Lymphoma

Lymphoma Lab Tests and health information

The lymphoma tests can give you an accurate reading of your platelet count and white blood cell count to determine if they are low, which may indicate that lymphoma is present in the bone marrow and blood, with results sent confidentially online. Order from Ulta Lab Tests today! 


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Description: A CBC or Complete Blood Count with Differential and Platelets test is a blood test that measures many important features of your blood’s red and white blood cells and platelets. A Complete Blood Count can be used to evaluate your overall health and detect a wide variety of conditions such as infection, anemia, and leukemia. It also looks at other important aspects of your blood health such as hemoglobin, which carries oxygen. 

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 

When is a Complete Blood Count test ordered?  

The complete blood count (CBC) is an extremely common test. When people go to the doctor for a standard checkup or blood work, they often get a CBC. Suppose a person is healthy and their results are within normal ranges. In that case, they may not need another CBC unless their health condition changes, or their healthcare professional believes it is necessary. 

When a person exhibits a variety of signs and symptoms that could be connected to blood cell abnormalities, a CBC may be done. A health practitioner may request a CBC to help diagnose and determine the severity of lethargy or weakness, as well as infection, inflammation, bruises, or bleeding. 

When a person is diagnosed with a disease that affects blood cells, a CBC is frequently done regularly to keep track of their progress. Similarly, if someone is being treated for a blood condition, a CBC may be performed on a regular basis to see if the treatment is working. 

Chemotherapy, for example, can influence the generation of cells in the bone marrow. Some drugs can lower WBC counts in the long run. To monitor various medication regimens, a CBC may be required on a regular basis. 

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: 

  • Anemia
  • Aplastic Anemia
  • Iron Deficiency Anemia
  • Vitamin B12 and Folate Deficiency
  • Sickle Cell Anemia
  • Heart Disease
  • Thalassemia
  • Leukemia
  • Autoimmune Disorders
  • Cancer
  • Bleeding Disorders
  • Inflammation
  • Epstein-Barr Virus
  • Mononucleosis

Commonly Asked Questions: 

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

The complete blood count (CBC) is a common, comprehensive screening test used to measure a person's overall health status.  

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: 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
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual 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: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

  • 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 also 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. 

  • 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. 

  • Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

  • Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (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 Basic Metabolic Panel test: 

  • Complete Blood Count with Differential and Platelets
  • Hemoglobin A1c
  • Iron and Total Iron Binding Capacity
  • Lipid Panel
  • Insulin
  • Vitamin B12 and Folate
  • C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

  • Diabetes 
  • Kidney Disease 
  • Liver Disease 

Commonly Asked Questions: 

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

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. 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? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

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. 


Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

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. 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

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: 

  • Diabetes
  • Kidney Disease
  • Liver Disease
  • Hypertension

Commonly Asked Questions: 

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

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

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. 


Description: A BUN/Creatinine ratio test is a blood test that measures levels of Urea Nitrogen and Creatinine in your blood and is useful in the diagnosis of renal disease.

Also Known As: Urea Nitrogen and Creatinine Ratio test, BUN test, Urea test, Urea Nitrogen test, Creat test, Blood Creatinine Test, Serum Creatinine Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a BUN Creatinine Ratio test ordered?

BUN is a component of the BMP and CMP, two categories of widely-used tests:

  • as part of a regular health examination
  • prior to beginning the use of specific pharmacological therapy, determine how well the kidneys are functioning.
  • When a patient who is critically ill visits the emergency room or is admitted to the hospital

When kidney problems are suspected during a hospital stay, BUN is frequently ordered along with creatinine or a renal panel. Kidney dysfunction can show several indications and symptoms, such as:

  • fatigue, inability to focus, poor appetite, or difficulty sleeping
  • Swelling or puffiness, especially in the face, wrists, abdomen, thighs, or ankles or around the eyes
  • Foamy, bloody, or coffee-colored urine
  • a reduction in the urine's volume
  • problems urinating, such as a burning sensation or an unusual discharge, or a change in frequency, particularly at night
  • discomfort in the middle of the back, below the ribs, and next to the kidneys
  • elevated blood pressure

BUN may also be required for:

  • Patients with long-term illnesses or conditions like diabetes, congestive heart failure, and myocardial infarction should have regular kidney function checks.
  • monitoring renal function and treatment at frequent intervals in individuals with known kidney disease
  • Monitoring kidney function both before and after taking specific medications
  • When a CT scan is anticipated, furthermore to a creatinine
  • periodically to check on the efficiency of the dialysis

During a health examination, a routine metabolic panel that includes creatinine may be ordered. It might be prescribed if a patient is critically ill or if a doctor has reason to believe that their kidneys aren't functioning properly. Kidney dysfunction can show several indications and symptoms, such as:

  • fatigue, inability to focus, poor appetite, or difficulty sleeping
  • Swelling or puffiness, especially in the face, wrists, abdomen, thighs, or ankles, or around the eyes
  • Foamy, bloody, or coffee-colored urine
  • a reduction in the urine's volume
  • problems urinating, such as a burning sensation or an unusual discharge, or a change in frequency, particularly at night
  • discomfort in the middle of the back, below the ribs, and next to the kidneys
  • elevated blood pressure

When a person has a known kidney ailment or a condition that could impair kidney function, a creatinine blood test may be prescribed along with a BUN test, urine albumin, and other tests on a regular basis. When a CT scan is anticipated, before and throughout some medication regimens, as well as before and after dialysis, both BUN and creatinine may be requested to check the efficacy of treatments.

What does a BUN Creatinine Ratio test check for?

When protein is broken down into its constituent parts in the liver, urea is produced as a waste product. Ammonia is created during this process, and it is later changed into the less harmful waste product urea. This examination counts the urea nitrogen levels in the blood.

Ammonia and urea both contain nitrogen as an ingredient. Because urea contains nitrogen and because the body excretes excess nitrogen via urea/urea nitrogen, the terms urea and urea nitrogen are sometimes used interchangeably. The liver releases urea into the blood, which travels to the kidneys where it is removed from the circulation and discharged as urine. Since this is a continuous process, urea nitrogen levels in the blood are typically low and steady.

The majority of illnesses or ailments that affect the liver or kidneys have the potential to have an impact on the blood's urea content. Urea concentrations in the blood will increase if the liver produces more urea or if the kidneys are not functioning properly and are having trouble removing wastes from the blood. BUN values may decrease if severe liver illness or injury prevents the synthesis of urea.

Muscles release creatinine as a waste product after breaking down a substance called creatine. The kidneys eliminate creatinine from the body by filtering nearly all of it from the blood and releasing it into the urine. The creatinine level in the blood and/or urine is determined by this test.

The process that creates the energy required to contract muscles includes creatine. The body produces both creatine and creatinine at a fairly steady rate. Blood levels are typically a good indication of how well the kidneys are functioning since the kidneys filter almost all of the creatinine from the blood and release it into the urine. The amount created is influenced by a person's size and muscular mass. As a result, men's creatinine levels will be a little bit greater than those of women and children.

Calculations that are used to assess kidney function can be done using data from a blood creatinine test in conjunction with data from other tests, including a 24-hour urine creatinine test.

Lab tests often ordered with a BUN Creatinine Ratio test:

  • Urine Protein
  • eGFR
  • Creatinine Clearance
  • Comprehensive Metabolic Panel
  • Basic Metabolic Panel
  • Cystatin C
  • Renal Panel
  • Urinalysis
  • Microalbumin
  • Beta-2 Microglobin

Conditions where a BUN Creatinine Ratio test is recommended:

  • Kidney Disease
  • Diabetes
  • Hypertension
  • Proteinuria

How does my health care provider use a BUN Creatinine Ratio test?

The creatinine test and blood urea nitrogen tests are primarily used to assess kidney function under various conditions, aid in the diagnosis of kidney illness, and keep track of persons who have either acute or chronic renal failure or dysfunction. When requested as a component of a renal panel, basic metabolic panel, or comprehensive metabolic panel, it may also be used to assess a person's overall health state.

When protein is digested in the liver, urea is produced as a waste product. The liver releases urea into the blood, which travels to the kidneys where it is removed from the circulation and discharged as urine. Since this is a continuous process, urea nitrogen levels in the blood are typically low and steady. However, the level of urea in the blood will increase if the kidneys become diseased or damaged and are unable to remove waste products from the blood.

The kidneys are a pair of bean-shaped organs that are situated on the right and left sides of the back at the base of the ribcage. They include around a million nephrons, which are very small blood filtering organs. Blood is continuously filtered via a glomerulus, a tiny collection of looping blood arteries, in each nephron. Water and tiny molecules can pass through the glomerulus, while blood cells and bigger molecules are retained. Each glomerulus has a little tube attached to it that gathers the fluid and molecules that flow through it and reabsorbs what the body can use. Urine is created by the leftover waste.

