Sjögren Syndrome

Sjögren's Syndrome Diagnostic Panel, Comprehensive

IMPORTANT:  RELEX Testing by Quest is included in this panel. Quest will execute the tests automatically if any of the following is triggered, and there will be an extra charge for each test that Quest runs. 

By ordering this test panel, you agree to pay extra for Quest's reflex tests.

• If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00
• If Mitochondrial Antibody Screen is positive, then Mitochondrial Antibody Titer will be performed at an additional charge (CPT code(s): 86381).

Early Sjogren's Syndrome Profile

Includes

Carbonic Anhydrase VI (CA VI) IgG Antibodies, Carbonic Anhydrase VI (CA VI) IgA Antibodies, Carbonic Anhydrase VI (CA VI) IgM Antibodies
Parotid Specific Protein (PSP) IgG Antibodies, Parotid Specific Protein (PSP) IgA Antibodies, Parotid Specific Protein (PSP) IgM Antibodies
Salivary Protein 1 (SP-1) IgG Antibodies, Salivary Protein 1 (SP-1) IgA Antibodies, Salivary Protein 1 (SP-1) IgM Antibodies

Clinical Significance

Sjogren's syndrome (SS) is a systemic autoimmune disease in which loss of salivary gland and lachrymal gland function is associated with hypergammaglobulinemia, autoantibody production, mild kidney and lung disease and eventually lymphoma. SS involves dry eyes and dry mouth without systemic features that may be either primary or secondary to another autoimmune disease, such as SLE. Patients with SS and picked up at a late stage in their disease, after the salivary glands and lachrymal glands are already destroyed, because they are asymptomatic until that time. At this point, only symptomatic treatment can be offered for abnormal lachrymal and salivary gland function. The diagnosis for SS is currently at a crossroad with the American College of Rheumatology providing which requires characteristic autoantibodies (SS-A/SS-B) or minor salivary gland biopsy. Since lip biopsies are not frequently performed in clinical practice, there is increased emphasis placed on autoantibodies in diagnosis. The current Ro and La antibodies can delay the diagnosis by over 6 years.Recently novel antibodies identified to salivary gland protein 1 (SP-1), carbonic anhydrase 6 (CA6) and parotid secretory protein (PSP) using western blot methodology. Further studies have shown that the isotype differentiation of the markers adds to the sensitivity of diagnosis of SS. These autoantibodies occurred earlier in the course of the disease than antibodies to Ro or La. In addition antibodies to SP-1, CA-6 and PSP were found in patients meeting the criteria for SS who lacked antibodies to Ro or La. Furthermore, in patients with idiopathic xerostomia and xerophthalmia for less than 2 years, 76% had antibodies to SP-1 and/or CA6 while only 31% had antibodies to Ro or La.
Antibodies to different isotypes (IgG, IgM & IgA of SP-1, CA6 and PSP are useful markers for identifying patients with SS at early stages of the disease or those that lack antibodies to either Ro or La.

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

Average Processing Time: 2 to 3 days

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

Average Processing Time: 2 to 3 days

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

Clinical Significance

Rheumatoid Arthritis Diagnostic IdentRA® Panel 2 - Early diagnosis of rheumatoid arthritis (RA), ie, diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis. The 14-3-3η protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those with psoriatic arthritis joint damage from those without joint damage.

Rheumatoid Factor (IgA, IgG, IgM) 

Reference Range(s)

• Rhematoid Factor (IgA)
  • ≤6 Negative
  • >6 Positive
• Rhematoid Factor (IgG)
  • ≤6 Negative
  • >6 Positive
• Rhematoid Factor (IgM)
  • ≤6 Negative
  • >6 Positive

Description: Rheumatoid Factor IgG is a blood test that measures the amount of rheumatoid factor IgG antibodies that are present in the blood’s serum.

Also Known As: RF Antibody Test, Rheumatoid Arthritis Factor Antibody Test, RF IgG Test, RF IgG Antibody Test, Rheumatoid Factor IgG Antibody Test

Collection Method: Blood Draws

Specimen Type: Serum

Test Preparation: No preparation required

When is a Rheumatoid Factor IgG test ordered?

When a person has RA signs and symptoms, an RF test may be ordered. Pain, warmth, swelling, and morning stiffness in the joints are common symptoms, as are nodules under the skin and, if the disease has progressed, signs of enlarged joint capsules and cartilage and bone loss on X-rays. When the first RF test is negative but the symptoms persist, the RF test may be repeated.

