All Autoimmune Tests

Autoimmune Tests Lab Test and health information

Over 80 diseases result from autoimmune responses, and the following tests are used to confirm the diagnosis and monitor the various autoimmune disorders.

Your body's immune system naturally helps fight against harmful bacteria and other foreign substances. This natural response revolves around antibodies and specific immune cells. Autoimmune diseases occur when your body's immune system fights against normal constituents, instead of harmful bacteria and other foreign substances. It has everything to do with your immune system failing to discern between "self" vs. "non-self" constituents. This failure to discern may produce immune cells or antibodies (or auto-antibodies) that target the body's own cells, tissues, and/or organs. These attacks cause inflammation and tissue damage that result in autoimmune disorders. 

SEE BELOW THE LIST OF TESTS FOR MORE INFORMATION ABOUT Autoimmune diseases


Name Matches
Myasthenia Gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. This assay aids in the differential diagnosis of MG-like muscle weakness, in differentiating between generalized MG and ocular MG, and in monitoring therapeutic response. If binding antibodies are negative, assays for blocking and modulating antibodies should be considered.

Myasthenia gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. This assay is most useful when the acetylcholinesterase receptor modulating antibodies are positive. The assay for blocking antibodies is useful in monitoring response to therapy.

Myasthenia gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. Modulating Antibody to AChR causes weakness by inhibiting or modulating binding to the receptors.

Actin is the major antigen to which smooth muscle antibodies react in autoimmune hepatitis. F-Actin IgG antibodies are found in 52-85% of patients with autoimmune hepatitis (AIH) or chronic active hepatitis and in 22% of patients with primary biliary cirrhosis (PBC). Anti-actin antibodies have been reported in 3-18% of sera from normal healthy controls.

Alternative Complement Pathway Functional, Serum

Preferred Specimen(s)

  • 1 mL serum collected in a red-top tube (no gel)
  • Minimum Volume 0.2 mL

SSPECIAL Collection Instructions

  1.  Immediately after specimen collection, place the tube on wet ice.
  2. Centrifuge at 4° C and aliquot serum into plastic vial.
  3. Freeze specimen within 30 minutes.

Transport Container

  • Transport tube
  • Transport Temperature: Frozen

 

Patient Preparation

  • Fasting preferred

Methodology

Enzyme Linked Immunosorbent Assay (ELISA)

Assay Category

This test uses a reagent or kit labeled by the manufacturer as research use only. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the FDA.


ALTERNATIVE PATHWAY ACTIVITY


Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Centromere antibody
  • Histone Antibody

Conditions where an ANA Screen test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA, ANA Screen IFA with Reflex to Titer and pattern IFA, ANA with Reflex, Antinuclear Antibody Screen, DNA-DS Antibody Test, DNA-DS Test, Anti ds-DNA Test, Scl-70 Antibody Test, Anti Scl-70 test, sjogren’s antibody test, SSA-A antibody test, SS-B Antibody test, Sm Antibody Test, Rnp Antibody Sm Rnp Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00

When is a Comprehensive ANA IFA Panel test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does a Comprehensive ANA IFA Panel blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with a Comprehensive ANA IFA Panel test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Autoantibodies
  • Centromere antibody
  • Histone Antibody
  • Nuclear Antibody

Conditions where a Comprehensive ANA IFA Panel test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use a Comprehensive ANA IFA Panel?

The antinuclear antibody test is one of the most common tests used to identify systemic lupus erythematosus. It is used as a primary test to assist evaluate a person for autoimmune illnesses that affect multiple tissues and organs throughout the body.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

 


ANAlyzeR™ ANA, IFA with Reflex Titer/Pattern, Systemic Autoimmune Panel 1

Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibody, Crithidia IFA with Reflex to Titer
  • Chromatin (Nucleosomal) Antibody
  • Sm Antibody
  • Sm/RNP Antibody
  • RNP Antibody
  • Sjogren's Antibodies (SS-A, SS-B)
  • Scleroderma Antibody (Scl-70)
  • Jo-1 Antibody
  • Centromere B Antibody
  • Complement Component C3c and C4c
  • Cardiolipin Antibodies (IgA, IgG, IgM)
  • Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
  • Rheumatoid Factor (IgA, IgG, IgM)
  • Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
  • 14.3.3 eta Protein
  • Thyroid Peroxidase Antibodies (TPO)

 

  • If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
  • If the DNA (ds) Antibody Screen is positive, then DNA (ds) Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

 

Alternative Name(s)

Expanded ANA Antibodies,Systemic Autoimmune Disorder,ANA and Expanded AI Testing,ANA and Systemic Autoimmunity,Comprehensive AI Testing,Early Systemic Autoimmune Disease,Autoimmune Disorders


Description: An ANCA screen is used to detect antineutrophil cytoplasmic antibodies in your blood to test for autoimmune vasculitis and to differentiate between Crohn’s disease and ulcerative colitis when testing for inflammatory bowel disease.

Also Known As: ANCA test, cANCA test, pANCA test, Serine Protease 3 test, Acticytoplasmic Test, 3-ANCA test, PR3-ANCA Test, MPO-ANCA test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an ANCA Screen test ordered?

When a person exhibits symptoms and signs that point to systemic autoimmune vasculitis, an ANCA test must be performed. Early indications of the illness could include a fever, weariness, weight loss, aches in the muscles and/or joints, and nocturnal sweats. As the illness worsens, damage to blood arteries all throughout the body may result in the signs and symptoms of consequences affecting different tissues and organs.

When a patient exhibits symptoms that point to inflammatory bowel disease and the doctor wants to differentiate between Crohn's disease and ulcerative colitis, they may be prescribed an ANCA test together with an anti-Saccharomyces cerevisiae antibody test.

What does an ANCA Screen test check for?

The immune system of a person makes autoantibodies called antineutrophil cytoplasmic antibodies that wrongly target and attack proteins found in the person's neutrophils. These autoantibodies are found in the blood and their concentration is determined by ANCA testing. The autoantibodies that target the proteins myeloperoxidase and proteinase 3 are two of the most prevalent forms or subgroups of ANCA.

