and LHSC microbiologist Wednesday. before sending.

Piperacillin/Tazobacta m have been associated with false positive results, if deemed a false positive result please contact the microbiologist.

Refer to template associated with the report. Send samples to the lab unopened. It is imperative that samples have minimal exposure to air before testing. Store (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date GALTCTOMF ( BAL Fluid) (see Galactomannan Aspergillus Antigen, Fluid) Glomerular Basement Membrane, IgG antibody (see Anti Glomerular Basement Membrane, Serum) Glutamic Acid Decarboxylase-65 Antibodies (see Anti Glutamic Acid Decarboxylase, Serum/CSF)

Hemoglobin A2 (see Hemoglobinopathy Screen) Hemoglobin Electrophoresis (see Hemoglobinopathy Screen) Hemoglobin F (Fetal) (see Hemoglobinopathy Screen) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Hemoglobin Gene Clinical Peripheral Weekly N/A 2019-07-11 Sequencing Immunology Blood HGS 4 mL K2 or K3 EDTA Lavender top Vacutainer tube 5 mL Red top Vacutainer tube

Pediatric: 0-2 years: Lavender 1.0 pk., Red 0.5 pk 2-10 years: 2 mL Lavender top, 2 mL Red Hamilton Molecular Diagnostic Genetics Requisition Hemoglobin H (see Hemoglobinopathy Screen) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Hemoglobinopathy Clinical Peripheral Bi-weekly Hb A: 2008-05-27 Screen Immunology Blood Newborn-1 Hemoglobin F (Fetal) month: <=10.0 Hemoglobin A2 4 mL K2 or K3 1-3 months: Hemoglobin EDTA Lavender 21.1-56.6 Electrophoresis top Vacutainer 3-6 months: Hemoglobin H tube 50.7-85.6 Ferritin Level 5 mL Red top 6-7 months: Vacutainer tube 83.5-96.8 >7 months: 95.5- Pediatric: 97.6 0-2 years: Lavender 1.0 Hb F: pk., Red 0.5 pk Newborn-1 2-10 years: 2 month: <=90.0 mL Lavender 1-3 months: top, 2 mL Red 42.4-75.6 top 3-6 months: GENERAL 12.4-46.0 LABORATORY 6-7 months: 1.2- REQUISITION 13.2 >7 months: 0.0- 1.2

Hb A2: 2.0-3.3

Hb H: Negative HGS (see Hemoglobin Gene Sequencing) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date HIST (see Anti Histone Group,Serum) HMG-CoA Reductase Clinical Adult: Batch analysis Negative: <20 U 2021-07-28 This test is restricted to (HMGCR) IgG Immunology 5 mL Gold top Positive: ≥20 U Neurologists and Antibodies, Serum Vacutainer tube Rheumatologists at 3-hydroxy-3-methyl- LHSC/SJHC upon glutaryl-CoA approval by Dr. Adrian reductase antibodies Pediatric: Budhram. Anti-HMGCR 0-2 years: 0.5 Accepted from referred antibodies mL Red in locations. HMG-CoA Reductase Microtainer antibodies 2-10 years: 2 HMGCR antibodies are mL Red top associated with tube necrotizing GENERAL autoimmune myopathy. LABORATORY REQUISITION HMG-CoA Reductase antibodies (see HMG-CoA Reductase (HMGCR) IgG Antibodies, Serum) IC (see Immune Complexes) IFE (see Immunofixation Electrophoresis, Serum, Immunofixation Electrophoresis, Urine) IFE Serum (see Immunofixation Electrophoresis, Serum) IFES (see Immunofixation Electrophoresis, Serum) IFEU24 (see Immunofixation Electrophoresis, Urine) IFEUR (see Immunofixation Electrophoresis, Urine) IgG Antibodies to double stranded DNA (see Anti double stranded DNA, IgG) IgG fractionation (see IgG Subclasses, Serum/Plasma) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date IgG Subclasses, Clinical Adult: Monday Friday Subclass IgG1 2009-05-13 IgG subclass testing Serum/Plasma Immunology 5 mL Gold top 0800-1600 g/L: includes IgG1, IgG2, IgG fractionation Vacutainer tube IgG3 and IgG4 as IgG subtypes 0-<2 years: 1.94- reported values. IgG subsets Pediatric: 8.42 IgG1 0-2 years: 0.5 2-<4 years: 3.15- IgG2 mL Red or Gold 9.45 IgG3 top Microtainer 4-<6 years: 3.06- IgG4 2-10 years: 3 9.45 mL Red top 6-<8 years: 2.88- Vacutainer tube 9.18 8-<10 years: Light Green (Li- 4.32-10.20 Heparin) or 10-<12 years: Lavender 4.23-10.60 (EDTA) top 12-<14 years: tubes are also 3.42-11.50 acceptable 14-<18 years: GENERAL 3.15-8.55 LABORATORY ≥18 years: 3.82- REQUISITION 9.29