A cyclic citrullinated peptide antibody test may be ordered along with RF or if the RF result is negative to help diagnose RA in someone who has joint inflammation but does not yet fit the criteria for RA.

Additional autoimmune-related tests, such as an ANA, as well as other markers of inflammation, such as a CRP and Sed Rate, as well as a CBC to examine blood cells, may be ordered in addition to the RF test.

What does a Rheumatoid Factor IgG blood test check for?

The autoantibody rheumatoid factor is an immunoglobulin M protein produced by the body's immune system. Autoantibodies attack a person's own tissues, mistaking them for "foreign" tissue. While the biological role of RF is unknown, its presence can be used to detect inflammatory and autoimmune activities. This test identifies and quantifies radiofrequency in the bloodstream.

The RF test is an important tool in the diagnosis of rheumatoid arthritis. A RF test will be positive in about 80% of people with RA. RF, on the other hand, can be found in persons with a range of different illnesses, including as Sjögren syndrome, as well as persistent bacterial, viral, and parasite infections, and some malignancies. It can be noticed in patients who have lung, liver, or kidney disease, and it can also be detected in a tiny percentage of healthy persons.

Lab tests often ordered with a Rheumatoid Factor IgG test:

• Rheumatoid Factor IgM
• Cyclic Citrullinated Peptide Antibody
• ANA
• Sed Rate
• C-Reactive Protein
• Immunoglobulins

Conditions where a Rheumatoid Factor IgG test is recommended:

• Rheumatoid Arthritis
• Autoimmune Disorders

How does my health care provider use a Rheumatoid Factor IgG test?

The rheumatoid factor test is used to diagnose rheumatoid arthritis and to distinguish it from other types of arthritis or diseases that generate similar symptoms.

While the clinical picture is critical in the diagnosis of RA, some signs and symptoms, particularly in the early stages of the disease, may not be present or follow a predictable pattern. Additionally, the signs and symptoms may not always be easy to distinguish because people with RA may also have other connective tissue disorders such Raynaud phenomenon, scleroderma, autoimmune thyroid problems, and systemic lupus erythematosus and present symptoms of these disorders. When RA is suspected, the RF test is one of several tools that can be used to aid determine a diagnosis.

What do my Rheumatoid Factor test results mean?

The results of the RF test must be interpreted in the context of a person's symptoms and medical history.

The presence of large amounts of RF in persons with symptoms and clinical indications of rheumatoid arthritis indicates that they are likely to develop RA. Higher RF levels are associated with a worse prognosis and more severe illness.

A negative RF test does not rule out the possibility of RA. Around 20% of persons with RA will have very low levels of RF or none at all. In these circumstances, a positive CCP antibody test can be utilized to confirm RA.

Sjögren syndrome, systemic lupus erythematosus, sarcoidosis tuberculosis, syphilis, HIV/AIDS, hepatitis, scleroderma, infectious mononucleosis, cancers such as leukemia and multiple myeloma, or disease of the liver, lung, or kidney may all produce positive RF test These other disorders are neither diagnosed or monitored with the RF test.

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

Description: RF is a blood test that is measures the amount of rheumatoid factor that is present in the blood’s serum. It is used along with other tests to diagnose rheumatoid arthritis.

Also Known As: RF Test, Rheumatoid Arthritis Factor Test

Collection Method: Blood Draws

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a Rheumatoid Factor test ordered?

When a person has RA signs and symptoms, an RF test may be ordered. Pain, warmth, swelling, and morning stiffness in the joints are common symptoms, as are nodules under the skin and, if the disease has progressed, signs of enlarged joint capsules and cartilage and bone loss on X-rays. When the first RF test is negative but the symptoms persist, the RF test may be repeated.

A cyclic citrullinated peptide antibody test may be ordered along with RF or if the RF result is negative to help diagnose RA in someone who has joint inflammation but does not yet fit the criteria for RA.

Additional autoimmune-related tests, such as an ANA, as well as other markers of inflammation, such as a CRP and Sed Rate, as well as a CBC to examine blood cells, may be ordered in addition to the RF test.

What does a Rheumatoid Factor blood test check for?