Creatinine and BUN tests may be performed to monitor for renal dysfunction and the efficacy of treatment if the results are abnormal or if a person has an underlying condition known to impact the kidneys, such as diabetes or high blood pressure. Before some procedures, such a CT scan, that can call for the use of medications that can harm the kidneys, such as creatinine and BUN tests in the blood may also be prescribed to assess renal function.

What do my BUN Creatinine Ratio test results mean?

BUN levels that are higher indicate poor renal health. This could be brought on by failure, injury, or acute or chronic renal disease. A condition that reduces blood flow to the kidneys, such as congestive heart failure, shock, stress, a recent heart attack, or serious burns, as well as conditions that impede urine flow or dehydration, may also be to blame.

When there is excessive protein breakdown, a considerable rise in the amount of protein in the diet, or gastrointestinal bleeding, BUN values may be increased.

Low BUN levels are rare and typically not reason for alarm. The BUN test is not typically used to diagnose or monitor these disorders, but they may appear in severe liver illness, malnutrition, and occasionally when a person is overhydrated.

BUN values may be normal even in the presence of substantial malfunction in the other kidney if one kidney is fully functional.

Blood creatinine levels that are higher than normal point to renal disease or other disorders that have an impact on kidney function. These may consist of:

For instance, infections or autoimmune illnesses can cause kidney blood vessels to enlarge or become damaged.

  • infection of the kidneys with bacteria
  • death of kidney cells brought on by chemicals or medications, for instance, in the tiny tubes of the kidneys
  • Urinary tract obstruction can be brought on by prostate disease, kidney stones, or other conditions.
  • reduced renal blood flow brought on by shock, dehydration, congestive heart failure, atherosclerosis, or diabetes-related problems

Although they are uncommon, low blood creatinine levels are often not a cause for alarm. They can be observed in diseases that cause a loss of muscular mass.

As part of a creatinine clearance test, 24-hour urine creatinine levels are compared to blood levels.

There are no established reference ranges for single, random urine creatinine values. They are typically used in conjunction with other exams to compare levels of other chemicals detected in urine. The urine albumin test, the urine albumin/creatinine ratio, and the urine protein test are a few examples.

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


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Description: A Creatinine test is a blood test that is used to evaluate the health of your kidneys and diagnose and monitor the treatment of kidney disease.

Also Known As: Create Test, Blood Creatinine Test, Serum Creatinine Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Creatinine test ordered?

During a health assessment, creatinine may be requested as part of a complete or basic metabolic panel. It may be ordered if a person is seriously ill or if a doctor feels that their kidneys aren't functioning properly.

When someone has a known renal condition or a disease that may impact kidney function, a creatinine blood test, coupled with a BUN test and urine albumin, may be ordered at regular intervals. When a CT scan is planned, before to and during some medication therapy, and before and after dialysis, both BUN and creatinine may be requested to assess the effectiveness of treatments.

What does a Creatinine blood test check for?

Creatinine is a waste product created by muscles when a molecule called creatine is broken down. The kidneys eliminate creatinine from the body by filtering almost all of it from the blood and excreting it in the urine. The level of creatinine in the blood and/or urine is measured in this test.

Creatine is a component of the energy-producing cycle that allows muscles to contract. The body produces both creatine and creatinine at a roughly steady rate. Because the kidneys filter almost all creatinine from the blood and excrete it in the urine, blood levels are usually an excellent predictor of how well the kidneys are operating. The amount produced is determined by the person's size and muscular mass. As a result, men's creatinine levels will be slightly higher than women's and children's.

A blood creatinine test's results can be combined with those from other tests, such as a 24-hour urine creatinine test, to produce calculations that are used to assess kidney function.

Lab tests often ordered with a Creatinine test:

  • BUN (Blood Urea Nitrogen)
  • Creatinine Clearance
  • Comprehensive Metabolic Panel (CMP)
  • Basic Metabolic Panel (BMP)
  • Urinalysis
  • Microalbumin and Creatinine Ratio
  • Cystatin C with eGFR
  • Beta-2 Microglobulin
  • Urine Protein

Conditions where a Creatinine test is recommended:

  • Kidney Disease
  • Diabetes
  • Proteinuria
  • Hypertension

How does my health care provider use a Creatinine test?

Kidney function is assessed with a creatinine blood test. It's usually requested in conjunction with a BUN test or as part of a basic or comprehensive metabolic panel, which consists of a series of tests designed to assess the operation of the body's primary organs. BMP or CMP tests are used to screen healthy persons during normal physical exams, as well as to help evaluate people who are acutely or chronically ill in the emergency room and/or hospital. Creatinine testing is sometimes done as part of a renal panel to assess kidney function.

Creatinine is a waste product created by muscles when a molecule called creatine is broken down. Because the kidneys filter almost all creatinine from the blood and discharge it into the urine, blood levels are usually an excellent predictor of how well the kidneys are operating.

The kidneys are a pair of bean-shaped organs placed on the right and left sides of the back at the bottom of the ribcage. Nephrons are a million microscopic blood filtering units found within them. Blood is continuously filtered by a small cluster of looping blood arteries called a glomerulus in each nephron. Water and tiny molecules flow through the glomerulus, but blood cells and bigger molecules are retained. Each glomerulus has a little tube attached to it that gathers the fluid and molecules that flow through it and then reabsorbs what the body can use. Urine is formed from the residual waste.

If the creatinine and BUN tests are abnormal, or if the patient has an underlying condition that affects the kidneys, such as diabetes or high blood pressure, creatinine and BUN tests may be used to monitor renal functionality and therapy effectiveness. Before some procedures, such as a CT scan, that may necessitate the use of medicines that can harm the kidneys, blood creatinine and BUN tests may be requested to assess renal function.

Creatinine test results can be utilized in calculations to determine renal function.

The estimated glomerular filtration rate, used as a screen to search for signs of early kidney damage, is calculated using blood creatinine readings, as well as age, weight, and sex.

What do my Creatinine test results mean?

Elevated creatinine levels in the blood indicate renal disease or other disorders affecting kidney function.

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


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Description: The Hepatic Function Panel is a blood test that measures multiple markers to evaluate the health of your liver.

Also Known As: Liver Profile Test, Liver Function Test, LFT, Liver Enzyme Test, Liver Test, Liver Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Hepatic Function Panel test ordered?

When someone is at risk for liver dysfunction, a liver panel, or one or more of its components, may be requested. Here are a few examples:

  • People who are taking drugs that could harm their liver
  • Those who are alcoholics or who use a lot of alcohol
  • Those who have a history of hepatitis virus exposure, either known or suspected
  • Individuals with a history of liver illness in their families
  • Overweight people, especially those with diabetes and/or high blood pressure

When a person exhibits signs and symptoms of liver disease, a liver panel may be done; however, most people with liver disease do not have any of these symptoms until the disease has been present for years or is very severe. Here are a few examples:

  • Weakness and exhaustion
  • Appetite loss.
  • Vomiting and nausea
  • Swelling and/or pain in the abdomen
  • Jaundice
  • Urine that is dark in color and feces that is light in color
  • Pruritus
  • Diarrhea

To make a diagnosis, no single collection of liver tests is usually used. Several liver panels are frequently done over the course of a few days or weeks to aid in determining the source of the liver illness and assessing its severity.

When liver illness is discovered, the liver panel or one or more of its components can be used to monitor it on a regular basis over time. A liver panel may be conducted on a regular basis to assess the efficacy of treatment for the liver condition.

What does a Hepatic Function Panel blood test check for?

A liver panel is a collection of tests used to diagnose, evaluate, and track the progression of liver illness or damage. The liver is one of the largest organs in the body, and it is placed behind the lower ribs in the upper right section of the belly. Drugs and substances that are detrimental to the body are metabolized and detoxified by the liver. It makes blood clotting factors, proteins, and enzymes, as well as regulating hormone levels and storing vitamins and minerals. Bile, a fluid produced by the liver, is delivered to the small intestine via ducts to aid in fat digestion or to the gallbladder to be stored and concentrated for later use.

Inflammation, scarring, bile duct blockages, liver tumors, and liver dysfunction can all be caused by a range of disorders and infections that cause acute or chronic liver damage. Toxins, alcohol, narcotics, and some herbal medications can all be dangerous. Before signs like jaundice, dark urine, light-colored feces, itching, nausea, exhaustion, diarrhea, and unexplained weight loss or increase appear, there may be considerable liver damage. To reduce damage and preserve liver function, early identification is critical.

The liver panel assesses the enzymes, proteins, and chemicals generated, processed, or removed by the liver, as well as those that are altered by liver injury. Some are produced by damaged liver cells, while others indicate a reduction in the liver's ability to execute one or more activities. When these tests are performed combined, they provide a picture of a person's liver's health, an indication of the severity of any liver injury, changes in liver status over time, and a starting point for further diagnostic testing.