Subclass IgG2 g/L:

0-<2 years: 0.23- 3.00 2-<4 years: 0.36- 2.25 4-<6 ye (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date IgG subsets (see IgG Subclasses, Serum/Plasma) IgG subtypes (see IgG Subclasses, Serum/Plasma) IgG1 (see IgG Subclasses, Serum/Plasma) IgG2 (see IgG Subclasses, Serum/Plasma) IgG3 (see IgG Subclasses, Serum/Plasma) IgG4 (see IgG Subclasses, Serum/Plasma) IgM antibodies to AGM1 (see Anti GM1, IgM serum) IgM antibodies to Ganglioside Monosialic Acid (see Anti GM1, IgM serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Immune Complexes Clinical 5 mL Gold top Batch Analysis Negative: ≤19 2010-01-11 This assay DOES NOT Circulating immune Immunology Vacutainer tube once/20 RU/mL quantitate C1q protein. complexes or 6 mL Red top business days IC Vacutainer tube Results higher than top CIC or EDTA standard will be plasma reported as >200 RU/mL. Pediatric: 0-2 years: 0.5 CIC as measured by mL Red C1q binding are found Microtainer sporadically in the 2-10 years: 2 normal population as a mL Red top result of infection and tube can also be elevated GENERAL after eating. Results LABORATORY from different REQUISITION technologies, methodologies and manufacturers kits may vary widely due to differences in standardization.

CIC testing is used to aid diagnosis only. CIC results are not diagnostic proof of the presence of absence of disease. Review the results in conj (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Immunofixation Clinical 5 mL Gold top Monday - Friday Interpretative 2009-02-27 Protein electrophoresis Electrophoresis, Immunology Vacutainer tube 0800-1600 analysis (PEL) is always Serum performed first. The IFE Light Green PEL result will IFE Serum (Li-Heparin) or determine if IFE is IFES Lavender performed. IFE is Light Chains (EDTA) top performed when an tubes are NOT abnormal band acceptable is detected on PEL that GENERAL has not been identified LABORATORY previously by IFE. If REQUISITION the band has been identified previously by IFE and the PEL pattern has not changed significantly, the IFE will not be repeated for ≥ 4 years.

IFE uses specific antisera to identify monoclonal immunoglobulins. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Immunofixation Clinical 24-hour urine or Monday - Friday Interpretative 2009-08-19 Protein electrophoresis Electrophoresis, Urine Immunology random urine 0800-1600 analysis (PEL) is always IFE A 24-hour urine performed first (unless IFEUR collection is the the total protein IFEU24 preferred concentration in the Light Chains specimen for urine sample is < 0.06 Bence Jones Protein analysis of g/L, in which case IFE Bence Jones will be performed protein (free directly). The PEL light chains). If result will determine if a 24-hour urine IFE is performed. IFE is not available, is performed when an the first voided abnormal globulin band morning is detected on PEL that specimen is has not been identified recommended. previously by IFE. If GENERAL the band has been LABORATORY identified previously by REQUISITION IFE and the PEL pattern has not changed significantly, the IFE will not be repeated for ≥ 4 years.