The autoantibody rheumatoid factor is an immunoglobulin M protein produced by the body's immune system. Autoantibodies attack a person's own tissues, mistaking them for "foreign" tissue. While the biological role of RF is unknown, its presence can be used to detect inflammatory and autoimmune activities. This test identifies and quantifies radiofrequency in the bloodstream.

The RF test is an important tool in the diagnosis of rheumatoid arthritis. A RF test will be positive in about 80% of people with RA. RF, on the other hand, can be found in persons with a range of different illnesses, including as Sjögren syndrome, as well as persistent bacterial, viral, and parasite infections, and some malignancies. It can be noticed in patients who have lung, liver, or kidney disease, and it can also be detected in a tiny percentage of healthy persons.

Lab tests often ordered with a Rheumatoid Factor test:

• Cyclic Citrullinated Peptide Antibody
• ANA
• Sed Rate
• C-Reactive Protein
• Immunoglobulins

Conditions where a Rheumatoid Factor test is recommended:

• Rheumatoid Arthritis
• Autoimmune Disorders

How does my health care provider use a Rheumatoid Factor test?

The rheumatoid factor test is used to diagnose rheumatoid arthritis and to distinguish it from other types of arthritis or diseases that generate similar symptoms.

While the clinical picture is critical in the diagnosis of RA, some signs and symptoms, particularly in the early stages of the disease, may not be present or follow a predictable pattern. Additionally, the signs and symptoms may not always be easy to distinguish because people with RA may also have other connective tissue disorders such Raynaud phenomenon, scleroderma, autoimmune thyroid problems, and systemic lupus erythematosus and present symptoms of these disorders. When RA is suspected, the RF test is one of several tools that can be used to aid determine a diagnosis.

What do my Rheumatoid Factor test results mean?

The results of the RF test must be interpreted in the context of a person's symptoms and medical history.

The presence of large amounts of RF in persons with symptoms and clinical indications of rheumatoid arthritis indicates that they are likely to develop RA. Higher RF levels are associated with a worse prognosis and more severe illness.

A negative RF test does not rule out the possibility of RA. Around 20% of persons with RA will have very low levels of RF or none at all. In these circumstances, a positive CCP antibody test can be utilized to confirm RA.

Sjögren syndrome, systemic lupus erythematosus, sarcoidosis tuberculosis, syphilis, HIV/AIDS, hepatitis, scleroderma, infectious mononucleosis, cancers such as leukemia and multiple myeloma, or disease of the liver, lung, or kidney may all produce positive RF test These other disorders are neither diagnosed or monitored with the RF test.

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

Description: Sed Rate is a blood test that is used to measure the rate that red blood cells fall to the bottom of a test tube. The measurement is based how many cells fall within one hour. This test can be used to determine infection or inflammation.

Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sed Rate Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Sed Rate test ordered?

When a condition or disease is believed to be causing inflammation in the body, an ESR may be ordered. Several inflammatory illnesses can be identified using this test. It may be requested, for example, if arthritis is suspected of producing joint inflammation and pain, or if inflammatory bowel disease is suspected of causing digestive symptoms.

When a person develops symptoms of polymyalgia rheumatica, systemic vasculitis, or temporal arteritis, such as headaches, neck or shoulder discomfort, anemia, pelvic pain, poor appetite, joint stiffness, and unexplained weight loss, a doctor may recommend an ESR. To follow the development of specific illnesses, the sed rate test can also be routinely ordered.

A health practitioner may wish to repeat the ESR before undertaking a full workup to look for disease.

What does a Sed Rate blood test check for?

The erythrocyte sedimentation rate is a test that evaluates the degree of inflammation in the body indirectly. The test evaluates the rate at which erythrocytes fall in a blood sample that has been placed in a tall, thin, vertical tube. The millimeters of clear fluid present at the upper portion of the tube after one hour are reported as the results.

When a drop of blood is inserted in a tube, the red blood cells settle out slowly, leaving just a small amount of transparent plasma. In the presence of an increased number of proteins, particularly proteins known as acute phase reactants, red cells settle at a faster pace. Inflammation raises the levels of acute phase reactants such as C-reactive protein and fibrinogen in the blood.

An inherent component of the immune system's response is inflammation. It could be chronic, showing symptoms over time with conditions like autoimmune illnesses or cancer, or acute, showing symptoms right away after a shock, injury, or infection.