Lab tests often ordered with a Hepatic Function Panel test:

  • GGT
  • Prothrombin Time and International Normalized Ratio
  • LD
  • Hepatitis A Testing
  • Hepatitis B Testing
  • Hepatitis C Testing
  • Emergency and Overdose Drug Testing
  • Ethanol
  • ANA
  • Smooth Muscle Antibody
  • Anti-LKM-1
  • Drugs of Abuse Testing
  • Copper
  • Ceruloplasmin
  • DCP
  • AFP Tumor Markers
  • Alpha-1
  • Antitrypsin
  • Acetaminophen
  • Ammonia

Conditions where a Hepatic Function Panel test is recommended:

  • Liver Disease
  • Jaundice
  • Hepatitis
  • Hemochromatosis
  • Wilson Disease
  • Cirrhosis

Commonly Asked Questions:

How does my health care provider use a Hepatic Function Panel test?

A liver panel can be performed to check for damage to the liver, especially if someone has an illness or is taking a medication that could harm the liver. For regular screening, a comprehensive metabolic panel, which is commonly conducted as part of a general health checkup, may be ordered instead of a liver panel. The majority of the liver panel is included in this group of tests, as well as other tests that evaluate other organs and systems in the body.

If a person has signs and symptoms that indicate suspected liver malfunction, a liver panel or one or more of its component tests may be done to assist identify liver disease. If a person has a known illness or liver disease, testing may be done at regular intervals to assess the liver's health and the efficiency of any therapies. To evaluate and monitor a jaundiced newborn, a variety of bilirubin tests may be ordered.

Abnormal tests on a liver panel may necessitate a repeat study of one or more tests, or the entire panel, to evaluate if the elevations or declines continue, and/or additional testing to discover the etiology of the liver dysfunction.

Typically, a panel consists of numerous tests performed simultaneously on a blood sample.

What do my Liver Panel Test results mean?

The findings of a liver panel test are not diagnostic of a specific condition; rather, they show that the liver may be malfunctioning. Abnormal liver test results in a person who has no symptoms or recognized risk factors may signal a transitory liver injury or reflect something going on elsewhere in the body, such as the skeletal muscles, pancreas, or heart. It could potentially signal the presence of early liver disease, necessitating more testing and/or periodic monitoring.

The results of liver panels are generally compared. Several sets of results from tests conducted over several days or weeks are sometimes analyzed together to see if a pattern emerges. Each person's test findings will be unique, and they will most likely alter over time. A healthcare professional examines the combined findings of liver tests to learn more about the underlying disease. Further testing is frequently required to discover the cause of the liver damage and/or illness.

Abnormal test results may signal a need to review a person's dosage or medication choice if they are taking medicines that may impact their liver. When a person with liver disease is being monitored, the healthcare provider will look at the findings of the liver panel together to see if liver function or damage is getting worse or better. Increased abnormalities in bilirubin, albumin, and/or PT, for example, may suggest a decline in liver function, whereas steady or improved findings may indicate liver function preservation or improvement.

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



Description: Hepatitis B Surface Antibody, Qualitative is a test that will determine if there are Hep B antibodies present in the blood.

Also Known As: Hep B Test, Hep B Surface Antibody Test, Hep B Antibody Test, Hepatitis B Antibody Test, Hep B Surface Ab Test, HBV Antibody Test, HBV Surface Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Qualitative Hepatitis B Surface Antibody test ordered?

When someone exhibits acute hepatitis-related signs and symptoms, a hepatitis B test may be requested to evaluate whether the symptoms are caused by HBV infection.

When the findings of normal testing, such as ALT and/or AST, are increased, hepatitis B tests may be performed as a follow-up. Since they may only cause minor symptoms that can be mistaken for the flu, acute forms of hepatitis can occasionally be identified in this way. Chronic hepatitis is more frequently found when routine test results are abnormal and more frequently has no symptoms.

When a person is at high risk for developing chronic hepatitis B, a test for hepatitis B surface antigen may be utilized for screening.

Hepatitis B tests may be run on a regular basis to check on persons with chronic hepatitis B infections. Since HBeAg may disappear on its own in certain individuals, hepatitis B surface antigen and hepatitis B e antigen measurements are often performed every six to twelve months. HBeAg and HBV DNA testing can be used to evaluate the efficacy of treatment in patients with chronic HBV.

What does a Qualitative Hepatitis B Surface Antibody test check for?

Hepatitis B tests look for chemicals that indicate a recent or past hepatitis B virus infection. While some tests look for viral proteins or antibodies created in response to an infection, others look for or assess the virus' genetic makeup. A person who has immunity as a result of prior exposure or who now has an active infection can be determined by the pattern of test findings.

The symptoms of hepatitis include inflammation and liver enlargement. It can be caused by a number of different things, one of which is virus infection. One of the five "hepatitis viruses" that have been found thus far is HBV. Hepatitis A, hepatitis C, hepatitis D, and hepatitis E make up the remaining four.

Contact with blood or other bodily fluids from an infected person can transfer HBV. For instance, sharing needles for IV drug usage or having sex without protection can expose someone. Greater risk applies to people who reside in or travel to regions of the world where hepatitis B is common. Rarely, generally during or after birth, women might transmit the virus to their newborns. The virus cannot be spread by innocuous actions like shaking hands, coughing, or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood. It can also spread through the sharing of objects like toothbrushes or razors with an infected individual.

Effective hepatitis B vaccines have been available in the United States since 1981, and starting in 1991, medical professionals there started immunizing newborns. Nevertheless, according to the Centers for Disease Control and Prevention, the virus is present in between 804,000 and 1.4 million Americans, the majority of whom are unaware that they are infected.

HBV infections can range in severity from a brief, mild form to a more dangerous, chronic variant that lasts for years. Serious side effects from persistent HBV can occasionally include cirrhosis or liver cancer.

Acute HBV infection, albeit potentially dangerous, typically goes away on its own in most adults. Children and infants are more likely than adults to have a persistent infection. 90% of newborns with HBV infection go on to acquire a chronic illness. Between 25% and 50% of children between the ages of one and five are at risk of acquiring chronic hepatitis. Only 6% to 10% of HBV infections that start after age five progress to chronic disease.

Most people with persistent infections won't show any symptoms. The signs and symptoms of acute infections are quite similar to those of other acute hepatitis types. Fever, exhaustion, nausea, vomiting, and jaundice are among the symptoms. The liver is damaged and unable to function normally when someone has acute hepatitis. It might not eliminate toxins or waste materials from the body, such bilirubin. Bilirubin and liver enzyme levels in the blood may rise as the disease progresses. Although tests like bilirubin or a liver panel can show a doctor that a patient has hepatitis, they cannot tell them what is causing it. The cause may be found with tests that look for hepatitis virus infection.

Testing for hepatitis B can be done in the absence of symptoms, to identify if an infection is acute or chronic, or to keep track of a chronic infection and how well therapy is working.

Lab tests often ordered with a Qualitative Hepatitis B Surface Antibody test:

  • Hepatitis A Antibody Testing
  • Hepatitis C Antibody Testing

Conditions where a Qualitative Hepatitis B Surface Antibody test is recommended:

  • Hepatitis B
  • Hepatitis C
  • Liver Disease

How does my health care provider use a Qualitative Hepatitis B Surface Antibody test?

Antibody generated in response to HBV surface antigen is detected by hepatitis B surface antibody test. It is used to determine the necessity for immunization or if a person has recovered from an infection and is immune. It can also arise from effective vaccination.

What do my Qualitative Hepatitis B Surface Antibody test results mean?

If antibodies are not detected, it indicates that a person has not developed antibodies to the Hepatitis B Virus.

If antibodies are detected, it indicates that a person has developed antibodies to the Hepatitis B Virus.

Clinical Significance

The detection of anti-HBs is indicative of a prior immunologic exposure to the antigen or vaccine. To determine immune status as ≥10 mIU/mL as per CDC guidelines, please order Hepatitis B Surface Antibody, Quantitative.

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


Description: Hepatitis B Surface Antibody, Quantitative is a test that will determine if there are Hep B antibodies present in the blood.

Also Known As: Hep B Test, Hep B Surface Antibody Test, Hep B Antibody Test, Hepatitis B Antibody Test, Hep B Surface Ab Test, HBV Antibody Test, HBV Surface Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Hepatitis B Surface Antibody Quantitative test ordered:

Hepatitis B antibody testing is generally ordered to determine immunity to Hepatitis B through the detection of antibodies in the blood. This testing is often requested for medical records related to school and healthcare professions.

What does a Hepatitis B Surface Antibody Quantitative blood test check for?

Antibodies to the hepatitis B virus are detected in hepatitis B antibody tests, which indicate a past infection or immunization against the virus.

Hepatitis is a liver infection that causes inflammation and enlargement. It can be caused by a number of factors, one of which is virus infection. HBV is one of five "hepatitis viruses" known to primarily infect the liver that have been found thus far. Hepatitis A, hepatitis C, hepatitis D, and hepatitis E are the other four.

HBV is disseminated through coming into touch with an infected person's blood or other bodily fluids. For example, exposure can occur through the sharing of IV drug needles or through unprotected intercourse. People who reside in or travel to places of the world where hepatitis B is common are more vulnerable. Mothers can spread the virus to their newborns on a rare occasion, generally during or after delivery. The virus is not spread through simple hand-to-hand contact, coughing, or sneezing. The virus, however, can survive for up to seven days outside the body, including in dried blood, and can be spread by sharing razors or toothbrushes with an infected individual.