IFE uses specific antisera to identify monoclonal immunoglobulins. Light Chain Screen (see Protein Electrophoresis, Urine) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Light Chains (see Immunofixation Electrophoresis, Serum, Immunofixation Electrophoresis, Urine) Monoclonal Protein Screen (see Protein Electrophoresis, Serum, Protein Electrophoresis, Urine) Myelin-Associated Clinical Adult: Batch analysis <1000 BTU 2010-01-11 This test is restricted to Glycoprotein IgM, Immunology 5 mL Gold top neurologists at Serum Vacutainer tube LHSC/SJHC upon Anti MAG, Serum or 6 mL Red top approval by Dr. Anti-MAG, IgM Vacutainer tube Budhram. Anti Myelin- Associated Accepted from referred Glycoprotein IgM Pediatric: in locations. 0-2 years: 0.5 mL Red High concentrations of Microtainer IgM MAG 2-10 years: 2 are mL Red top found in approximately tube 50% of patients with GENERAL peripheral neuropathies LABORATORY accompanied by IgM REQUISITION monoclonal gammopathies. Lower concentrations of MAG IgM autoantibodies can also be found in patients with inflammatory neuropathies, multiple sclerosis, systemic lupus erythematosus and healthy individuals. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Myositis Antibodies Clinical Adult: Batch analysis Negative 2019-04-04 This test is available Profile Immunology 5 mL Gold top exclusively to Autoimmune Myositis Vacutainer tube Rheumatologists and Panel or 6 mL Red top Respirologists at Myositis-specific Vacutainer tube LHSC/SJH and antibodies as well as accepted from Anti Mi-2 alpha EDTA, heparin referred in locations. Anti Mi-2 beta or citrate Anti TIF1 gamma plasma Immunoblot results will Anti MDA5 be reported as either Anti NXP2 Pediatric: negative or positive for Anti SAE1 0-2 years: Red specific antibodies as Anti Ku 0.5 pk the following. Anti PM-Scl 100 2-10 years: 2 Anti PM-Scl 75 mL Red top 1+ Weak Positive Anti JO1 GENERAL 2+ Positive Anti SRP LABORATORY 3+ Strong Positive Anti PL-7 REQUISITION Anti PL-12 Anti EJ Anti OJ Anti Ro-52 Myositis-specific antibodies (see Myositis Antibodies Profile) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Neuromyelitis Clinical 5 mL Gold top Batch analysis Negative 2018-06-04 This test is available to Spectrum Profile Immunology or 6 mL Red top LHSC Neurologists Anti Myelin Vacutainer tube only and accepted from Oligodendrocyte as well as referred in locations. Glycoprotein and Anti EDTA, heparin A single autoantibody Aquaporin4, IgG or citrate test is not diagnostic Anti AQP4 antibody plasma is and should not be used Anti NMO antibody acceptable to determine course of Anti MOG antibody treatment. Pediatric: The test result must be 0-2 years: Red evaluated with 0.5pk. consideration of clinical 2-10 years: 2 presentation, patient mL Red top history and other laboratory tests. CSF will also be accepted. Note: CSF This test can be used samples will to help distinguish also be between Multiple accepted and Sclerosis (MS) and only be Neuromyelitis Optica processed if Spectrum Disorders accompanied (NMOSD). by a serum sample. GENERAL LABORATORY REQUISITION Oligoclonal Banding (see Protein Electrophoresis, CSF) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Oxygen Affinity (see p50 O2 Affinity Hemoglobin) P-ANCA / Anti-MPO (anti-myeloperoxidase antibody) (see ANCA) p50 O2 Affinity Clinical Peripheral Weekly N/A 2019-07-11 McMaster University Hemoglobin Immunology Blood Medical Centre Oxygen Affinity Molecular Genetics 4 mL K2 or K3 Laboratory, Room EDTA Lavender 2N22 top Vacutainer 1200 Main Street West, tube 5 mL Red Hamilton, ON L8N 3Z5 top Vacutainer Telephone: 905-521- tube 2100 ex.76944 Fax: 905-521-7913 Pediatric: Email: 0-2 years: moleculargenetics@hh Lavender 1.0 sc.ca pk., Red 0.5 pk 2-10 years: 2 N/A mL Lavender top, 2 mL Red Attach CBC chart to Hemoglobinopa requisition thy Investigations Form Panel includes: (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF, Comprehensive Myositis Panel, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Paraneoplastic Clinical Adult: Batched analysis Negative 2021-06-22 This test is available Antibody Panel, Immunology 5 mL Gold top only to external clients. Serum/CSF Vacutainer tube Anti-Hu (ANNA-1) or 6 mL Red top Paraneoplastic Anti-Yo (PCA-1) Vacutainer tube syndromes are a group Anti-Ri (ANNA-2) of rare disorders; some Anti-CV2 (CRMP5) EDTA, heparin of which are caused by Anti-Ma2/Ta or citrate autoimmune reactions Anti-Amphiphysin plasma are also against co- Anti-Recoverin acceptable expressed by cancer Anti-SOX1 cells and neurons. Anti-Titin Pediatric: Below are the most Anti-Zic4 0-2 years: 0.5 frequent cancers Anti-GAD65 mL Red associated with Anti-Tr (DNER) Microtainer paraneoplastic 2-10 years: 2 syndromes and mL Red top autoantibodies. tube Antibodies against CSF samples Associated will also be Neurological accepted. DisordersFrequently Suggest CSF Associated Tumors be submitted Hu (ANNA- with serum for 1)Paraneoplastic testing. encephalomyelitisSmall CLINICAL cell lung cancer, IMMUNOLOGY neuroblastomaYo REQUISITION (PCA-1)Paraneoplastic cerebellar (more...) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date PCA-2/Anti-MAP1B (see Comprehensive Autoimmune Encephalitis Panel, Serum/CSF) PELS (see Protein Electrophoresis, Serum) PELU24 (see Protein Electrophoresis, Urine) PELUR (see Protein Electrophoresis, Urine) Protein Clinical Both specimen Batched Negative for 2009-02-27 Electrophoresis, CSF Immunology types are oligoclonal Oligoclonal Banding required: banding. 1. CSF and 2. Either a 5 mL IgG: 10-30 mg/L Gold top or 6 : <350 mL Red top mg/L Vacutainer tube IgG/Albumin GENERAL Ratio: 0.00-0.23 LABORATORY IgG/Alb Index: REQUISITION 0.25-0.85 with no visible banding in electrophoresis