The ESR is a non-specific indication that can rise in a number of disorders; it is not a diagnostic test. It provides you with a fundamental understanding of whether you have an inflammatory condition or not.

Given the availability of more recent, specialized tests, there have been reservations about the ESR's utility. The ESR test, on the other hand, is commonly used to diagnose and monitor temporal arteritis, systemic vasculitis, and polymyalgia rheumatica. Extremely high ESR values can aid in differentiating between rheumatic diseases. Furthermore, ESR may still be a viable alternative in some cases, such as when newer tests are unavailable in resource-constrained places or while monitoring the progression of a disease.

Lab tests often ordered with a Sed Rate test:

• C-Reactive Protein
• ANA
• Rheumatoid Factor

Conditions where a Sed Rate test is recommended:

• Vasculitis
• Autoimmune Disorders
• Rheumatoid Arthritis
• Osteoarthritis
• Celiac Disease
• Lupus
• Chronic Fatigue Syndrome
• Juvenile Rheumatoid Arthritis
• Inflammatory Bowel Disease

How does my health care provider use a Sed Rate test?

The erythrocyte sedimentation rate is a non-specific, very straightforward test that has been used for many years to detect inflammation associated with infections, malignancies, and autoimmune illnesses.

Because an elevated ESR often indicates the presence of inflammation, but does not tell the health practitioner where the inflammation is in the body or what is causing it, it is referred to as a non-specific test. Other illnesses besides inflammation may have an impact on an ESR. As a result, other tests, such C-reactive protein, are routinely paired with the ESR.

ESR is used to identify temporal arteritis, systemic vasculitis, and polymyalgia rheumatica, among other inflammatory illnesses. A notably elevated ESR is one of the crucial test results used to support the diagnosis.

This test can be used to track disease activity and treatment response in both of the disorders mentioned above, as well as several others including systemic lupus erythematosus.

What do my Sed Rate test results mean?

Because ESR is a non-specific inflammatory measure that is influenced by a variety of circumstances, it must be used in conjunction with other clinical findings, the individual's medical history, and the results of other laboratory tests. The health practitioner may be able to confirm or rule out a suspected illness if the ESR and clinical data match.

Without any signs of a specific condition, a single elevated ESR is usually insufficient to make a medical conclusion. A normal result does not, however, rule out inflammation or illness.

Inflammation, as well as anemia, infection, pregnancy, and aging, can cause a moderately raised ESR.

A severe infection with a rise in globulins, polymyalgia rheumatica, or temporal arteritis are common causes of an extremely high ESR. Depending on the person's symptoms, a health practitioner may employ various follow-up tests, such as blood cultures. Even if there is no inflammation, people with multiple myeloma or Waldenstrom's macroglobulinemia have extraordinarily high ESRs.

Rising ESRs may suggest increased inflammation or a poor response to therapy when monitoring a condition over time; normal or falling ESRs may indicate an adequate response to treatment.

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

Description: The C-Reactive Protein (CRP) test measures the levels of C-reactive protein, a substance produced by the liver in response to inflammation in the body. It is a non-specific marker of inflammation and is used to evaluate the presence and intensity of inflammation. The CRP test helps healthcare providers assess the severity of an inflammatory condition and monitor response to treatment.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a C-Reactive Protein test ordered?

A C-Reactive Protein (CRP) test may be ordered in several situations to assess a patient's inflammation levels:

1. Infection or Inflammatory Diseases: The test is ordered when a patient shows signs of infection or has symptoms of inflammatory diseases such as rheumatoid arthritis, lupus, or inflammatory bowel disease.

2. Monitoring Response to Treatment: For patients with known inflammatory conditions, the CRP test helps healthcare providers monitor the effectiveness of treatment and track changes in inflammation levels over time.

3. Cardiovascular Risk Assessment: The CRP test may be ordered as part of a cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

4. Post-Surgery Monitoring: After surgical procedures, the CRP test can be ordered to monitor post-operative inflammation levels and identify any complications or infections.

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:

A C-Reactive Protein (CRP) test is commonly ordered for:

1. Inflammatory Diseases: The test helps assess the severity of inflammatory diseases such as rheumatoid arthritis, lupus, vasculitis, or inflammatory bowel disease.

2. Infections: Elevated CRP levels can indicate the presence of infections, whether bacterial, viral, or fungal, and help healthcare providers identify the site of inflammation.