Effective hepatitis B vaccines have been available in the United States since 1981, and health care providers began immunizing infants at birth in 1991. Despite this, the CDC believes that between 804,000 and 1.4 million persons in the United States are infected with the virus, the majority of whom are unaware of their infection.

HBV infections can range in severity from a mild infection that lasts a few weeks to a more dangerous chronic infection that lasts years. Chronic HBV can sometimes lead to significant problems including cirrhosis or liver cancer.

The great majority of people who have chronic infections don't show any signs or symptoms. The symptoms of acute infections are remarkably similar to other types of acute hepatitis. Fever, tiredness, nausea, vomiting, and jaundice are some of the symptoms. The liver is damaged and unable to function normally in acute hepatitis. It may not be able to remove toxins or waste products like bilirubin from the body. Bilirubin and liver enzyme levels in the blood may rise as the disease progresses. While tests like bilirubin and a liver panel can tell a doctor if someone has hepatitis, they can't tell them what's causing it. Tests for hepatitis virus infection may aid in determining the cause.

Lab tests often ordered with a Hepatitis B Surface Antibody Quantitative test:

  • Hepatitis A antibody test
  • Hepatitis C antibody test
  • Acute Viral Hepatitis Panel
  • Hepatic Function Panel
  • Bilirubin Fractionated
  • Comprehensive Metabolic Panel
  • AST
  • ALT
  • Gamma-Glutamyl Transferase

Conditions where a Hepatitis B Surface Antibody Quantitative test is recommended:

  • Hepatitis
  • Liver Disease

How does my health care provider use a Quantitative Hepatitis B Surface Antibody test?

Antibody generated in response to HBV surface antigen is detected by hepatitis B surface antibody test. It is used to determine the necessity for immunization or if a person has recovered from an infection and is immune. It can also arise from effective vaccination.

What do my Hepatitis B antibody test results mean?

If antibodies are not detected, it indicates that a person has not developed antibodies to the Hepatitis B Virus.

If antibodies are detected, it indicates that a person has developed antibodies to the Hepatitis B Virus.

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


Description: The hepatitis B Surface antigen test is a blood test that checks for hepatitis b antigen in your blood’s serum. If hepatitis B antigen is detected, confirmation testing will be performed.

Also Known As: Hep B Test, HBsAg Test, Hepatitis B Antigen Test, HBV Test, HBV Surface Antigen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT:  NOTE THIS IS A REFLUX TEST - The price charged for this test is only for the Hepatitis B Surface Antigen. ADDITIONAL CHARGE OF $39 WILL OCCUR FOR THE REFLUX CONFIRMATION if the Hepatitis B Surface Antigen is positive.

When is a Hepatitis B Surface Antigen test ordered?

When someone develops signs and symptoms of acute hepatitis, hepatitis B tests may be conducted to see if they are caused by HBV infection.

When standard test findings such as ALT and/or AST are elevated, hepatitis B testing may be ordered as a follow-up. Acute varieties of hepatitis can sometimes be diagnosed this way since they only generate minor symptoms that are easily confused with the flu. Chronic hepatitis is more typically diagnosed when routine test results are abnormal and has no symptoms.

When someone falls into one of the high risk categories for chronic hepatitis B, a test for hepatitis B surface antigen may be utilized for screening.

Hepatitis B tests may be repeated on a regular basis to monitor persons who have chronic hepatitis B infections. Hepatitis B surface antigen and hepatitis Be antigen are normally evaluated every 6 months to a year since HBeAg can disappear on its own in certain persons. HBeAg and HBV DNA testing can be used to detect whether or not a patient is receiving effective treatment for chronic HBV.

What does a Hepatitis B Surface Antigen blood test check for?

Hepatitis B tests look for chemicals that indicate a present or former hepatitis B infection. Some tests look for viral antigen or antibodies produced in response to an infection, while others look for or analyse the virus's genetic material. A person with a current active infection or immunity as a result of earlier exposure can be identified by the pattern of test findings.

Hepatitis is a liver infection that causes inflammation and enlargement. It can be caused by a number of factors, one of which is virus infection. HBV is one of five "hepatitis viruses" known to primarily infect the liver that have been found thus far. Hepatitis A, hepatitis C, hepatitis D, and hepatitis E are the other four.

HBV is transmitted through contact with an infected person's blood or other bodily fluids. For example, exposure can occur through the sharing of IV drug needles or through unprotected intercourse. People who live in or go to locations where hepatitis B is widespread are more vulnerable. Mothers can spread the virus to their newborns on a rare occasion, usually during or after delivery. The virus is not spread through simple hand-to-hand contact, coughing, or sneezing. The virus, however, can survive for up to seven days outside the body, including in dried blood, and can be spread by exchanging razors or toothbrushes with an infected individual.

Efficient hepatitis B vaccines have already been available in the United States since 1981, and health care providers began immunizing newborns at birth in 1991. Despite this, the CDC believes that between 804,000 and 1.4 million persons in the United States are infected with the virus, the majority of whom are unaware of their infection.

HBV infections can range in severity from a mild infection that lasts a few weeks to a more dangerous chronic infection that lasts years. Chronic HBV can sometimes lead to significant problems including cirrhosis or liver cancer.

Acute HBV infection, albeit potentially dangerous, normally goes away on its own in most adults. Infants and children are more likely than adults to get a persistent infection. Ninety percent of newborns affected with HBV will develop a chronic illness. Between the ages of one and five, the risk of having chronic hepatitis lowers to 25% to 50%. Only 6% to 10% of HBV illnesses become chronic in children over the age of five.

The great majority of people who have chronic infections don't show any signs or symptoms. The symptoms of acute infections are remarkably similar to other types of acute hepatitis. Fever, tiredness, nausea, vomiting, and jaundice are some of the symptoms. The liver is damaged and unable to function normally in acute hepatitis. It may not be able to remove toxins or waste products like bilirubin from the body. Bilirubin and hepatic enzyme levels in the blood may rise as the disease progresses. While tests like bilirubin and a liver panel can tell a doctor if someone has hepatitis, they can't tell them what's causing it. Tests for hepatitis virus infection may aid in determining the cause.

Hepatitis B testing can be used to detect infection in the absence of symptoms, to establish whether an infection is acute or chronic, and to track the progress of a chronic infection and its treatment.

Lab tests often ordered with a a Hepatitis B Surface Antigen test:

  • Hepatitis A Test
  • Hepatitis C Test
  • Hepatitis Panel
  • Hepatic Function Panel
  • Bilirubin
  • AST
  • AST
  • GGT
  • Comprehensive Metabolic Panel

Conditions where a Hepatitis B Surface Antigen test is recommended:

  • Hepatitis
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Liver Disease
  • HIV

How does my health care provider use a Hepatitis B Antigen test?

Hepatitis B viral tests can be used for a number of different reasons. Some tests look for antibodies produced in response to HBV infection, while others look for antigens produced by the virus and yet others look for viral DNA.

In most cases, one set of tests is used as an initial panel of tests to diagnose HBV infection or determine the reason of acute symptoms, while another set of tests may be performed after a diagnosis to track disease progression, detect chronic infection, and/or determine carrier status.

What do my Hepatitis B Surface antigen test results mean?

Hepatitis B tests can be requested alone, although they are frequently ordered in combination, depending on the purpose for testing. The results of the tests are usually compared. The significance of one test result may be influenced by the outcome of another. However, not everyone is subjected to all tests.

If the findings of initial and follow-up testing suggest that a person has chronic hepatitis B, the individual may be treated with medication, and the effectiveness of that therapy can be tracked using HBe antigen and antibody tests, as well as HBV DNA tests.

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


Description: The hepatitis C antibody test is a test that looks for the antibodies for hepatitis C, if they are found more testing will be performed. The additional test for a positive hepatitis C antibody result is a quantitative test that will measure the amount of the virus that is present. This can be used for treating hepatitis C. This test also may be used to rule out hepatitis C in many cases.

Also Known As: Anti HCV Test, HCV Antibody Test, Hep C Antibody Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT - THIS IS A REFLEX TEST AND AN ADDITIONAL CHARGE OF $179 WILL BE APPLIED IF THE Hepatitis C Antibody is reactive.

If Hepatitis C Antibody is reactive, then Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge of $179.00

When is a Hepatitis C Antibody test ordered?

The CDC recommends using an HCV antibody test to check for HCV infections in patients who:

  • Have ever injected illegal substances
  • Before July 1992, received a blood transfusion or an organ transplant.
  • Have ever received clotting factor concentrates before to 1987
  • ave ever been on long-term dialysis
  • Children born to HCV-positive women
  • Have been exposed to hepatitis C-infected blood
  • Are healthcare, emergency medical, or public safety employees who have been exposed to HCV-positive blood through needlesticks, sharps, or mucosal contact
  • Have been diagnosed with chronic liver disease
  • Have HIV and were born between 1945 and 1965, irrespective of any HCV risk factors

Since 1992, the blood supply in the United States has been regulated, and any units of blood that test positive for HCV are not used in another person. HCV infection from transfused blood is now estimated to be one case per two million transfused units.

