Test Code AGBAL Aspergillus Galactomannan EIA (BAL)
Clinical Indications
The Platelia™ Aspergillus Galactomannan EIA is a test, when used in
conjunction with other
diagnostic procedures, such as microbiological culture,
histological examination of biopsy specimens, and radiographic
evidence that can be used to aid in the diagnosis of Invasive
Aspergillosis. Twice weekly monitoring of neutropenic patients
is
often recommended in the peer-reviewed literature to obtain
maximum
diagnostic utility of the assay.
Additional Test Codes
Epic Order Name: ASPERGILLUS
GALACTOMANN
(aka AGBAL)
Sunquest Order Code: AGBAL
Epic Px Code: LAB7092
Specimen Collection Type
BAL
collected in a sterile, screw top
container
Minimum Collection Volume
0.5 mL
Reference Range
The reference range is an index of <0.5 numerical index
values will be reported.
Patients with an index of ≥0.5 are considered to be positive
for
galactomannan antigen.
Patients with an index of <0.5 are considered to be negative
for
galactomannan antigen.
Specimens testing positive will be retested to confirm the
positive
result.
•A reference Index Value of <0.5 has been shown to be
appropriate for both serum and bronchial lavage specimen types.
Critical Value
N/A
Interpretation
For maximum sensitivity, the test should be performed at
least
twice weekly during neutropenia. The exact frequency of testing
in
non-hospitalized patients with chronic
graft-versus-host-disease
(CGVHD) would
depend upon the degree of
immunosuppression. The test should be used in conjunction with
other diagnostic procedures.
Two consecutive positive results are required for classification
as
true positive, thus it is recommended that a follow-up specimen
be
submitted from the patient upon receipt of the initial positive
result; ideally prior to initiation of anti fungal therapy to
achieve maximum specificity.
Rejection Criteria
Specimens that have been stored at ambient temperature,
specimens received in trap containers, specimens beyond their
acceptable length of time from collection as listed in the
specimen
stability.
Specimen Availability for Add-on Testing
24 hours
Specimen Stability
Frozen (preferred): 4 days
Refrigerated: 24 hours
Ambient: Unacceptable
Day(s) Performed
Monday through Saturday
Performing Lab- Department
TUKHS-BH-Mail Outs
CPT Code
87305
LOINC Code
62467-6
Test Alias
Platelia Aspergillus Galactomannan EIA
(BAL)
Additional Information / Notes
Assay Limitations
A negative test result cannot rule out the diagnosis of
Invasive
Aspergillosis. Patients at risk for Invasive Aspergillosis
should
be tested twice per week.
If a positive result is obtained, a second specimen should be
collected and sent for testing immediately.
The performance of the test has not been evaluated with
neonatal
specimens.
This test may exhibit reduced detection in patients with
chronic
granulomatous disease and Job’s Syndrome.
The concomitant use of mold-active, anti fungal therapy in some
patients with Invasive Aspergillosis may result in reduced
sensitivity of the test.
There are reports in the literature of positive galactomannan
test
results in patients receiving
piperacillin/tazobactam,therefore,
results in these patients should be interpreted with caution
and
confirmed with other diagnostic methods.
There are reports in the literature of positive galactomannan
test
results in patients with intestinal mucositis caused by
chemotherapy and irradiation, which allows for extra absorption
of
dietary galactomannan.
False-positive Galactomannan results have been shown in
patients
receiving Plasmalyte for intravenous hydration or if Plasmalyte
is
used for BAL
collection.