An individual's blood sample is combined with neutrophils for the test, which is then put on a slide and stained fluorescently. Under a microscope, ANCA will exhibit a pattern of fluorescence if they are present. Atypical ANCA, perinuclear, or cytoplasmic ANCA are possible classifications for the pattern. Alternately, a direct ELISA assay can be used in the laboratory to check for myeloperoxidase or proteinase 3 antibodies. When investigating possible vasculitis cases, fluorescence and ELISA testing are frequently combined.

ANCA may be found in a number of autoimmune conditions that result in organ failure, tissue damage, and inflammation.

Systemic vasculitis is a group of diseases characterized by blood vessel deterioration and injury. Due to blood channel narrowing and obstruction, which results in a reduction in blood supply, it can harm tissue and organs. Aneurysms, which are weak spots in the walls of blood vessels that have the potential to burst, can also be created. The degree of autoimmune activity and the areas of the body affected by systemic vasculitis determine the symptoms that an affected person may experience. There are a few forms of systemic vasculitis that are closely linked to ANCA production:

  • Polyangiitis and granulomatosis
  • Miniature polyangiitis
  • Polyangiitis along with eosinophilic granulomatosis
  • Nodular polyarteritis

The most typical cases of cANCA/PR3 antibodies and pANCA/MPO antibodies include granulomatosis with polyangiitis and microscopic polyangiitis, respectively. To varied degrees of responsiveness, both may be present in all three categories.

An instance of inflammatory bowel disease known as ulcerative colitis is characterized by inflamed and harmed tissues in the colon's lining. UC and Crohn disease, another kind of IBD that can affect any section of the intestinal tract, can be challenging to distinguish from one another. Atypical ANCA is typically seen in UC patients, but only 20% of CD patients may be positive.

Lab tests often ordered with an ANCA Screen test:

  • Antibody Panel
  • Complete Blood Count (CBC)
  • Sed Rate
  • C-Reactive Protein
  • Urinalysis
  • ASCA
  • Calprotectin
  • Lactoferrin

Conditions where an ANCA Screen test is recommended:

  • Autoimmune Disorders
  • Vasculitis
  • Inflammatory Bowel Disease

How does my health care provider use an ANCA Screen test?

ANCA antibody tests can be used to:

  • Assist in the detection and diagnosis of granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis, among other types of autoimmune vasculitis. This test may occasionally be performed to keep tabs on the patient's progress in therapy or to spot a relapse of certain illnesses.
  • Help distinguish between Crohn's disease and ulcerative colitis, two prevalent varieties of inflammatory bowel illness.

ANCA are immune system-generated autoantibodies that wrongly target proteins in a person's neutrophils. Myeloperoxidase and proteinase 3 are the targets of the majority of ANCA subgroups.

There are two possible exam types:

  • ANCA testing are most frequently carried out with indirect immunofluorescence microscopy. Neutrophils and serum samples are combined to allow any potential autoantibodies to interact with the cells. A fluorescent stain is applied to the sample before it is placed on a slide. After that, the slide is studied under a microscope to identify any patterns. MPO antibodies are linked to the perinuclear pattern, while PR3 antibodies are linked to the cytoplasmic pattern. Atypical ANCA is yet another potential pattern.
  • Antibodies to proteinase 3 and myeloperoxidase can be evaluated separately and specifically using an immunoassay technique.

ANCA, MPO, and PR3 are three tests that some labs will run as a panel, while others will only run MPO and PR3 if the initial ANCA test is positive.

Erythrocyte sedimentation rate and/or C-reactive protein tests to check for inflammation, complete blood counts to measure and assess white and red blood cells, and urinalysis, blood urea nitrogen, and creatinine tests to assess kidney function are additional tests that may be carried out to help with diagnosis. Viral tests for hepatitis or CMV may be prescribed for some patients.

What do my ANCA Screen test results mean?

Care must be taken while interpreting ANCA test results and many considerations must be made. A doctor will take into account clinical symptoms in addition to the outcomes of laboratory testing and other kinds of examinations, such imaging investigations.

Positive results from the ANCA, PR3, and/or MPO tests aid in confirming the diagnosis of systemic autoimmune vasculitis and identifying its many subtypes. However, a biopsy of an afflicted spot is frequently needed to confirm a diagnosis.

Results from negative ANCA tests indicate that an autoimmune vasculitis is not likely to be the cause of a person's symptoms.

Multiple ANCA patterns may be observed for a successful outcome using the indirect immunofluorescence microscopy method.

Perinuclear fluorescence is especially prominent close to the nucleus. In about 90% of samples MPO antibodies will be present with a pANCA pattern.

Fluorescence that is cytoplasmic spreads throughout the cell's cytoplasm. In about 85% of samples PR3 antibodies will be present with a cANCA pattern.

Very little or no fluorescence indicates negative ANCA.

If the ANCA test is positive, another test is run to figure out how much antibody is actually present. The term for this is titer. A serum sample is diluted in stages to determine the titer, and the presence of the antibody is checked after each dilution. The titer is the highest dilution at which the antibody can be found. The titer is 1:64, for instance, if a serum tests positive after being diluted 64 times. More antibody is found in the blood the greater the titer.

ANCA levels can fluctuate over time and are occasionally used in a broad sense to monitor disease activity and/or therapeutic response; nevertheless, titer levels may be variable in certain patients, inadequately reflecting the status of remission or relapse.

More than 80% of individuals with active granulomatosis with polyangiitis have a positive PR3 antibody test and a positive cANCA or pANCA.

Indicators of microscopic polyangitis, glomerulonephritis, eosinophilic granulomatosis with polyangiitis, and Goodpasture syndrome include positive tests for MPO antibodies and a positive pANCA. Other autoimmune diseases such systemic lupus erythematosus, rheumatoid arthritis, and Sjögren syndrome may also exhibit MPO and pANCA.

Patients with signs of an inflammatory bowel illness may benefit from ANCA testing.