When someone has abnormal liver panel findings, for example, or signs and symptoms of hepatitis, HCV antibody testing may be performed. It may be done as part of an acute hepatitis panel in these circumstances. Most persons who are newly infected with HCV have no symptoms or have symptoms that are so minor that they rarely induce a person to seek medical help and get tested for HCV. However, approximately 10-20% of people may have signs and symptoms such as weariness, stomach pain, decreased appetite, and jaundice.

When an antibody test is positive, an HCV RNA test or viral load is requested as follow-up testing to confirm an active infection. If the HCV antibody test is positive, some laboratories will do this test automatically.

When a person is diagnosed with HCV infection, genotyping is often requested before therapy begins to help with treatment selection.

HCV viral load testing may be ordered at the start of treatment, on a regular basis to monitor treatment response, and at the end of treatment to assess its effectiveness.

What does a Hepatitis C Antibody blood test check for?

Hepatitis C is a virus that causes a liver infection that results in liver inflammation and damage. Hepatitis C tests are a collection of tests used to detect, diagnose, and track the progress of a hepatitis C virus infection. The most frequent HCV test searches for antibodies produced in response to an HCV infection in the blood. Other assays detect viral RNA, quantify the amount of viral RNA present, or define the virus's unique subtype.

Hepatitis C is one of five hepatitis viruses known to cause the disease, with the others being A, B, D, and E. HCV is spread by contact with contaminated blood, primarily through intravenous drug users sharing needles, but also through sharing blood-contaminated personal items like razors, sex with an infected person, healthcare occupational exposure, and, less commonly, from mother to baby during childbirth. HCV was commonly spread via blood transfusions before HCV tests became accessible in the 1990s.

While HCV is not as contagious as hepatitis B, no vaccination exists to prevent infection. In North America, hepatitis C infection is a common cause of chronic liver disease. According to the Centers for Disease Control and Prevention, there were about 30,500 instances of acute hepatitis C in the United States in 2014, with 2.7 to 3.9 million persons living with chronic hepatitis C.

Many people who are afflicted have no symptoms and are unaware that they are infected. The acute HCV infection may produce few to mild nonspecific symptoms, and the chronic infection may go unnoticed for a decade or two before producing enough liver damage to impair liver function.

A positive antibody test is followed with a hepatitis C RNA test, which detects virus genetic material, because the antibody test can remain positive in most patients even after they have eliminated the infection. A positive RNA test result indicates that the virus is present, that the infection has not cured, and that the person may need treatment. To help guide treatment, the hepatitis C genotyping test establishes which strain of virus is present.

A liver panel, which is a collection of tests used to examine the health of the liver, can also be ordered by healthcare providers.

Lab tests often ordered with a Hepatitis C Antibody test:

  • Hepatitis A Antibody
  • Hepatitis B Antibody
  • Hepatitis Panel
  • Hepatic Function Panel
  • ALT
  • AST
  • GGT
  • Bilirubin
  • Comprehensive Metabolic Panel

Conditions where a Hepatitis C Antibody test is recommended:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • HIV
  • Sexually Transmitted Diseases
  • Liver Disease
  • Hepatitis

How does my health care provider use a Hepatitis C Antibody test?

Hepatitis C tests are used to detect and diagnose hepatitis C virus infection, as well as to advise therapy and/or monitor the course of treatment.

An HCV antibody test is performed to determine whether or not you have been exposed to the virus before. It looks for antibodies to the virus, which indicates HCV infection. This test will not tell you if you have an active or prior HCV infection. There is some evidence that a "weakly positive" test could be a false positive. All positive antibody tests should be followed by an HCV RNA test, which identifies viral RNA in the blood to assess whether or not the person has a current infection, according to the Centers for Disease Control and Prevention.

The HCV antibody test can be used to establish which of the most prevalent hepatitis viruses is causing a person's symptoms as part of an acute viral hepatitis panel.

The tests listed below can help identify an infection and advise and monitor treatment:

HCV RNA tests: A quantitative HCV RNA test detects and counts viral RNA particles in the blood. This test can be used to confirm the virus's presence and diagnose a live infection. Viral load assays are also used before and throughout treatment to compare the amount of virus present before and after treatment to measure treatment response.

HCV RNA, Qualitative is used to determine whether an infection is present or past. If any HCV viral RNA is identified, the result is reported as "positive" or "detected"; otherwise, the result is ""negative"" or "not detected." This test is no longer often used.

To help guide treatment, viral genotyping is done to detect the kind, or genotype, of HCV present. HCV has five basic kinds and more than 50 subtypes; the most common, genotype 1, accounts for around 75% of infections in the United States. The medications chosen for treatment are influenced by the genotype of HCV infection.

What do my Hepatitis C Antibody test results mean?

Antibody tests for HCV are usually reported as "positive" or "negative."

If the virus is present, the results of HCV viral load tests are provided as a number. The result is frequently reported as "negative" or "not found" if no virus is present or if the amount of virus is too small to detect.

The table below shows how the HCV screening and follow-up tests are interpreted. If the HCV antibody test is positive, the person tested is infected or has likely been infected with hepatitis C at some point. If the HCV RNA test comes back positive, the person is currently infected. If no HCV viral RNA is found, the person either does not have an active infection or has very low levels of the virus.

Antibody to HCV HCV RNA Negative for HCV infection There is no infection or it is too soon after exposure for the test to be reliable; if suspicion persists, retesting at a later period may be necessary.

Positive or inconclusive Negative Past infection or no illness; if necessary, additional tests

Positive, Negative, or Indeterminate Infection currently present

An HCV viral load can be used to determine whether or not treatment is working for monitoring purposes. A high or increasing viral load could indicate that treatment isn't working, whereas a low, declining, or undetectable viral load could indicate that it is.

Successful treatment reduces viral load by 99 percent or more shortly after starting treatment and frequently results in undetectable viral load when treatment is finished. An undetectable viral load in a treated person's blood 12 weeks after the conclusion of treatment indicates that the HCV infection has responded to therapy, according to guidelines from the American Association for the Study of Liver Diseases and the Infectious Disease Society of America.

The findings of the HCV genotype test determine the strain of HCV a person has and aid in treatment selection and duration. Treatment options vary depending on a number of criteria, including the person's HCV genotype and liver condition.

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


Description: Hepatitis C Viral RNA Quantitative is a blood test that detects and measures Viral HCV RNA in the blood. This test is used to check if a patient has an active Hepatitis C infection.

Also Known As: HCV Test, HCV RNA Test, HCV Viral Load Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Hepatitis C Viral RNA test ordered?

When an antibody test is positive, more testing is required to confirm an active infection, such as an HCV RNA test or viral load. In some labs, if the HCV antibody test is positive, this test will be run immediately.

Testing for HCV viral load may be required before starting therapy, on a regular basis to track treatment response, and at the end of treatment to gauge its efficacy.

What does a Hepatitis C Viral RNA test check for?

The liver infection known as hepatitis C is brought on by a virus and is characterized by liver inflammation and destruction. Hepatitis C tests are a collection of tests used to identify, pinpoint, and track the progress of a hepatitis C virus infection. The most popular HCV test checks for blood antibodies created in response to an HCV infection. Other tests identify the specific subtype of the virus or measure the quantity or presence of viral RNA.

One of the five hepatitis viruses known to cause the disease, along with hepatitis A, B, D, and E, is hepatitis C. HCV is spread through contact with contaminated blood, primarily through the sharing of needles by intravenous drug users, but it can also be transmitted through sex with an infected person, through occupational exposure in the healthcare industry, and, less frequently, from a mother to her unborn child during childbirth. Before HCV testing were made available in the 1990s, blood transfusions were a common way for HCV to spread.

There is presently no vaccination to prevent infection with HCV, despite the fact that it is less contagious than hepatitis B. In North America, hepatitis C infection is a typical contributor to chronic liver disease. According to the Centers for Disease Control and Prevention, there were roughly 30,500 cases of acute hepatitis C in the United States in 2014, and there are between 2.7 and 3.9 million Americans who have chronic hepatitis C.

Many infected people exhibit no symptoms and are unaware of their illness. The acute HCV infection may not manifest any symptoms or only mild, nonspecific ones, whereas the chronic infection may go unnoticed for ten or twenty years before producing enough liver damage to impair liver function.

Hepatitis C antibody tests are used to check for the infection in persons, such as those with risk factors but no visible symptoms, those who have hepatitis or liver disease symptoms, or those who have been exposed to the virus.

A positive antibody test is followed by a hepatitis C RNA test, which detects the genetic material of the virus, because the antibody test can remain positive in the majority of patients even though they have recovered from the infection. A positive RNA test result indicates the virus is present, the infection has not cleared up, and treatment may be necessary.

