This unit code has been inactivated.

Please see unit code 20392.

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

Tropheryma whipplei is the cause of Whipple's disease, a bacterial infection that can affect any system of the body, but occurs most often in the small intestine. Real-Time PCR is a highly sensitive and specific method to detect the presence of T. whipplei DNA in clinical specimens.

This test is not approved for New York patient testing.

Antibody titers ≧1:4 against Staphylococcal beta-ribitol teichoic acid are associated with deep-seated Staphylococcus aureus infections. Rising and falling titers are of prognostic value in the evaluation of treatment and detection of recurrence.

This test is approved for New York patient testing.

This panel includes total T cells (CD3) and total B cells (CD19) only. The relative and absolute total T and B cell values are useful in the evaluation of individuals with suspected immunodeficiency disease.

Test performed at Quest Diagnostics Nichols Institute.

A minimal four-fold increase between pre-immunization and post-immunization sera is considered a normal response to tetanus toxoid. Levels ≧0.50 IU/mL are generally considered protective, whereas levels less than 0.05 IU/mL indicate a lack of protective antibody. Levels between 0.05 and 0.49 IU/mL are indeterminate for the presence of protective antibody and may indicate a need for further immunization to tetanus toxoid.

This test is approved for New York patient testing.

 Vaccine Response Testing

A minimal four-fold increase between pre-immunization and post-immunization sera is considered a normal response to tetanus toxoid. Levels ≧0.50 IU/mL are generally considered protective, whereas levels less than 0.05 IU/mL indicate a lack of protective antibody. Levels between 0.05 and 0.49 IU/mL are indeterminate for the presence of protective antibody and may indicate a need for further immunization to tetanus toxoid.

This test is approved for New York patient testing.

See individual assay for description.

Panel Includes:

• Diphtheria Antitoxoid, ELISA
• Tetanus Antitoxoid, ELISA

 Vaccine Response Testing

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

The detection of thyroid peroxidase (TPO) antibodies is useful in differentiating thyroid-related from non-thyroid-related lethargy, depression, or obesity. TPO antibodies are found in chronic (Hashimoto's) thyroiditis, primary myxedema, and thyrotoxicosis (Grave's disease). TPO antibodies may also be found in various endocrine diseases, such as adrenal insufficiency, pernicious anemia, and diabetes mellitus. Thyroid peroxidase (TPO) is the specific antigen bound by thyroid microsomal antibodies, thus, TPO antibodies and thyroid microsomal antibodies are considered equivalent.

This test is not approved for New York patient testing.

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

This test is for identification of ticks, lice, insects, and other arthropods of medical significance. Identification is based on morphological criteria.

This test is available for New York patient testing.

Ticks that are identified as species known to carry Lyme Disease will reflex to Lyme Disease (Borrelia burgdorferi) DNA (Focus Unit Code 42200) at an additional charge.

This test is approved for New York patient testing.

This unit code has been inactivated.

Please see the following unit codes
47800, 23100, and 47600

See individual assay for description.

Panel Includes:

• Anaplasma phagocytophilum (HGE Agent) IgG/IgM Antibody, IFA
• Babesia microti IgG and IgM Antibody, IFA
• Borrelia burgdorferi C6 Peptide Ab, ELISA
• Ehrlichia chaffeensis Antibody, IFA

See individual assays for description.

Panel Includes:

• Anaplasma phagocytophilum (HGE agent) IgG &IgM Antibody ELISA
• Babesia microti IgG & IgM Antibody Panel, IFA
• Borrelia burgdorferi IgG Antibody, IFA (Serum)

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgG and IgM Antibody Panel, ELISA
• Herpes Simplex Virus (HSV) 1/2 IgM and HerpeSelect^® Type-Specific IgG Antibody, ELISA
• Rubella IgG and IgM Antibody, ELISA
• Toxoplasma gondii IgG and IgM Antibody Panel, ELISA

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgG and IgM, Ab Panel, ELISA
• Herpes Simplex Virus 1/2 Antibody and IgM Antibody Panel, ACIF/IFA
• Rubella IgG and IgM, ELISA
• Toxoplasma gondii IgG and IgM, ELISA

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgG Antibody, ELISA
• Herpes Simplex Virus (HSV) 1/2 Type-Specific IgG (HerpeSelect^®), ELISA
• Rubella IgG Antibody, ELISA
  
• Toxoplasma gondii IgG Antibody, ELISA

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgG Antibody, ELISA
• Herpes Simplex Virus (HSV) 1/2 Antibody, ACIF
• Rubella IgG Antibody, ELISA
• Toxoplasma gondii IgG Antibody, ELISA

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgM Antibody, ELISA
• Herpes Simplex Virus (HSV) 1/2 IgM Antibody, ELISA
• Rubella IgM Antibody, ELISA
• Toxoplasma gondii IgM Antibody, ELISA

See individual assay for description.