If the atypical ANCA is positive and the ASCA is negative, ulcerative colitis is probably present.

As long as ASCA is positive and atypical ANCA is negative, Crohn's disease is most likely present. Even if ANCA and/or ASCA tests are negative, a person may nonetheless have UC, CD, or another IBD.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and/or C-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases (e.g., crescentic glomerulonephritis, microscopic polyarteritis and Churg-Strauss syndrome), bowel disease (Crohn's Disease, ulcerative colitis, primary sclerosing cholangitis, and autoimmune hepatitis) as well as with other autoimmune diseases (drug-induced lupus, SLE, Felty's syndrome). ANCA has classically been divided into C-ANCA and P-ANCA depending on the immunofluorescent pattern observed. More recently the specific antigens responsible for these patterns have been described and isolated. The antigen that gives the C-ANCA pattern is proteinase-3 (PR-3). Multiple antigens are responsible for P-ANCA pattern, the principle antigen being myeloperoxidase (MPO). Patients with vascular diseases will generally have either a C-ANCA pattern or P-ANCA pattern, and give positive results in specific tests for PR-3 or MPO. Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies however, may not be directed towards MPO. Patients with drug induced lupus, etc., often present with a P-ANCA pattern that is associated with antibodies against MPO.

Description: Apo A1 and B is a blood test that measures that amount of Apolipoprotein A1 and Apolipoprotein B in the blood’s serum along with the ratio between B/A1. This test is used to assess cardiovascular risk. Low levels of APO A1 are associated with Coronary Artery Disease (CAD) and are said to predict CAD better then triglycerides and HDL does.

Also Known As: Apo A1 and B Test, Apo A1 Test, Apo B Test, APOAB Test, Apolipoprotein B-100 Test, Apolipoprotein Evaluation Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting for 12 hours is required.

When are Apolipoprotein A1 and B tests ordered?

Apolipoprotein A-I and B, as well as other lipid tests, may be ordered as part of a screening to identify a person's risk of cardiovascular disease.

Apo A-I is a protein that plays a key function in lipid metabolism and is the most abundant protein in HDL, or "good cholesterol." Excess cholesterol in cells is removed by HDL, which transports it to the liver for recycling or elimination. Apo A-I levels tend to rise and fall with HDL levels, and apo A-I deficits are linked to an increased risk of CVD.

Apo B is a protein that plays a role in lipid metabolism and is the major protein component of lipoproteins including VLDL and LDL, popularly known as "bad cholesterol." Apo B concentrations are similar to LDL-C concentrations.

What does Apolipoprotein A1 and B blood tests check for?

Lipids are transported throughout the bloodstream by apolipoproteins, which mix with them. Lipoproteins are held together by apolipoproteins, which protect the water-repellent lipids at their core.

Lipoproteins are cholesterol or triglyceride-rich proteins that transport lipids throughout the body for cell absorption. HDL, on the other hand, is like an empty cab or taxi. It travels to the tissues to collect excess cholesterol before returning it to the liver. Cholesterol is either recycled for future use or eliminated in bile in the liver. The only mechanism for cells to get rid of excess cholesterol is by HDL reverse transport. It protects the arteries and, if enough HDL is present, it can even reverse the formation of fatty plaques, which are deposits caused by atherosclerosis and can contribute to cardiovascular disease.

Sticking with the taxi analogy, the driver is Apolipoprotein A. It permits HDL to be detected and bound by receptors in the liver at the end of the transport by activating the enzymes that load cholesterol from the tissues into HDL. Apolipoprotein A is divided into two types: apo A-I and apo A-II. Apo A-I has a higher prevalence than apo A-II. Apo A-I concentrations can be evaluated directly, and they tend to rise and fall in tandem with HDL levels. Deficiencies in apo A-I are linked to an increased risk of cardiovascular disease.

Chylomicrons are lipoprotein particles that transport dietary fats from the digestive system to tissue, primarily the liver, via the bloodstream. These dietary lipids are repackaged in the liver and combined with apo B-100 to create triglyceride-rich VLDL. This combo is similar to a taxi with a full load of passengers and apo B-100 as the driver. The taxi moves from place to place in the bloodstream, releasing one passenger at a time.

Triglycerides are removed from VLDL by an enzyme called lipoprotein lipase, which produces intermediate density lipoproteins first, then LDL. VLDL contains one molecule of apo B-100, which is kept as VLDL loses triglycerides and shrinks to become the cholesterol-rich LDL. Apo B-100 is detected by receptors on the surface of many different types of cells in the body. The absorption of cholesterol into cells is aided by these receptors.

LDL and apo B-100 transport cholesterol that is essential for cell membrane integrity, sex hormone generation, and steroid production. Excess LDL, on the other hand, can cause fatty deposits in artery walls, as well as blood vessel hardening and scarring. Atherosclerosis is a condition in which fatty deposits restrict blood arteries. The risk of a heart attack increases as the atherosclerotic process progresses.

LDL-C levels, which are typically ordered as part of a lipid profile, tend to mimic Apo B-100 levels. Many experts believe that apo B levels will eventually show to be a more accurate predictor of CVD risk than LDL-C. Others disagree, believing that vitamin B is only a modestly superior choice and that it should not be used on a regular basis. The clinical utility of apo B, as well as other developing cardiac risk markers including apo A-I, Lp(a), and hs-CRP, is still unknown.

Lab tests often ordered with Apolipoprotein A1 and B tests:

  • Cholesterol Total
  • HDL Cholesterol
  • LDL Cholesterol
  • Triglycerides
  • Lipid Panel
  • Lipoprotein (a)
  • Homocysteine
  • hs-CRP
  • Lipoprotein Fractionation, Ion Mobility

Conditions where Apolipoprotein A1 and B tests are recommended:

  • Cardiovascular Disease
  • Heart Attack
  • Stroke
  • Congestive Heart Failure
  • Angina

How does my health care provider use Apolipoprotein A1 and B tests?

An apo B/apo A-I ratio can be determined by ordering both an apo A-I and an apo B test. To assess the risk of developing CVD, this ratio is sometimes used instead of the total cholesterol/HDL ratio.