3. Cardiovascular Diseases: The CRP test is used as part of cardiovascular risk assessment to identify individuals at higher risk of developing heart disease or to assess the severity of existing cardiovascular conditions.

Commonly Asked Questions:

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

Healthcare providers use the results of a C-Reactive Protein (CRP) test to:

1. Assess Inflammation Levels: Elevated CRP levels indicate the presence and intensity of inflammation in the body, helping healthcare providers evaluate the severity of an inflammatory condition.

2. Monitor Treatment Response: Regular CRP testing allows healthcare providers to monitor the effectiveness of treatments for inflammatory conditions and track changes in inflammation levels over time.

3. Guide Diagnosis and Further Testing: Elevated CRP levels, combined with other clinical findings, can help healthcare providers diagnose and differentiate between different inflammatory conditions and guide the need for further diagnostic tests or evaluations.

By effectively utilizing the results of a C-Reactive Protein (CRP) test, healthcare providers can assess inflammation levels, monitor treatment response, and make informed decisions regarding patient care, including treatment adjustments and further investigations if necessary.

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 Protein Electrophoresis Serum test is a blood test that checks for abnormal and defective proteins in your blood’s serum.

Also Known As: SPEP Test, Protein Total and Electrophoresis Test, Protein ELP Test, SPE Test, Serum Protein Electrophoresis Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Protein Electrophoresis test ordered?

In order to further investigate anomalous results from other laboratory tests or to assess a patient's symptoms, protein electrophoresis may be requested. Electrophoresis may be prescribed periodically after a disease or illness has been diagnosed to track its progression and the efficacy of treatment.

One may request serum electrophoresis:

• As a follow-up to aberrant results on other laboratory tests, such as elevated urine protein levels, elevated calcium levels, low white- or red-blood-cell counts, total protein and/or albumin levels,
• when symptoms point to an autoimmune illness, an acute or ongoing infection, a kidney or liver disorder, or a condition that causes protein loss,
• Look for the presence of a distinctive band in the beta or gamma region when a medical professional is looking into symptoms that point to multiple myeloma, such as bone pain, anemia, fatigue, unexplained fractures, or recurrent infections; if a sharp band is seen, its identity as a monoclonal immunoglobulin is typically confirmed by immunofixation electrophoresis.
• to observe the progression of multiple myeloma treatment to see if the monoclonal band shrinks or vanishes entirely.

What does a Protein Electrophoresis test check for?

All cells and organs depend heavily on proteins as their building blocks. They make up the structural components of the majority of organs and the hormones and enzymes that control bodily processes. The proteins found in bodily fluids perform a wide range of various tasks, including the transportation of nutrients, the elimination of toxins, the regulation of metabolic processes, and the defense against foreign invaders. These proteins can be divided via a process called protein electrophoresis depending on their size and electrical charge.

When bodily fluid proteins are separated by electrophoresis, a distinctive pattern of bands with varying widths and intensities forms, representing the protein combination present. There are five components of this pattern: albumin, alpha 1, alpha 2, beta, and gamma. The beta fraction may occasionally be further split into beta 1 and beta 2.

About 60% of the blood's protein is made up of albumin, which is produced by the liver. Proteins other than albumin are referred to collectively as "globulins." The majority of globulins are likewise made in the liver, with the exception of immunoglobulins and a few complement proteins.

Lab tests often ordered with a Protein Electrophoresis test:

• Albumin
• Urine Protein
• Serum Free Light Chains
• Immunoglobulins
• Allpha-1 Antitrypsin
• Cryoglobulins

Conditions where a Protein Electrophoresis test is recommended:

• Multiple Myeloma
• Kidney Disease
• Multiple Sclerosis
• Malnutrition
• Proteinuria

How does my health care provider use a Protein Electrophoresis test?

When distinct protein groups are present in blood or other body fluids in unusually high or low numbers, protein electrophoresis is used to detect the presence of abnormal proteins, the absence of normal proteins, and the presence or absence of defective proteins.

The body uses proteins for a variety of functions, such as nutrient delivery, toxin elimination, metabolic regulation, and defense against foreign invaders.

Proteins are divided by protein electrophoresis according to their size and electrical charge. This represents the mix of proteins present in the bodily fluid under evaluation and creates a distinctive pattern of bands on a test medium that are varied widths and intensities. Five parts of the pattern are identified: albumin, alpha 1, alpha 2, beta, and gamma. The beta fraction may occasionally be further split into beta 1 and beta 2.