A liver panel is a collection of tests that doctors might conduct to evaluate the condition of the liver.

Lab tests often ordered with a Hepatitis C Viral RNA test:

  • Hepatitis C Antibody Test
  • Hepatitis A Testing
  • Hepatitis B Testing
  • Acute Hepatitis Panel
  • Hepatic Function Panel
  • Bilirubin
  • AST
  • ALT
  • GGT

Conditions where a Hepatitis C Viral RNA test is recommended:

  • Hepatitis C
  • Hepatitis B
  • Liver Disease

How does my health care provider use a Hepatitis C Viral RNA test?

Hepatitis C tests are used to detect and identify the presence of the hepatitis C virus, to direct therapy, and/or to track the progress of an HCV infection.

The HCV RNA test finds and counts the amount of viral RNA in the blood. This examination may be used to identify an ongoing infection and confirm the virus's existence. By comparing the amount of virus before and after treatment, viral load tests are also used to assist measure the effectiveness of the medication.

What do my Hepatitis C Viral RNA test results mean?

If the virus is present, the HCV viral load test results are given as a number. The result is frequently labeled "negative" or "not detected" if there is no virus present or if the virus concentration is too low to detect it.

The individual has an active infection if the HCV RNA test is positive. If no HCV viral RNA is found, either the person does not have an active infection or there are extremely few copies of the virus in their system.

An HCV viral load can show whether or not treatment is working for monitoring purposes. A high or rising viral load can indicate that the treatment is ineffective, whereas a low, falling, or undetectable viral load might suggest that it is.

Soon after starting treatment, a successful course of treatment induces a reduction in viral load of 99% or more, and after treatment is finished, the viral load is typically undetectable. An undetectable viral load in a treated person's blood 12 weeks after the completion of treatment indicates that the HCV infection has responded to therapy, per recommendations from the American Association for the Study of Liver Diseases and the Infectious Disease Society of America.

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


Includes

Hepatitis A Antibody, Total; Hepatitis B Surface Antibody, Qualitative; Hepatitis B Surface Antigen with Reflex Confirmation; Hepatitis B Core Antibody, Total; Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).


If Hepatitis C Antibody is reactive, Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).


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.


Direct Antiglobulin Test (DAT) with Reflex to Anti C3 and Anti IgG

IMPORTANT - NOTE THIS IS A REFLEX TEST AND AN ADDITIONAL CHARGE OF $64 WILL OCCUR IF THE QUEST RUNS THE REFLEX TEST.

If DAT (Coombs, Direct) is positive, Anti C3d and Anti IgG will be performed at an additional charge of $64.00

Reference Range(s)

Negative

Clinical Significance

The DAT (Direct Coomb's test) is positive if red cells have been coated, in vivo, with immunoglobulin, complement, or both. A positive result can occur in immune-mediated red cell destruction, autoimmune hemolytic anemia, a transfusion reaction or in patients receiving certain drugs.

 


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: The electrolyte panel test is a blood test that measures levels of electrolytes in the blood’s serum.

Also Known As: Lytes Panel, Anion Gap Panel, Electrolyte Test, Lytes Test, Anion Gap Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Electrolyte Panel test ordered?

An electrolyte panel may be requested as part of a regular screening or as a diagnostic tool when an individual symptoms, such as:

  • Accumulation of fluid
  • Weakness Nausea or vomiting
  • Confusion
  • Heartbeat irregularity

It is usually requested as part of an examination when a person has an acute or chronic illness, as well as at regular intervals when a person has a disease or condition, or is receiving medication that can induce an electrolyte imbalance. Electrolyte tests are frequently requested at regular intervals to evaluate the therapy of disorders such as high blood pressure, heart failure, lung ailments, and liver and kidney disease.

What does an Electrolyte Panel test check for?

Electrolytes are minerals that are found as dissolved salts in bodily tissues and blood. Electrolytes help transfer nutrients into and waste out of the body's cells, maintain a healthy water balance, and control the body's acid/base level as electrically charged particles.

The electrolyte panel determines the concentrations of sodium, potassium, chloride, and bicarbonate in the blood.

Sodium, potassium, and chloride are all found in a person's diet. By reabsorption or disposal into the urine, the kidneys assist in maintaining correct levels. The lungs regulate CO2 and provide oxygen. The body produces CO2, which is balanced with bicarbonate. The total balance of these substances is a sign of how well various essential biological functions are working. They play a role in a variety of biological activities, including cardiac and skeletal muscle contraction, as well as nerve impulse conduction.

A fluid, electrolyte, or pH imbalance can be caused by any disease or condition that changes the volume of fluid in the body, such as dehydration, or affects the lungs, kidneys, metabolism, or respiration. To ensure the appropriate functioning of metabolic processes and the supply of the right quantity of oxygen to tissues, normal pH must be maintained within a limited range of 7.35-7.45 and electrolytes must be in balance.

The anion gap, which is a value calculated from the results of an electrolyte panel, is a related "test." It indicates the difference in charge between positively and negatively charged ions. Although an aberrant anion gap is non-specific, it can indicate the presence of hazardous chemicals or metabolic or respiratory problems.

Lab tests often ordered with an Electrolyte Panel test:

  • Basic Metabolic Panel (BMP)
  • Comprehensive Metabolic Panel (CMP)
  • Creatinine
  • Glucose

Conditions where an Electrolyte Panel test is recommended:

  • Acidosis
  • Alkalosis
  • Kidney Disease
  • Hypertension
  • Dehydration
  • Congestive Heart Failure

How does my health care provider use an Electrolyte Panel test?

An electrolyte, fluid, or pH imbalance is detected using the electrolyte panel. It's commonly ordered as part of a normal physical examination. It is available as a standalone test or as part of a basic or comprehensive metabolic panel. Other tests like as BUN, creatinine, and glucose may be included in these panels.

Electrolyte measures can be used to assess illnesses including dehydration, kidney disease, lung disease, or heart disease that induce electrolyte imbalances. Repeat testing can then be performed to track the progress of treatment for the ailment that caused the imbalance.

Because electrolyte and acid-base imbalances can occur in a wide range of acute and chronic disorders, the electrolyte panel is commonly used to assess patients in both the emergency room and the hospital.

The electrolyte panel includes tests for the following electrolytes:

  • Sodium—the majority of sodium in the body is located in extracellular fluid, which is situated outside of cells and helps to regulate the quantity of water in the body.
  • Potassium is an electrolyte that is mostly present inside the body's cells. The plasma, or liquid portion of the blood, contains a modest but vital amount of potassium. Potassium levels must be monitored since even modest variations might alter the heart's rhythm and ability to contract.
  • Chloride—this electrolyte travels in and out of cells to assist maintain electrical neutrality, and its level is usually the same as sodium's.
  • Bicarbonate—the primary function of bicarbonate, which is produced and reabsorbed by the kidneys, is to maintain a constant pH level and, secondarily, to maintain electrical neutrality.

An anion gap calculation may be included in the electrolyte panel data.

If a person has an electrolyte imbalance, such as sodium or potassium, the health practitioner may prescribe additional testing of that specific electrolyte, as well as monitoring the imbalance until it resolves. If someone has an acid-base imbalance, a health care provider may prescribe blood gas tests, which measure the pH, oxygen, and carbon dioxide levels in an arterial blood sample to assist assess the severity of the problem and track its progress.

What do my electrolyte panel test results mean?

Several disorders and diseases can induce high or low electrolyte levels. They are often influenced by the amount of food taken and absorbed by the body, the amount of water in the body, and the amount excreted by the kidneys. They are also influenced by hormones like aldosterone, which conserves sodium while promoting potassium disposal, and natriuretic peptides, which stimulate sodium excretion via the kidneys.

People with malfunctioning kidneys, for example, may retain an excessive amount of water in their bodies. This has the effect of diluting sodium and chloride, lowering their quantities below normal. People who have lost a lot of fluid, on the other hand, may have higher potassium, sodium, and chloride levels. Some diseases, such as heart disease and diabetes, can disrupt the body's fluid and electrolyte balance, resulting in abnormal electrolyte levels.

Knowing which electrolytes are out of balance can assist a health care provider in determining the underlying cause and making treatment recommendations to restore appropriate balance. An electrolyte imbalance, if left untreated, can cause dizziness, cramping, irregular heartbeat, and even death.

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


Recently, inhibitors of anaplastic lymphoma kinase (ALK) have been used successfully in treating patients harboring gene fusions between echinoderm microtubule-associated protein-like 4 (EML4) and ALK. This is a reverse transcription PCR-based exon scanning approach to encompass fusion variants spanning nearly the entire EML4 gene.

Clinical Significance

FISH, B-Cell Chronic Lymphocytic Leukemia Panel - This test is performed to detect the rearrangements of 6q21(SEC63),6q23(MYB),ATM(11q22.3),centromere 12(D12Z3), 13q14.3(DLEU),13q34(LAMP1) and TP53(17p13.1) regions,by FISH (fluorescence in situ hybridization). This assay is useful for prognostic assessment for chronic lymphocytic leukemia/ small lymphocytic lymphoma(CLL/SLL).