An apo A-I test may be ordered in the following situations:

Assist in the diagnosis of apo A-I deficiency caused by genetic or acquired diseases.

Assist those with a personal or family history of heart disease, high cholesterol, or triglycerides in their blood.

Keep track of how well lifestyle changes and lipid therapies are working.

An apo A-I test can be ordered in conjunction with an apo B test to determine the apo B/apo A-I ratio. This ratio is occasionally used instead of the total cholesterol/HDL ratio to assess the risk of developing CVD.

As an alternative to non-HDL-C, Apo B levels may be ordered to assess the success of lipid treatment.

An apo B test may be conducted in rare circumstances to assist determine a genetic issue that causes apo B overproduction or underproduction.

What do my Apolipoprotein A1 and B test results mean?

Low apo A-I levels are linked to low HDL levels and slowed elimination of excess cholesterol from the body. Low levels of apo A-I, as well as high levels of apo B, are linked to a higher risk of cardiovascular disease.

Deficiencies in apo A-I are caused by a number of hereditary diseases. Abnormal lipid levels, notably excessive amounts of low-density lipoprotein, are common in people with certain illnesses. They frequently have a higher rate of atherosclerosis. Low apo A-I levels are caused by several genetic diseases.

Raised apo B levels are linked to elevated LDL-C and non-HDL-C levels, and are linked to an increased risk of cardiovascular disease. Elevations may be caused by a high-fat diet and/or a reduction in LDL clearance from the blood.

A direct cause of abnormal apo B levels is some hereditary diseases. Familial combined hyperlipidemia, for example, is an inherited condition that causes excessive cholesterol and triglyceride levels in the blood. Apolipoprotein B deficiency, also known as Bassen-Kornzweig syndrome, is a relatively rare hereditary disorder that results in unusually low amounts of apo B.

A variety of underlying diseases and other factors might result in abnormal apo B levels.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Beta-2-Glycoprotein 1, apolipoprotein H, is a cofactor in antiphospholipid antibody binding and is the critical antigen in the antiphospholipid antibody syndrome. Beta-2-Glycoprotein 1 Antibody is more specific than Cardiolipin Antibody that may express reactivity in patients with syphilis and other infectious diseases

Beta-2-Glycoprotein 1, apolipoprotein H, is a cofactor in antiphospholipid antibody binding and is the critical antigen in the antiphospholipid antibody syndrome. Beta-2-Glycoprotein 1 Antibody is more specific than cardiolipin antibody that may express reactivity in patients with syphilis and other infectious diseases.

Beta-2-Glycoprotein 1, apolipoprotein H, is a cofactor in antiphospholipid antibody binding and is the critical antigen in the antiphospholipid antibody syndrome. Beta-2-Glycoprotein 1 Antibody is more specific than cardiolipin antibody that may express reactivity in patients with syphilis and other infectious diseases.

Beta-2-Glycoprotein 1, apolipoprotein H, is a cofactor in antiphospholipid antibody binding and is the critical antigen in the antiphospholipid antibody syndrome. Beta-2-Glycoprotein 1 Antibody is more specific than cardiolipin antibody that may express reactivity in patients with syphilis and other infectious diseases.

Description: The Beta 2 Microglobulin test is a blood test used to detect the protein Beta-2 Microglobulin in your blood’s serum, and is used in the examination of multiple myeloma and lymphoma.

Also Known As: B2M Test, β2-Microglobulin Test, Thymotaxin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Beta-2 Microglobulin test ordered?

This test may be requested during the initial examination of a patient with multiple myeloma in order to stage the condition as well as on an ongoing basis to assess disease activity and track the efficacy of treatment. When a person has myeloma or lymphoma, it may occasionally be requested to help evaluate their prognosis.

What does a Beta-2 Microglobulin test check for?

Almost every cell in the body has beta-2 microglobulin on its surface. Cells, notably B lymphocytes and tumor cells, release this protein into the blood. It is found in the majority of bodily fluids, and when the immune system is stimulated or when cell creation and/or destruction are increased, its level rises.

With tumors like multiple myeloma and lymphoma, as well as with inflammatory conditions and infections, B2M is typically high in the blood. B2M may be useful as a tumor marker because it is elevated in blood cell malignancies. This page concentrates on its usage as a tumor marker, despite the fact that it can be used to evaluate kidney function.

Blood cell malignancies that have migrated to the brain, such lymphoma, as well as some chronic diseases like multiple sclerosis and viral infections like HIV can cause a rise in the B2M level in the CSF of affected individuals.

Lab tests often ordered with a Beta-2 Microglobulin test:

  • Albumin
  • Tumor Markers

Conditions where a Beta-2 Microglobulin test is recommended:

  • Cancer
  • Multiple Myeloma
  • Lymphoma

How does my health care provider use a Beta-2 Microglobulin test?

On the surface of almost every cell in the body is beta-2 microglobulin. This protein is released into the blood by cells, particularly B lymphocytes and tumor cells. The majority of body fluids contain it, and its level increases when the immune system is activated or when cell formation and/or destruction are elevated.

B2M is generally elevated in the blood with cancers such multiple myeloma and lymphoma, as well as with inflammatory diseases and infections. Due to the fact that B2M is raised in blood cell malignancies, it may be useful as a tumor marker. Despite the fact that it can be used to assess kidney function, this page focuses on its use as a tumor marker.

A spike in the B2M level in the CSF of affected people can be brought on by blood cell malignancies that have spread to the brain, including lymphoma, as well as some chronic conditions like multiple sclerosis and viral infections like HIV.

What do my Beta-2 Microglobulin test results mean?

Increased levels of B2M in the blood and/or urine point to a problem but do not serve as a diagnosis for any particular illness or condition. They do, however, represent the level of cancer present and the severity of the disease. If the B2M level is highly raised, someone who has been diagnosed with multiple myeloma or lymphoma is likely to have a worse prognosis.