Panel Includes:

• Cytomegalovirus IgM Antibody, ELISA
• Herpes Simplex Virus (HSV) 1/2 IgM, IFA
• Rubella IgM, ELISA
• Toxoplasma gondii IgM, ELISA

Toxic shock syndrome (TSS) is associated with strains of Staphylococcus aureus that produce TSS toxin-1 (TSST-1) and/or staphylococcal enterotoxin B (SEB). TSST-1 is associated with approximately 65% of TSS cases, whereas SEB is associated with approximately 20% of cases. Individuals lacking antibodies to TSST-1 or to SEB (approximately 10% and 20% of adults, respectively) are presumed to be at highest risk of TSS. This test is thus designed to identify antibody-negative individuals at risk for TSS; it should not be used as a tool for diagnosing TSS.

This test is approved for New York patient testing.

Toxic shock syndrome (TSS) is associated with Staphylococcus aureus strains producing TSS toxin-1 (TSST-1), enterotoxin B (SEB), or enterotoxin C (SEC). TSST-1 causes essentially all menstrual TSS cases and approximately 40% of non-menstrual TSS cases. SEB and SEC account for most other non-menstrual TSS cases.

This ELISA procedure utilizes the excretory-secretory (ES) antigen of T. canis larvae to minimize crossreactivity with antigens of Ascaris spp. and of other parasites. Results must be interpreted with caution, as broad variations in antibody response occur and levels may remain elevated for years after infection. Generally, antibody levels are higher in patients with visceral larva migrans than in patients with ocular larva migrans or asymptomatic infection. Although a negative result (<1.00) usually rules out infection with Toxocara spp, testing of serial samples in parallel may be useful in following patients with suspected toxocariasis.

This test is approved for New York patient testing.

The ELISA procedure utilizes the excretory-secretory (ES) antigen of T. canis larvae to minimize crossreactivity with antigens of Ascaris spp and of other parasites.

This test is approved for New York patient testing.

Smears are stained with a fluorescent monoclonal antibody that will detect the presence of Toxoplasma gondii tachyzoites in specimens. A Giemsa stain is also performed.

This test is available for New York patient testing.

The detection of Toxoplasma gondii DNA is based upon the real-time PCR amplification and detection of specific T. gondii genomic sequences from total DNA extraction from the specimen.

This test is approved for New York patient testing.

IgA antibodies against Toxoplasma gondii have been detected in acute toxoplasmosis, but not in cases of chronic toxoplasmosis or in uninfected individuals. T gondii IgA is thus a valuable tool for the early detection of acute disease in pregnant women and individuals with AIDS. Because IgA antibodies do not cross the placenta, assessment of IgA antibodies against T. gondii is also a reliable method for detecting congenital T. gondii infection. See Focus Unit Code 4412 for parallel testing.

This test is not approved for New York patient testing.

T. gondii can cause severe medical complications in infants and immunocompromised or immunosuppressed individuals. Quantification of T. gondii DNA by this assay is based upon the real-time amplification and detection of T. gondii genomic DNA. The quantitative range of this assay is 100 - 1,000,000 T. gondii DNA copies/mL.

This test is not approved for New York patient testing.

T. gondii IgG is typically detected within 1-2 weeks of infection, peaks within 2-3 months, and persists at low but detectable levels throughout life.

This test is not approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

Because some toxoplasmosis patients produce IgM for up to 2 years following primary infection, detection of T. gondii-specific IgM cannot be considered a reliable indicator of recent infection. The measurement of T. gondii-specific IgG avidity (functional affinity) can assist in discriminating recent from past toxoplasmosis. A high avidity index as measured by Focus' AviDx(tm) assay excludes, with >95% accuracy, the possibility that infection occurred within the previous five months. In contrast, a low avidity index usually indicates infection within the preceding eight months.

This test is not approved for New York patient testing.

 Toxoplasma IgG Avidity Testing

T. gondii IgM is typically detected within a few days of infection, peaks within a few weeks, and usually falls to undetectable levels within a few months. In some patients, however, T. gondii IgM persists for more than a year following infection; thus, detection of T. gondii IgM, particularly in adults, does not necessarily indicate recent or ongoing toxoplasmosis.

This test is approved for New York patient testing.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is not approved for New York patient testing.

T. gondii IgG is typically detected within 1-2 weeks of infection, peaks within 2-3 months, and persists at low but detectable levels throughout life. T. gondii IgM is typically detected within a few days of infection, peaks within a few weeks, and usually falls to undetectable levels within a few months. In some patients, however, T. gondii IgM persists for more than a year following infection; thus, detection of T. gondii IgM, particularly in adults, does not necessarily indicate recent or ongoing toxoplasmosis.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

T. gondii IgG is typically detected within 1-2 weeks of infection, peaks within 2-3 months, and persists at low detectable levels throughout life. T. gondii IgM is typically detected within a few days of infection, peaks within a few weeks, and usually falls to undetectable levels within a few months. In some patients, however, T. gondii IgM persists for more than a year following infection; thus detection of T. gondii IgM, particularly in adults, does not necessarily indicate recent or ongoing toxoplasmosis.
IgA antibodies against Toxoplasma gondii have been detected in acute toxoplasmosis, but not in chronic toxoplasmosis or in uninfected individuals. T. gondii IgA is thus a valuable tool for the early detection of acute disease in pregnant women and individuals with AIDS. Because IgA antibodies do not cross the placenta, assessment of IgA antibodies against T. gondii is also a reliable method for detecting congenital T. gondii infection.