Galectin-3

Clinical Significance

A galectin-3 test may be ordered for the identification of individuals with chronic heart failure at elevated risk of disease progression.

Performing Laboratory 

Cleveland HeartLab, Inc 
6701 Carnegie Avenue, Suite 500
Cleveland, OH 44103-4623

Elevations of IgG, A and/or M are seen in generalized hypergammaglobulinemia, chronic inflammatory conditions and in lymphoproliferative diseases such as multiple myeloma, lymphoma and leukemias. Decreased levels are found in immunodeficiency states, generalized hypogammaglobulinemia and in unrecognized pediatric patients.

Description: A Lactate Dehydrogenase or LD test is a blood test that measure the level of the enzyme Lactate Dehydrogenase in your blood’s serum and can be used to detect a wide variety of disorders including liver disease, kidney disease, infections, and pancreatitis.

Also Known As: LD Test, LDH Test, Lactic Acid Dehydrogenase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Lactate Dehydrogenase test ordered?

When a health practitioner feels that a disease or condition is causing cellular or tissue damage, an LD level, coupled with other tests such as a comprehensive metabolic panel, may be requested. More specific tests, such as alanine transaminase, aspartate aminotransferase, or alkaline phosphatase, may be used to identify the illness and pinpoint which organs are affected if LD is increased. Total LD levels may be ordered at regular intervals to monitor the course and/or resolution of the acute or chronic issue once it has been diagnosed.

When a person has had muscle damage or injury, or when they have signs and symptoms of hemolytic anemia, LD levels may be ordered.

When a person has been diagnosed with cancer, LD testing may be performed on a regular basis.

When a person exhibits signs and symptoms of meningitis, or when there is an accumulation of fluid around the heart, lungs, or abdomen, this test may be recommended.

What does a Lactate Dehydrogenase blood test check for?

Lactate dehydrogenase is an energy-producing enzyme found in nearly all of the body's cells, with the highest concentrations in the heart, liver, muscles, kidneys, lungs, and blood cells; bacteria also produce LD. This test determines the amount of LD in the blood or other bodily fluids.

In the fluid component of the blood, just a little quantity of LD is normally measurable. When cells are injured or destroyed, LD is released into the bloodstream. As a result, an LD blood level is a non-specific indicator of tissue damage elsewhere in the body. It cannot be used to determine the underlying cause or location of cellular damage on its own. It can, however, be used in conjunction with other blood tests to assist diagnose and/or monitor disorders that cause tissue damage, such as liver or blood diseases, or cancer.

Fluid can accumulate or the components of the fluid present can change when there is damage, inflammation, or infection in a specific area of the body, such as the brain, heart, or lungs. The amount of LD in the fluid could help you figure out what's wrong. When a person has bacterial meningitis, for example, LD levels in the cerebrospinal fluid are usually high. The LD test, in combination with other tests, can be used to detect whether fluid buildup around the heart, lungs, or abdominal cavity is caused by injury or inflammation or by an imbalance of fluid pressure inside blood vessels and blood protein levels. Some fluids that can be analyzed using an LD test are listed in the article on Body Fluid Analysis.

Lab tests often ordered with a Lactate Dehydrogenase test:

  • Comprehensive Metabolic Panel
  • Haptoglobin
  • Hepatic Function Panel

Conditions where a Lactate Dehydrogenase test is recommended:

  • Liver Disease
  • Kidney Disease
  • Lung Diseases
  • Heart Disease
  • Heart Attack
  • Anemia
  • Meningitis
  • Pancreatic Diseases
  • Testicular Cancer
  • Ovarian Cancer
  • Lymphoma
  • Leukemia

How does my health care provider use a Lactate Dehydrogenase test?

A lactate dehydrogenase test is a non-specific test that can be used to diagnose a variety of diseases and disorders. When cells are injured or destroyed, LD, an enzyme found in practically all of the body's cells, is released from the cells into the fluid portion of blood. As a result, the presence of LD in the blood is a general sign of tissue and cellular damage. In the presence of certain disorders, the amount of LD may also grow in other types of body fluids.

A blood test for LD may be used:

  • As a broad measure of whether or not acute or chronic tissue injury exists and how severe it is
  • To diagnose and track the progression of illnesses such as anemia and severe infections.
  • To aid in the staging, prognosis, and/or monitoring of cancers such as germ cell tumors, lymphoma, leukemia, melanoma, and neuroblastoma, as well as lymphoma, leukemia, melanoma, and neuroblastoma.

Body fluids are subjected to an LD test for a variety of reasons:

  • To aid in the evaluation of cerebrospinal fluid and the differentiation between bacterial and viral meningitis
  • To identify whether the build up of fluid is related to an injury and inflammation or to an imbalance of pressure within blood vessels and the amount of protein in the blood by evaluating other body fluids such as peritoneal, pleural, or pericardial fluid. This information is useful in determining therapy options.

Other fluids that can be tested using an LD test are included in the article on Body Fluid Analysis.

What do my lactate dehydrogenase test results mean?

LD values that are elevated usually indicate tissue damage. As cellular death begins, LD levels normally climb, peak after a period of time, and then begin to diminish. LD levels are raised in a number of situations, indicating that it has a wide tissue distribution.

Elevated LD levels may be seen with:

  • Hemolytic anemia
  • Pernicious anemia 
  • Infectious mononucleosis
  • Meningitis
  • Encephalitis
  • HIV
  • Sepsis
  • Intestinal and pulmonary infarctions
  • Acute kidney disease
  • Acute hepatitis
  • Acute muscle damage
  • Pancreatitis
  • Fractures of the bones
  • Malignancies of the testicles, lymphoma, or other cancers

A high level of LD in the blood may suggest that cancer treatment has failed. A high level is associated with a poorer prognosis for cancer patients. Moderately high LD blood levels may remain in several chronic and progressive diseases. LD levels that are low or normal do not usually indicate a concern. When a high amount of ascorbic acid is consumed, low levels can occur.

Fluids in the body:

  • Cerebrospinal fluid—a high LD implies bacterial meningitis, whereas a low or normal amount indicates viral meningitis is more likely.
  • Pericardial fluid, peritoneal fluid, or pleural fluid with a high LD is an exudate, while fluid with a low LD is a transudate. Cirrhosis or congestive heart failure are the most common causes of transudates. Exudates can have a variety of causes, and determining the cause usually necessitates additional testing.

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


Lactate Dehydrogenase Isoenzymes

Clinical Significance

Diagnostic aid for myocardial infarction. Also for malignancies, anemias, and acute liver and muscle injury.

 

Includes

LD 1, LD 2, LD 3, LD 4, LD 5

Methodology

Electrophoresis

Reference Range(s)

  • LD 119-38 %
  • LD 230-43 %
  • LD 316-26 %
  • LD 43-12 %
  • LD 53-14 %

Alternative Name(s)

LD Isoenzymes without Total LD,LDI


CD20 antigen is expressed on the surface of >90% of B-cell non-Hodgkin's Lymphomas (NHL). Binding to CD20 antigen is necessary for the antitumor effect of Rituxan®.

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

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.



The localization of lymphocytes, a specific type of WBCs (or white blood cells), in one or more lymph nodes is what is referred to as lymphoma – a cancer.  In both the lymphatic and blood circulatory systems, lymphocytes travel all over the body.  Tissue fluids are drained and carried all over the body as lymph and then back to the blood circulatory system via the lymphatic system, which is a network of lymph nodes and vessels (or lymphatics).  In areas such as the groin, neck, chest, armpits, and abdomen, lymph nodes are found in chains or individually. As the lymph fluid goes through the nodes (tiny lymphoid tissue organs whose job it is to filter lymph), abnormal cells and microorganisms are destroyed. Natural killer cells, T-lymphocytes and B-lymphocytes are some of the lymphocytes and macrophages contained in lymph nodes.         

The immune system is controlled by T-lymphocytes.  When it comes to immune responses, these lymphocytes decide when a response is necessary, its scale or severity, in addition to triggering it.  Furthermore, they counteract a variety of foreign bodies attacking the body.  B-lymphocytes work to create antibodies that are activated when an individual gets a vaccine against hepatitis, mumps or measles, or any other diseases. 10 to 15 percent of all the lymphocytes in the bloodstream are of the natural killer (or NK) variety, another type of lymphocytes.  Abnormal cells that have been attacked by viruses and cancerous cells are usually attacked and killed by NK cells.    

In the case of lymphoma, any of these cells may be involved either singly or as a combination.  The occurrence of abnormal cells in the lymph nodes, one or more, or lymphoid tissues could signal the onset of lymphoma.  The uncontrollable reproduction of these cells means that their number exceeds that of normal cells in the affected node causing the node to grow in size before the abnormal cells start spreading to other nodes in the lymphatic system.  The abnormal cells may also travel to the tonsils, thymus, bone marrow, adenoids and spleen, and other organs closely related to the lymphatic system.     