When multiple myeloma is being treated, a patient's levels should gradually decline over time to show whether the patient is improving. Levels that are stable or rising suggest that the subject is not responding.

Increases in the CSF in a person with an illness like HIV/AIDS suggest that the central nervous system is probably involved.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Collection Instructions

Allow sample to clot for 30 minutes, spin at 3,000 RPM for 10 minutes and transfer serum to plastic, amber vial. If amber vial is not available, wrap tube in aluminum foil to protect from light. Freeze within 30 minutes and send frozen.


Clinical Significance

To detect the presence of autoantibodies specific to Bp 180 in a patient's sera as an aid to diagnosis bullous pemphigoid.


Clinical Significance

Bullous pemphigoid (BP) is a chronic blistering disorder found mainly in the elderly but occasionally encountered in children. It is characterized by frequent recurring tense blisters and erythema. IgG anti-basement membrane zone (BMZ) antibodies are found in the serum of patients, and immunofluorescence demonstrates linear staining with IgG or C3 at the BMZ of the lesion. Target antigens of the autoantibodies in BP patient serum are BP180 and BP230, also called BPAG1 and BPAG2. Anti-BP230 is highly specific to BP and considered to be a useful serologic marker of the the disease. The BP230 ELISA kit has recombinant protein of both N-terminus and C-terminus of BP230 as solid phase and measures anti-BP230 autoantibodies in patient serum specifically.


Description: The CRP test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

When a person's medical history and signs and symptoms indicate that they may have a significant bacterial infection, a CRP test may be recommended. When a newborn displays signs of infection or when a person has sepsis symptoms including fever, chills, and rapid breathing and heart rate, it may be ordered.

It's also commonly requested on a regular basis to check illnesses like rheumatoid arthritis and lupus, and it's routinely repeated to see if medication is working. This is especially effective for inflammation issues because CRP levels decrease as inflammation decreases.

What does a C-Reactive Protein blood test check for?

C-reactive protein is a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. After trauma or a heart attack, with active or uncontrolled autoimmune illnesses, and with acute bacterial infections like sepsis, markedly higher levels are reported. CRP levels can rise by a thousand-fold in response to inflammatory diseases, and their elevation in the blood can occur before pain, fever, or other clinical signs. The test detects inflammation caused by acute situations or monitors disease activity in chronic diseases by measuring the level of CRP in the blood.

The CRP test is not a diagnostic tool, although it can tell a doctor if inflammation is occurring. This information can be combined with other indicators like signs and symptoms, a physical exam, and other tests to establish whether someone has an acute inflammatory disorder or is having a flare-up of a chronic inflammatory disease. The health care provider may next do additional tests and treatment.

This CRP test should not be confused with the hs-CRP test. These are two separate CRP tests, each of which measures a different range of CRP levels in the blood for different purposes.

Lab tests often ordered with a C-Reactive Protein test:

  • Sed Rate (ESR)
  • Procalcitonin
  • ANA
  • Rheumatoid Factor
  • Complement

Conditions where a C-Reactive Protein test is recommended:

  • Arthritis
  • Autoimmune Disorders
  • Pelvic Inflammatory Disease
  • Inflammatory Bowel Disease
  • Sepsis
  • Vasculitis
  • Systemic Lupus Erythematosus
  • Meningitis and Encephalitis

Commonly Asked Questions:

How does my health care provider use a C-Reactive Protein test?

A health practitioner uses the C-reactive protein test to diagnose inflammation. CRP is an acute phase reactant, a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. The CRP test is not a diagnostic test for any ailment, but it can be used in conjunction with other tests to determine whether a person has an acute or chronic inflammatory disorder.

CRP, for example, can be used to detect or track substantial inflammation in someone who is suspected of having an acute ailment like:

  • Sepsis is a dangerous bacterial infection.
  • An infection caused by a fungus
  • Inflammation of the pelvis

People with chronic inflammatory diseases can use the CRP test to detect flare-ups and/or see if their medication is working. Here are a few examples:

  • Inflammatory bowel disease
  • Arthritis, which can take many forms.
  • Autoimmune disorders, examples include lupus and vasculitis

CRP is occasionally requested in conjunction with an erythrocyte sedimentation rate, another inflammatory test. While the CRP test is not specific enough to diagnose an illness, it does serve as a broad marker for infection and inflammation, alerting doctors to the need for more testing and treatment. A variety of additional tests may be used to determine the source of inflammation, depending on the probable cause.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

CRP levels in the blood that are high or rising indicate the existence of inflammation, but they don't tell you where it is or what's causing it. A high CRP level can establish the presence of a severe bacterial infection in people who are suspected of having one. High levels of CRP in persons with chronic inflammatory disorders indicate a flare-up or that treatment isn't working.

When the CRP level rises and then falls, it indicates that the inflammation or infection is diminishing and/or responding to treatment.

Is there anything else I should know about C-Reactive Protein?

CRP levels can rise during pregnancy, as well as with the use of birth control tablets or hormone replacement therapy. Obese people have also been found to have higher CRP levels.

In the presence of inflammation, the erythrocyte sedimentation rate test will also rise; however, CRP rises first and then falls faster than the ESR.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

  • Complete Blood Count
  • Lipid Panel
  • Comprehensive Metabolic Panel
  • Lp-Pla2
  • Glucose

Conditions where a hs-CRP test is recommended:

  • Heart Attack
  • Heart Disease
  • Cardiovascular Disease
  • Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


C4B is a complement binding protein that specifically binds 50% circulating protein S, a vitamin K dependent cofactor of protein C activation. Since C4B may be elevated in certain disease states, this may affect the available "free protein S" to engage in anticoagulant activity.

Most Popular

Description: A hs-CRP or High Sensitivity C-Reactive Protein test is a blood test used to accurately detect lower concentrations of the protein C-Reactive Protein. This test is used to evaluate your risk of cardiovascular and heart disease and to check for inflammation and many other issues.

Also Known As: hsCRP Test, Cardiac CRP Test, high sensitivity C-reactive protein Test, CRP Test for heart disease.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a hs-CRP test ordered?