For accurate interpretation, the CSF and serum must be assayed together and the results compared. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Protein Clinical 5 mL Gold top Monday - Friday Albumin: 35.7 2010-01-25 Based on consultation Electrophoresis, Immunology Vacutainer tube 0800-1600 54.9 g/L with the main users of Serum Alpha 1: 1.9 4.1 the test, it has been PELS Light Green (Li- g/L decided to limit the Monoclonal Protein Heparin) or Alpha 2: 4.5 9.8 collection frequency to Screen Lavender g/L ≥ 3 weeks for repeat SPE (EDTA) top Beta 1: 3.0 6.0 testing. If serum Serum Protein tubes are NOT g/L protein electrophoresis Electrophoresis acceptable Beta 2: 2.0 5.4 is ordered and it has GENERAL g/L been <20 days since LABORATORY Gamma: 7.1 the collection date of REQUISITION 15.6 g/L the last sample run, the test will be cancelled.

Abnormal bands are identified by immunofixation electrophoresis. Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Protein Clinical 24-hour urine or Monday - Friday Interpretative 2009-02-27 Based on consultation Electrophoresis, Urine Immunology random urine 0800-1600 analysis with the main users of PELUR A 24-hour urine the test, it has been PELU24 collection is the decided to limit the Monoclonal Protein preferred collection frequency to Screen specimen for ≥ 3 weeks for repeat Light Chain Screen analysis of testing. If urine protein Bence Jones Protein Bence Jones electrophoresis is Screen protein (free ordered and it has Urine Protein light chains). If been <20 days since Electrophoresis a 24-hour urine the collection date of is not available, the last sample run, the the first voided test will be cancelled. morning specimen is Abnormal bands are recommended. identified by GENERAL immunofixation LABORATORY electrophoresis. REQUISITION Serum Free Light Chains (see Free Light Chains, Serum/Plasma) Serum Protein Electrophoresis (see Protein Electrophoresis, Serum) SPE (see Protein Electrophoresis, Serum) Test Name Laboratory Specimen Type Test Schedule Reference Effective Comments Range Date Systemic Sclerosis Clinical Adult: Batch analysis Negative 2019-12-12 This test is available Profile Immunology 5 mL Gold top exclusively to Anti Scl-70 Vacutainer tube Rheumatologists and Anti CENP A or 6 mL Red top Respirologists at Anti CENP B Vacutainer tube LHSC/SJHC and Anti RP11 as well as accepted from Anti RP155 EDTA, Heparin referred in locations. Anti Fibrillarin or Citrate Anti NOR90 plasma Immunoblot results will Anti Th/To be reported as either Anti PM-Scl100 Pediatric: negative or positive for Anti PM-Scl75 0-2 years: Red specific antibodies as Anti Ku 0.5 mL the following: Anti PDGFR Microtainer (+) Borderline Anti Ro-52 2-10 years: 2 1+ Weak Positive mL Red top 2+ Positive tube 3+ Strong Positive GENERAL LABORATORY REQUISITION Tau Protein (see Beta-2 Transferrin) TCOM (see Complement Total, Serum) Total Complement Function Assay (see Complement Total, Serum) Urine Protein Electrophoresis (see Protein Electrophoresis, Urine)