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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.