There is currently no consensus on when to get an hs-CRP test. It may be beneficial for treatment purposes to order hs-CRP for those that have kidney disease, diabetes or inflammatory disorders.

It's possible that hs-CRP will be tested again to confirm that a person has persistently low levels of inflammation.

What does a hs-CRP blood test check for?

C-reactive protein is a protein found in the blood that rises in response to infection and inflammation, as well as after trauma, surgery, or a heart attack. As a result, it's one of numerous proteins referred to as acute phase reactants. The high-sensitivity CRP test detects low levels of inflammation in the blood, which are linked to an increased risk of developing cardiovascular disease.

According to the American Heart Association, CVD kills more people in the United States each year than any other cause. A number of risk factors have been related to the development of CVD, including family history, high cholesterol, high blood pressure, being overweight or diabetic, however a considerable number of people with few or no recognized risk factors will also acquire CVD. This has prompted researchers to investigate for new risk variables that could be causing CVD or could be used to identify lifestyle modifications and/or treatments that could lower a person's risk.

High-sensitivity CRP is one of an increasing number of cardiac risk markers that may be used to assess an individual's risk. According to certain research, monitoring CRP with a highly sensitive assay can assist identify the risk level for CVD in persons who appear to be healthy. CRP levels at the higher end of the reference range can be measured with this more sensitive test. Even when cholesterol levels are within an acceptable range, these normal but slightly elevated levels of CRP in otherwise healthy persons might indicate the future risk of a heart attack, sudden cardiac death, stroke, and peripheral artery disease.

Lab tests often ordered with a hs-CRP test:

  • Complete Blood Count
  • Lipid Panel
  • Comprehensive Metabolic Panel
  • Lp-Pla2
  • Glucose

Conditions where a hs-CRP test is recommended:

  • Heart Attack
  • Heart Disease
  • Cardiovascular Disease
  • Stroke

How does my health care provider use a hs-CRP test?

A test for high-sensitivity C-reactive protein can be used to assess a person's risk of cardiovascular disease. It can be used in conjunction with a lipid profile or other cardiac risk markers, such as the lipoprotein-associated phospholipase A2 test, to provide further information regarding the risk of heart disease.

CRP is a protein that rises in the bloodstream as a result of inflammation. A continuous low level of inflammation, according to studies, plays a crucial role in atherosclerosis, the narrowing of blood vessels caused by the build-up of cholesterol and other lipids, which is typically linked to CVD. The hs-CRP test successfully detects low levels of C-reactive protein, indicating low but chronic inflammation, and so aids in predicting a person's risk of developing CVD.

Some specialists believe that high-sensitivity CRP is a good test for assessing CVD, heart attacks, and stroke risk, and that it can help in the evaluation process before a person gets one of these health problems. Some experts believe that combining a good marker for inflammation, such as hs-CRP, with a lipid profile is the best way to predict risk. This test has been recommended by several organizations for persons who are at a moderate risk of having a heart attack in the following ten years.

What does my hs-CRP test result mean?

Even when cholesterol levels are within an acceptable range, high levels of hs-CRP in otherwise healthy people have been found to predict an elevated risk of future heart attacks, strokes, sudden cardiac death, and/or peripheral arterial disease.

Higher hs-CRP concentrations indicate a higher risk of cardiovascular disease, while lower values indicate a lower risk. Individuals with hs-CRP values at the high end of the normal range are 1.5 to 4 times more likely than those with low levels of hs-CRP to have a heart attack.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: Ion Mobility Lipoprotein Fractionation is a test that uses a gas-phase technology to separate the lipid particles by size. As each particle is separated, they are counted.

Also Known As: LDL Particle Testing, LDL-P Test, LDL Subclass Test, sdLDL Test, LDL Fractionations Test, LDL Particle Size Test, LDL Particle Number Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting preferred, but not required

When is a Lipoprotein Fractionation test ordered?

When someone has a personal or family history of early cardiovascular disease, this testing may be ordered as part of an overall evaluation of cardiac risk, especially if the person does not have typical cardiac risk factors like high cholesterol, high LDL cholesterol, high triglyceride, low HDL cholesterol, smoking, obesity, inactivity, diabetes, and/or hypertension.

When a person with elevated LDL-P and/or a high proportion of tiny, dense LDL particles has undertaken cholesterol-lowering treatment or lifestyle adjustments, the healthcare practitioner may conduct LDL lipoprotein subfraction testing, as well as other lipid tests, to assess treatment success.

Although LDL-P is not typically suggested as a screening test, some healthcare practitioners are using it in conjunction with a battery of other cardiac risk tests to evaluate a person's overall risk of getting CVD.

What does a Lipoprotein Fractionation blood test check for?

Low-density lipoproteins are lipid-transporting particles that travel throughout the body. Protein, cholesterol, triglyceride, and phospholipid molecules are all present in each particle. As they move through the bloodstream, their makeup changes. Lipoprotein particles range in size from large and fluffy to small and dense, depending on which molecules are eliminated and which are added. The relative amounts of particles with different characteristics in the blood are determined by LDL particle testing. Subfractionation testing is a term used to describe this process.

Traditional lipid testing determines the amount of LDL cholesterol in the blood but does not assess the number of LDL particles. Increased numbers of small, dense LDL particles have been linked to inflammation and are more likely to produce atherosclerosis than fewer light, fluffy LDL particles, according to some research. Researchers believe that the existence of an elevated quantity of sdLDL could be one of the reasons why some people have heart attacks while having relatively low total and LDL cholesterol levels.

The number of sdLDL particles in a person's blood is determined in part by genetics, in part by sex, and in part by lifestyle and overall health. Increased levels of sdLDL are linked to certain diseases and disorders, like as diabetes and hypertension.

By examining a person's triglyceride and high-density lipoprotein cholesterol levels, it is usually able to estimate whether they have a high amount of sdLDL particles. Typically, these tests are done as part of a lipid profile. People with high triglycerides and low HDL-C have higher levels of sdLDL. More sdLDL is connected with a triglyceride level greater than 120 mg/dL and an HDL-C level less than 40 mg/dL in men and less than 50 mg/dL in women.