What do my Protein Electrophoresis test results mean?

A health professional can roughly determine the amount of each protein fraction and whether any aberrant proteins are present using protein electrophoresis assays. Immunofixation electrophoresis is useful for determining whether a specific kind of immunoglobulin is present. An explanation of the findings could be included in the lab report.

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

Description: A Complete Blood Count (CBC) test is a common laboratory test that provides valuable insights into a patient's overall health and helps detect potential blood disorders or abnormalities. It examines the three major components of blood: red blood cells (RBCs), white blood cells (WBCs), and platelets. By measuring various parameters related to these blood cells, the CBC test offers essential information for diagnosis, monitoring, and treatment planning.

Also Known As: CBC test, Complete Blood Count Test, Total Blood Count Test, CBC with Differential and Platelets test, Hemogram test  

Collection Method: Blood Draw 

Specimen Type: Whole Blood 

Test Preparation: No preparation required 

Average Processing Time: 1 to 2 days

When is a Complete Blood Count test ordered?  

A CBC test may be ordered in various situations. These include:

1. Routine Check-ups: Doctors often include a CBC test as part of routine check-ups to assess overall health and screen for any underlying blood-related conditions.

2. Evaluation of Symptoms: When a patient presents with unexplained symptoms such as fatigue, weakness, frequent infections, bruising, or excessive bleeding, a CBC test can help identify potential causes or abnormalities.

3. Monitoring Chronic Conditions: Patients with chronic conditions like anemia, infections, autoimmune disorders, or blood-related diseases require regular CBC tests to monitor their condition, track treatment effectiveness, and adjust therapies accordingly.

4. Pre-Surgical Assessment: Prior to surgery or invasive medical procedures, doctors order CBC tests to evaluate a patient's blood cell counts and ensure their ability to handle the procedure safely.

What does a Complete Blood Count test check for? 

The complete blood count (CBC) is a blood test that determines the number of cells in circulation. White blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs) are three types of cells suspended in a fluid called plasma. They are largely created and matured in the bone marrow and are released into the bloodstream when needed under normal circumstances. 

A CBC is mainly performed with an automated machine that measures a variety of factors, including the number of cells present in a person's blood sample. The findings of a CBC can reveal not only the quantity of different cell types but also the physical properties of some of the cells. 

Significant differences in one or more blood cell populations may suggest the presence of one or more diseases. Other tests are frequently performed to assist in determining the reason for aberrant results. This frequently necessitates visual confirmation via a microscope examination of a blood smear. A skilled laboratory technician can assess the appearance and physical features of blood cells, such as size, shape, and color, and note any anomalies. Any extra information is taken note of and communicated to the healthcare provider. This information provides the health care provider with further information about the cause of abnormal CBC results. 

The CBC focuses on three different types of cells: 

WBCs (White Blood Cells) 

The body uses five different types of WBCs, also known as leukocytes, to keep itself healthy and battle infections and other types of harm. The five different leukocytes are eosinophiles, lymphocytes, neutrophiles, basophils, and monocytes. They are found in relatively steady numbers in the blood. Depending on what is going on in the body, these values may momentarily rise or fall. An infection, for example, can cause the body to manufacture more neutrophils in order to combat bacterial infection. The amount of eosinophils in the body may increase as a result of allergies. A viral infection may cause an increase in lymphocyte production. Abnormal (immature or mature) white cells multiply fast in certain illness situations, such as leukemia, raising the WBC count. 

RBCs (Red Blood Cells) 

The bone marrow produces red blood cells, also known as erythrocytes, which are transferred into the bloodstream after maturing. Hemoglobin, a protein that distributes oxygen throughout the body, is found in these cells. Because RBCs have a 120-day lifespan, the bone marrow must constantly manufacture new RBCs to replace those that have aged and disintegrated or have been lost due to hemorrhage. A variety of diseases, including those that cause severe bleeding, can alter the creation of new RBCs and their longevity. 

The CBC measures the number of RBCs and hemoglobin in the blood, as well as the proportion of RBCs in the blood (hematocrit), and if the RBC population appears to be normal. RBCs are generally homogeneous in size and shape, with only minor differences; however, considerable variances can arise in illnesses including vitamin B12 and folate inadequacy, iron deficiency, and a range of other ailments. Anemia occurs when the concentration of red blood cells and/or the amount of hemoglobin in the blood falls below normal, resulting in symptoms such as weariness and weakness. In a far smaller percentage of cases, there may be an excess of RBCs in the blood (erythrocytosis or polycythemia). This might obstruct the flow of blood through the tiny veins and arteries in extreme circumstances. 