T-cell lymphomas are less common than B-cell lymphomas.  

Symptoms of Lymphoma  

The lymph nodes in the groin, neck, and armpits may swell painlessly and/or the spleen becomes enlarged in people with lymphoma.  Increased levels of abnormal lymphocytes may also be discovered in the blood of affected individuals.  Additional signs and symptoms of lymphoma include:    

  • Episodes of chills and fever 
  • Fatigue 
  • Instances of night sweats  
  • Significant loss of weight, up to 10 percent or higher, for no apparent reason  
  • Diminished appetite 
  • Pain in the neck or flank 
  • Itchiness  

The individual’s breathing may be affected if the lymph node in question is located in the chest area.  If the affected lymph node is in the abdomen, abdominal pain may be experienced.  Since the above symptoms may be mild in nature, diagnosing lymphoma may, at times, be quite hard.  While some people may experience a low-grade fever, others may not have any noticeable signs.  The physician, or individual suffering from lymphoma, may not be able to feel or see the swollen lymph node even though it is there.   

Hodgkin Disease/Lymphoma   

The presence of Reed-Sternberg cells, big unique cells, characterizes Hodgkin disease/lymphoma.  

People between the ages of twenty and forty years, as well as those over the age of 55, have a higher prevalence of Hodgkin lymphoma.  Each year, around 9,000 individuals in the US are diagnosed with this disease, with 1,300 deaths, according to the ACS (or American Cancer Society).    

A variety of theories have attempted to explain the cause of Hodgkin Lymphoma.  The involvement of a virus, or other infectious agent, has been mentioned in a number of them.  According to other theories, cell mutations are to blame.  Specific causes are yet to be identified, even though research is still ongoing.  Similarly, there has been no clear explanation as to why males appear to be more vulnerable to HL.    

Based on the cells that are present as well as the abnormal lymph node structure, Hodgkin Lymphoma can be further divided.  A depletion of lymphocytes, a higher number of small lymphocytes, or a combination of various types of cells or fibrosis (occurrence of bands of scarring) may be seen in lymph nodes.  With HL,  a benign, mostly mixed, reactive cell population forms the majority of the cells in the lymph nodes, while Reed-Sternberg cells (tumor cells) are the minority.                                      

Non-Hodgkin Lymphoma  

About 4 percent of all newly diagnosed cancer cases in the US are Non-Hodgkin lymphoma.  This lymphoma is slightly more common in Caucasians and men than in women.  Individuals with a compromised immune system, those with HIV/AIDS, as well as those at an advanced age, face a higher risk of developing this disease.   

While around 20,000 people die from the disease annually, around 72,000 are diagnosed in a similar period according to the American Cancer Society.  Since the 1970s, the occurrence of the disease is almost double.  While cases relating to women account for the highest increase, the main reason for the upward trend is yet to be discovered.  Since the late nineties, however, non-Hodgkin lymphoma related deaths have been on the decrease.    

The systems used to classify the many different types of non-Hodgkin lymphoma have evolved as understanding about them grows.  Some of the changes in the classification systems used are attributed to the introduction of new methods of evaluating the cells involved in the disease.   

Many doctors have adopted the REAL (or Revised European American Lymphoma) classification proposed by the International Lymphoma Study Group back in the nineties.  The main function that the cell should be providing was the main focus of this classification.  For instance, while cell to cell interactions are left to T-lymphocytes, the main function of B-lymphocytes is to produce antibodies.  These characteristics are combined with genetic and phenotypic studies of the cells under the WHO (or World Health Organization) classification system – which is also the latest system.  Having been adopted by many healthcare professionals as the current standard, the World Health Organization classification added to the REAL classification.    

Non-Hodgkin Lymphoma Types  

Due to the various classification systems and changes made to them over the years, non-Hodgkin lymphoma classification can be somewhat confusing.  Natural Killer and T- cell lymphomas are less common in the US than B-cell non-Hodgkin lymphomas.  Around 15 percent of non-Hodgkin lymphomas affect T-lymphocytes, with approximately 85 percent involving mature B-lymphocytes.  

The following are some of the most common B-cell lymphomas types:   

* DLBCL (or Diffuse Large B-cell Lymphoma).  Of all non-Hodgkin lymphoma cases in the US, DLBCL constitutes about a third. While this disease mostly occurs in older individuals, it can affect anyone and is considered to grow swiftly.  

* Follicular Lymphoma.  About a fifth of all lymphoma cases in the US are of this type.  Over time, about a third of all Follicular lymphomas turn into the fast-growing DLBCL type described above, even though they are generally known to grow slower.  

* B-cell chronic lymphocytic lymphoma / small lymphocytic lymphoma (or CLL/ SLL).  

Characterized by small lymphoma cells, CLL/SLL is a slowly progressing disease.  The lymphoma cells are mostly small-sized.  While SLL generally involves the lymph nodes, CLL is predominantly found in the bone marrow; however, both of these are considered the same disease and combined make up about 24 percent of all lymphomas.   

The following are some of the main types of T-cell lymphomas:  

* Precursor T-lymphoblastic lymphoma (leukemia). Depending on where the affected cells are located, in the bone marrow or the blood, this disease can be considered to be leukemia or lymphoma.  Of all lymphoma cases, about 1 percent fall under this category.   

* Peripheral or Mature T-cell lymphomas.  4 to 5 percent of all lymphomas fall under the different known categories of mature T-cell lymphomas.    

* Sezary Syndrome, Mycosis Fungoides, and Other Types Of Cutaneous T-Cell Lymphomas.  These types of lymphomas are different from other types because, unlike the rest, they start on the skin instead of internal organs or lymphoid tissue.  This means that even though they are quite uncommon, they very unique.  Of all non-melanoma skin cancer cases, this specific group makes up less than 1 percent. Five percent of all lymphomas are skin lymphomas.  

Lymphoma Testing  

When it comes to testing, the main goal is to distinguish the condition from other conditions and recognize and keep track of complications, if any, in addition to diagnosing and staging the lymphoma.  To diagnose lymphoma a few blood tests can be used.  

Lab Testing  

The examination of affected lymphoid tissue and lymph nodes by a pathology specialist is the gold standard when it comes to testing for both non-Hodgkin and Hodgkin lymphomas.  Using a fine needle aspiration procedure or biopsy obtained from the affected lymph tissue or node, the sample is evaluated microscopically.     

The following lab tests may also be used:  

CBC (or Complete Blood Count).  To rule out leukemia and other non-lymphoma conditions and to test for the presence of anemia, a CBC may be administered.  The CBC can identify low platelet or low white blood cell counts that may indicate whether lymphoma is present in the blood and/or bone marrow   

* Biopsy and Evaluation of The Bone Marrow.  The cells in the bone marrow are examined using this test.  Lymphoid aggregates and/or abnormal lymphoid cells may be found with lymphoma.  

Blood Smear Test.  The quality of platelets, white and red blood cells, and that of lymphoma cells, or any other abnormal cells, where present, is examined under this test.   

* Immunophenotyping.  By testing for specific identifying markers inside or on the membrane of cells, this test can be used to spot affected cells.  Usually listed numerically, these commonly used identifying factors are referred to as CD (or clusters of differentiation).  Classification of the cells is possible by creating a list of the clusters of differentiation present on the cells.  Immunohistochemistry and flow cytometry are a couple of the ways in which this test can be conducted.   

* Chromosome Analysis Test.  To establish whether bits of chromosomes have moved, chromosome analysis evaluates the chromosomes in the cancer cell nucleus. For lymphomas, this test is rarely used.   

* Molecular Genetic Analysis Tests.  To establish whether the cells under consideration belong to one clone, molecular genetic analysis can be used to look for genetic changes by examining the DNA of the cancerous cell.  

* Body fluids, including cerebrospinal fluid, can be analyzed if the lymphoma is thought to have spread to other parts of the body.  

Beta-2 Microglobulin Test.  The prognosis may be predicted with the help of the Beta-2 Microglobulin test.  

Serum Creatinine Test.  If a disease referred to as nephritic syndrome, affecting the kidneys, is linked with Hodgkin lymphoma, serum creatinine levels may be higher than normal.  

* Studies of Serum Chemistry.  The prognosis may also be determined with the help of serum chemistry studies such as LDH (or lactate dehydrogenase).  

Hepatitis B Test.  * Since rituximab therapy is linked with negative side effects in individuals suffering from hepatitis B, a hepatitis B test is used to determine the suitability of the treatment.  

* HIV (Human Immunodeficiency Virus) Test.  The lymphoma outcome in HIV patients may be improved by using an antiretroviral treatment. 

Non-laboratory Tests. 

The following non-laboratory tests may be used primarily to help stage and monitor lymphoma: 

* MRI (or magnetic resonance imaging). 

* Exploratory surgery (only necessary on occasion). 

* Physical examination. 

* CT (or computed tomography) scans. 

* PET (or positron emission tomography) scans. 

* Chest X-ray.