Other lipoprotein particles, such as HDL and VLDL, can also be subfractionated, however these tests are generally utilized in research settings and are not discussed on this page.

Lab tests often ordered with a Lipoprotein Fractionation test:

  • Lipid Panel
  • HDL Cholesterol
  • LDL Cholesterol
  • Direct LDL
  • Apolipoprotein A-1
  • Apolipoprotein B
  • Lipoprotein (a)
  • Triglycerides
  • Homocysteine
  • Hs-CRP
  • VAP

Conditions where a Lipoprotein Fractionation test is recommended:

  • Cardiovascular Disease
  • Heart Disease

How does my health care provider use a Lipoprotein Fractionation test?

Low-density lipoprotein particle testing determines the number, size, density, and/or electrical charge of LDL particles. It may be useful in determining cardiac risk in patients with a personal or family history of heart disease at a young age, particularly if their total cholesterol and LDL cholesterol levels are not markedly increased. LDL subfraction testing is usually done in conjunction with or after a lipid profile.

While the LDL-C test is a good predictor of cardiovascular disease risk for many people, research has indicated that certain persons with healthy LDL-C levels nonetheless have an increased risk of CVD. Similarly, even if their LDL-C is at a safe level, people with chronic diseases like diabetes may be at higher risk. The quantity of LDL particles and/or their size has been recommended as an additional factor to consider when assessing CVD risk in these populations. Lipoprotein subfraction testing may be done in these situations to further assess a person's CVD risk.

LDL-P is sometimes requested to see how well a treatment is working at reducing the quantity of tiny, dense LDL particles.

LDL subfraction testing has been employed in clinical settings, although VLDL or HDL subfraction testing is primarily used in research. This is because LDL cholesterol has been established as the key risk factor for heart disease, and LDL assessment has received increased attention in research and development.

What do my Lipoprotein Fractionation test results mean?

The method and reporting format utilized in an LDL-P test, as well as the person's total cholesterol, LDL-C, VLDL, and/or HDL cholesterol, are all reflected in the results. Because different methods divide subclasses based on different physical qualities, results may not be immediately comparable from one method to the next or from one laboratory to the next.

Usually, the result is evaluated in context of a lipid profile and the risk it implies:

  • If a person has a high number of mostly tiny, dense LDL and an elevated LDL-P, this result will enhance the person's risk of cardiovascular disease beyond the risk associated with total LDL.
  • If a person only has large, fluffy LDL and a low LDL-P, this discovery will not put them at any greater risk.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.



How familiar are you with autoimmune diseases? 

Your body’s immune system naturally helps fight against harmful bacteria and other foreign substances. This natural response revolves around antibodies and specific immune cells. Autoimmune diseases occur when your body’s immune system fights against normal constituents, instead of harmful bacteria and other foreign substances. It has everything to do with your immune system failing to discern between “self” vs. “non-self” constituents.  This failure to discern may produce immune cells or antibodies (or auto-antibodies) that target the body’s own cells, tissues, and/or organs.  These attacks cause inflammation and tissue damage that result in autoimmune disorders. 

Over 80 diseases have been classified as resulting from autoimmune responses, and there is evidence to suggest that there are 40 other diseases that may have an autoimmune basis.

According to the National Institutes of Health, nearly 24 million people in the US suffer from autoimmune disease. While the majority of these diseases are, in fact, rare, the number of people suffering from them continues to rise. These diseases affect women on a larger scale than men. In the case of Lupus, women are ten times more likely to be affected.

Medical professionals are unaware of what causes most autoimmune diseases, save for the fact that genetic predisposition seems to play its part. There are some autoimmune diseases, like rheumatic fever, where a virus or bacterial infection is what leads to the confused immune response. T-cells are antibodies and immune cells that attack good cells.  The T-cells misidentify the good cells as the microbes that are infecting the body.

There are two main types of autoimmune diseases, systemic and localized. The systemic autoimmune diseases are disorders that lead to multi-organ damage. In contrast, the localized autoimmune disorders lead to direct damage to a single organ or tissue. The lines can be blurred between the two types; however, as medical professionals point out that the damage caused by localized autoimmune disorders often indirectly impacts other organs and systems in the body.

There are also instances where certain autoimmune diseases do not cause antibodies to attack a particular organ or tissue but rather a certain type of cell. One example involves anti-phospholipid antibodies and how they attack regular platelet phospholipids. This happens inside blood vessels, and the event can lead to improper blood clot formation and thrombosis.

Autoimmune diseases aren’t always easily recognizable either, especially systemic disorders. Multiple symptoms that frequently change in severity can leave doctors searching for a diagnosis for an extended period of time. Any vague and slow to develop signs and symptoms, although present, can also serve to be misleading to medical professionals. There are a variety of symptoms that stem from the various autoimmune diseases, including joint pain, fever, and fatigue. Many people also report a feeling of generally being unwell.

Which lab tests are used to detect autoimmune disorders depends on which disease a medical professional suspects to be the culprit. Blood tests are commonly used for diagnosis because doctors need to know what autoantibodies are in attack mode. Two inflammation tests, CRP (or C-reactive protein) and ESR (or erythrocyte sedimentation rate), are also commonly used in diagnosis. Sometimes a person may have more than a single autoimmune disease.  As examples, individuals who suffer from Addison disease often are type 1 diabetics, and people with sclerosing cholangitis often suffer from ulcerative colitis.

Below is a list of several of the more well-known autoimmune diseases. You can also find out additional information from the AARDA (American Autoimmune Related Diseases Association) about these diseases and more.