Platelets 

Platelets, also known as thrombocytes, are small cell fragments that aid in the regular clotting of blood. A person with insufficient platelets is more likely to experience excessive bleeding and bruises. Excess platelets can induce excessive clotting or excessive bleeding if the platelets are not operating properly. The platelet count and size are determined by the CBC. 

Lab tests often ordered with a Complete Blood Count test: 

• Reticulocytes
• Iron and Total Iron Binding Capacity
• Basic Metabolic Panel
• Comprehensive Metabolic Panel
• Lipid Panel
• Vitamin B12 and Folate
• Prothrombin with INR and Partial Thromboplastin Times
• Sed Rate (ESR)
• C-Reactive Protein
• Epstein-Barr Virus
• Von Willebrand Factor Antigen

Conditions where a Complete Blood Count test is recommended: 

A CBC test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Anemia: CBC helps identify different types of anemia, such as iron deficiency anemia, vitamin B12 deficiency anemia, or autoimmune hemolytic anemia.

2. Infections: An abnormal CBC count can indicate the presence of an infection, whether bacterial, viral, or fungal. It provides information about the severity and type of infection.

3. Leukemia: CBC abnormalities may suggest the presence of certain blood cancers, including leukemia. Further tests are necessary to confirm the diagnosis.

4. Inflammatory Disorders: Conditions like rheumatoid arthritis, lupus, or vasculitis can cause changes in the CBC results, indicating ongoing inflammation or autoimmune processes.

Commonly Asked Questions: 

How does my health care provider use a Complete Blood Count test? 

Health care providers use the results of a CBC test to:

1. Confirm Diagnoses: Abnormal CBC findings help in diagnosing specific conditions or diseases, such as anemia, infections, blood disorders, or certain cancers.

2. Monitor Treatment Progress: Regular CBC tests allow doctors to evaluate the effectiveness of treatments or therapies and make necessary adjustments based on blood cell count improvements or changes.

3. Guide Further Investigations: If CBC results indicate abnormalities, doctors may recommend additional specialized tests or refer the patient to a hematologist or other relevant specialists for further evaluation and diagnosis.

By understanding the purpose, significance, and applications of a CBC test, patients and healthcare providers can utilize this valuable diagnostic tool to aid in the management of various health conditions and ensure optimal patient care.

What do my Complete Blood Count results mean? 

A low Red Blood Cell Count, also known as anemia, could be due many different causes such as chronic bleeding, a bone marrow disorder, and nutritional deficiency just to name a few. A high Red Blood Cell Count, also known as polycythemia, could be due to several conditions including lung disease, dehydration, and smoking. Both Hemoglobin and Hematocrit tend to reflect Red Blood Cell Count results, so if your Red Blood Cell Count is low, your Hematocrit and Hemoglobin will likely also be low. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Differential results mean? 

A low White Blood Cell count or low WBC count, also known as leukopenia, could be due to a number of different disorders including autoimmune issues, severe infection, and lymphoma. A high White Blood Cell count, or high WBC count, also known as leukocytosis, can also be due to many different disorders including infection, leukemia, and inflammation. Abnormal levels in your White Blood Cell Count will be reflected in one or more of your different white blood cells. Knowing which white blood cell types are affected will help your healthcare provider narrow down the issue. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

What do my Platelet results mean? 

A low Platelet Count, also known as thrombocytopenia, could be due to a number of different disorders including autoimmune issues, viral infection, and leukemia. A high Platelet Count, also known as Thrombocytosis, can also be due to many different disorders including cancer, iron deficiency, and rheumatoid arthritis. Results should be discussed with your health care provider who can provide interpretation of your results and determine the appropriate next steps or lab tests to further investigate your health. 

NOTE: Ulta Lab Tests provides CBC test results from Quest Diagnostics as they are reported. Often, different biomarker results are made available at different time intervals. When reporting the results, Ulta Lab Tests denotes those biomarkers not yet reported as 'pending' for every biomarker the test might report. Only biomarkers Quest Diagnostics observes are incorporated and represented in the final CBC test results provided by Ulta Lab Tests. 