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

See individual assay for description.

Panel Includes:

• Toxoplasma gondii IgG Avidity (AviDx™), ELISA
• Toxoplasma gondii IgG, IgM and IgA, ELISA

 Toxoplasma IgG Avidity Testing

IgA antibody recognizing tissue transglutaminase (TG) is a marker of celiac disease associated with gluten-sensitive enteropathy or dermatitis herpetiformis. Over 90% of sera from celiac patients are positive for TG IgA. Like gliadin antibodies, TG IgA gradually disappears from the circulation with adherence to gluten-free diet.

This test is approved for New York patient testing.

 Serologic Tests for Celiac Disease

This test (also referred to as FTA-ABS) is a specific treponemal assay to detect antibody to T. pallidum. The FTA-ABS becomes reactive 4-6 weeks after infection. Unlike the nontreponemal tests, once the FTA-ABS test becomes reactive, it remains reactive for many years. Since the reactivity found with the FTA-ABS does not indicate response to therapy, it is not suitable for monitoring treatment. The FTA-ABS test does not distinguish between syphilis and other treponematoses such as yaws, pinta and bejil.

This test is approved for New York patient testing.

Treponema pallidum is the causative agent of syphilis, a sexually transmitted disease that can progress to severe central nervous system involvement if left undiagnosed and treated. Direct detection of treponemes from clinical specimens is an important tool to aid in the early diagnosis of syphilis. Real-time PCR detection offers increased sensitivity compared to microscopy or other direct detection methods.

This test is approved for New York patient testing.

Although this assay may be used to detect treponemal antibody in CSF, the VDRL is the recommended method. For the diagnosis of neurosyphilis, all serum and CSF tests for syphilis should be evaluated in conjunction with clinical presentation.

This test is not approved for New York patient testing.

This panel detects both IgG and IgM antibodies to T. pallidum and is intended to identify cases of congenital syphilis in newborns or infants. A positive (reactive) result for FTA-ABS IgM is indicative of recent infection.

Only specimens from infants <1 year of age are acceptable; for T. pallidum antibody testing in individuals > 1 year of age, please order Focus Unit Code 20486 Treponema pallidum Antibody, IFA (Serum).

This test is not approved for New York patient testing.

The ELISA technique for the detection of Trichinella IgG antibody offers significant improvements in sensitivity compared to the widely-used bentonite flocculation (BF) and latex agglutination (LA) tests. An excretory-secretory antigen is employed to reduce nonspecific reactivity; however, crossreactivity with other parasitic antigens (e.g., strongyloides, filaria, malaria) may occur. Such crossreactivity is usually associated with results in the equivocal range. The trichinella antibody ELISA must be considered a screening test for Trichinella exposure. The diagnosis of trichinosis requires a compatible patient history and supporting pathologic findings.

This test is approved for New York patient testing.

The diagnosis of trichomoniasis is assuming higher priority since recent studies have suggested that the infection enhances susceptibility to other infections, in particular, human immunodeficiency virus. The application of culture to detect Trichomonas vaginalis from appropriate clinical specimens improves diagnosis when compared to direct examination alone. Culture of Trichomonas has increased sensitivity (>80%) over that of the wet mount method and is considered the "gold standard" method if specimens are collected properly and inoculated as quickly as possible into the appropriate culture medium.

This test is approved for New York patient testing.

Smears are stained with a fluorescent monoclonal antibody that will detect the presence of Trichomonas in urogenital specimens. More elaborate testing such as DFA direct staining and culture for Trichomonas is sometimes warranted and has proven to be valuable in confirming the diagnosis.

This test is available for New York patient testing.

The serodiagnosis of Chagas' disease or American trypanosomiasis by IFA is highly sensitive and specific, although crossreactions may occur with leishmaniasis. A T. cruzi IgM response is observed in acute disease prior to IgG seroconversion. In chronic Chagas' disease IgG antibody is detected.

This test is approved for New York patient testing.

The serodiagnosis of Chagas' disease or American trypanosomiasis by IFA is highly sensitive and specific, although crossreactions may occur with leishmaniasis. A T. cruzi IgM response is observed in acute disease prior to IgG seroconversion. In chronic Chagas' disease IgG antibody is detected.

This test is approved for New York patient testing.

The serodiagnosis of Chagas' disease or American trypanosomiasis by IFA is highly sensitive and specific, although crossreactions may occur with leishmaniasis. A T. cruzi IgM response is observed in acute disease prior to IgG seroconversion. In chronic Chagas' disease IgG antibody is detected.

This test is approved for New York patient testing.

• Francisella tularensis Antibody, DA

Tysabri® (natalizumab) is a monoclonal antibody therapy used to treat multiple sclerosis (MS), a serious autoimmune disease that results in damage to the brain and spinal cord. Patients being treated with Tysabri can develop Tysabri-specific antibodies that may block the therapeutic effect of the treatment.

This test is approved for New York patient testing.