  • Addison Disease
  • Antiphospholipid Syndrome
  • Autoimmune Hepatitis
  • Celiac Disease
  • Graves’ Disease
  • Guillain-Barre Syndrome
  • Hashimoto Thyroiditis
  • Inflammatory Bowel Disease
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Pernicious Anemia
  • Primary Biliary Cirrhosis
  • Sclerosing Cholangitis (see Autoimmune-associated Liver Diseases)
  • Reactive Arthritis
  • Rheumatoid Arthritis
  • Juvenile Rheumatoid Arthritis
  • Sarcoidosis
  • Scleroderma
  • Sjögren Syndrome
  • Lupus (Systemic Lupus Erythematosus or SLE)
  • Type 1 Diabetes
  • Vasculitis

Sarcoidosis is a medical condition caused by immune system cells clumping together to form lumps called granulomas. Granulomas can develop in any part of the body, but the most common (and serious) sites where they form are in the lungs, eyes, lymph nodes, and skin. Granulomas often disappear on their own within two to three years. Sometimes, though, granulomas clump together. When this occurs in an important organ, it can cause it to become inflamed. If the granulomas persist for long enough, they can impede the function of the organ and cause fibrosis, that is, permanent scarring. 

The precise cause of sarcoidosis is not well understood. Many risk factors are believed to contribute to the disease, including genetic predisposition, immune system overreactions when exposed to bacteria or viruses, and environmental triggers like chemicals and allergens. 

Sarcoidosis occurs in people of all ages and communities, but sufferers are most commonly over the age of 55 and of Northern European or African descent. In the United States, African American women are the demographic group most often diagnoses with sarcoidosis. The US reports more than 25,000 new cases of sarcoidosis per year. 

The severity and duration of sarcoidosis vary from patient to patient: 

  • You may have sarcoidosis without ever noticing symptoms. Mild cases may cause non-specific symptoms that are easily mistaken for other conditions. 
  • You may experience an acute case of sarcoidosis which resolves on its own within a few years. This is called “remission.” Acute sarcoidosis may or may not return in the future. 
  • You may have chronic sarcoidosis, growing worse over time. 

The National Heart Lung and Blood Institute reports that half of all sarcoidosis sufferers will go into remission within three years of being diagnosed. At 10 years after diagnosis, two-thirds of sufferers will be in remission. 

Sarcoidosis does not cause long-term health effects for most sufferers. However, about one-third of those with the disease will experience organ damage to some extent. People who suffer sarcoidosis in their lungs or hearts may experience severe consequences, including death. Sarcoidosis can, on rare occasions, cause blindness. 

Symptoms  

The symptoms you may experience with sarcoidosis vary widely in type and severity. The specific tissues and organs affected by the disease matter and symptoms can change over time. Some people with sarcoidosis experience no symptoms at all. Some symptoms are very similar to those caused by other health conditions.

Examples of these include: 

  • Fever 
  • Weight loss 
  • Fatigue 
  • Loss of appetite 
  • Night sweats 
  • Swollen and/or painful joints 
  • Swollen lymph nodes 

The symptoms may be different, depending on which organs are affected: 

The Lungs 

According to the American Lung Association, up to 90 percent of all sarcoidosis cases affect the lungs. Sarcoidosis symptoms in the lungs tend to worsen over time as scar tissue forms, and the lungs become stiff. Common symptoms include: 

  • Dry coughing 
  • Shortness of breath 
  • Wheezing or strained breathing 
  • Pain, tightness, or discomfort in the chest 

The Skin 

Skin issues occur in roughly one-quarter of all sarcoidosis cases. Signs and symptoms include: 

  • Sores appearing on the cheeks, nose, eyelids, and ears 
  • Bumpy rashes on the ankles or shins — these appear reddish and raised, and may feel tender, warm, or itchy 
  • Inflammation and raised skin around scars 
  • Skin discoloration 

The Eyes 

Symptoms that affect the eyes include: 

  • Light sensitivity 
  • Blurred vision 
  • Pain or itching 
  • Excessive tears 
  • Red or burning eyes 
  • Inflammation 

The Heart 

Symptoms that are common when the heart is affected include: 

  • Abnormal heart rhythm 
  • Chest pain 
  • Rapid heartbeat 
  • Symptoms like congestive heart failure, including shortness of breath, coughing, wheezing, and swollen legs and ankles. 

The Nervous System 

Symptoms affecting the nervous system and brain include: 

  • Headaches 
  • Seizures 
  • Loss of coordination 
  • Fatigue 
  • Tremors 

Skeleton and/or Muscles 

If sarcoidosis granulomas occur in the bones or muscles, they may cause pain and/or joint stiffness. 

Other symptoms 

May also cause the following effects: 

  • Swollen salivary glands 
  • Enlarged liver 
  • Enlarged spleen 
  • Kidney stones 
  • Kidney failure (rare) 

Testing

Testing for sarcoidosis involves determining which tissues are affected as well as accurately diagnosing the disease. Tests are also used to gauge the severity of the disease and monitor its progress. It’s also important to rule out other conditions that may cause similar granulomas. These include tuberculosis and certain fungal infections. 

Lab Tests 

  • ACE (Angiotensin Converting Enzyme) This test is useful for diagnosing Sarcoidosis and monitoring both the progress of the disease and its response to treatment. Sarcoidosis causes elevated ACE levels, but other conditions can also have this effect. Examples include diabetes, hyperthyroidism, tuberculosis, and fungal infections. 
  • Liver Panel or CMP (Comprehensive Metabolic Panel) This is a battery of tests that assess the function of the liver and or kidneys. They can tell if those organs have been damaged by the disease. 
  • CBC (Complete Blood Count) This test may be ordered to evaluate red and white blood cells. 
  • C-Reactive Protein (CRP) A key test to detect inflammation. ESR (Erythrocyte Sedimentation Rate) testing may be used as an alternative. 
  • Calcium Elevated calcium levels in the blood or urine may be a sign of sarcoidosis. This is because the granulomas produce vitamin D, which increases calcium absorption in the intestines. 
  • Vitamin D A vitamin D test is often used as a follow-up if elevated calcium levels are detected. 
  • Cerebrospinal Fluid (CSF) Analysis This test may be used to confirm or deny sarcoidosis in the brain or nervous system. 
  • AFB TestingSputum CulturesFungal Tests These are all used to rule out other conditions that may cause signs and symptoms like sarcoidosis.