NOTE: Only measurable biomarkers will be reported. Certain biomarkers do not appear in healthy individuals. 

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

Reflex Parameters for Manual Slide Review

CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

• Confirmation of differential percentages
• WBC and platelet estimates, when needed
• Full review of RBC morphology
• Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
• significant findings
• If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

• Immature, abnormal, or toxic cells
• nRBC’s
• Disagreement with automated differential
• Atypical/abnormal RBC morphology
• Any RBC inclusions

Step 3 - If any of the following are seen on the manual differential, a Pathologist will review the slide:

• WBC<1,500 with abnormal cells noted
• Blasts/immature cells, hairy cell lymphs, or megakaryocytes
• New abnormal lymphocytes or monocytes
• Variant or atypical lymphs >15%
• Blood parasites
• RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
• crystals, Pappenheimer bodies or bizarre morphology
• nRBC’s

Description: The Comprehensive Metabolic Panel (CMP) test is a widely used blood test that provides valuable insights into a patient's overall health and helps evaluate the function of various organs and systems in the body. It measures a comprehensive set of chemical substances in the blood, including electrolytes, kidney and liver function markers, glucose, and protein levels. The CMP test offers a comprehensive overview of the body's metabolic state and aids in diagnosing and monitoring various conditions.

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred.

Average Processing Time: 1 to 2 days 

When is a Comprehensive Metabolic Panel test ordered:  

A Comprehensive Metabolic Panel (CMP) test may be ordered in several situations to assess a patient's health:

1. Routine Health Check-ups: Doctors often include a CMP test as part of routine check-ups to assess overall health, screen for underlying conditions, and establish a baseline for future comparisons.

2. Evaluation of Organ Function: The CMP test provides valuable information about the function of vital organs such as the liver, kidneys, and pancreas. It helps detect abnormalities or diseases affecting these organs, such as liver disease, kidney dysfunction, or diabetes.

3. Monitoring Medications or Treatments: Patients undergoing certain medications or treatments, such as those that may impact liver or kidney function, require regular monitoring through CMP tests to ensure the treatments are well-tolerated and effective.

4. Investigation of Symptoms: When patients present with symptoms like fatigue, abdominal pain, jaundice, frequent urination, or unexplained weight loss, a CMP test can aid in identifying potential underlying causes or imbalances.

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

• Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

• Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

• Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

• Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

• AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

• Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

• Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Protein, Total: this is a measure of total protein levels in your blood. 
  Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Sodium: this is a measure of sodium in your blood's serum. Sodium is a vital mineral for nerve and muscle cell function.

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Vitamin B12 and Folate
• Prothrombin with INR and Partial Thromboplastin Times
• Sed Rate (ESR)
• C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

A Comprehensive Metabolic Panel (CMP) test can assist in diagnosing and monitoring various conditions or diseases, including:

1. Liver Diseases: The CMP helps identify liver diseases such as hepatitis, cirrhosis, or liver damage due to alcohol abuse or medication toxicity.

2. Kidney Diseases: Abnormalities in kidney function markers on the CMP test can indicate conditions like chronic kidney disease, kidney infections, or kidney stones.

3. Diabetes or Glucose Imbalances: The CMP provides crucial information on blood glucose levels, aiding in the diagnosis and management of diabetes or identifying glucose imbalances.

4. Electrolyte Imbalances: Abnormal levels of electrolytes detected by the CMP can indicate conditions such as dehydration, kidney dysfunction, or hormonal disorders.

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

Health care providers use the results of a Comprehensive Metabolic Panel (CMP) test to:

1. Diagnose Medical Conditions: Abnormalities in CMP test results can help healthcare providers diagnose various conditions such as liver disease, kidney dysfunction, diabetes, or electrolyte imbalances.

2. Monitor Treatment Effectiveness: Regular CMP tests allow healthcare providers to monitor the impact of treatments or medications on organ function, glucose control, or electrolyte balance.

3. Evaluate Overall Health: The CMP test provides a comprehensive snapshot of the patient's metabolic state and aids in evaluating overall health, identifying potential risk factors, and guiding further investigations if necessary.

By effectively utilizing the results of a Comprehensive Metabolic Panel (CMP) test, healthcare providers can diagnose conditions, monitor treatment progress, and make informed decisions regarding patient care and management.

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

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

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79.