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Test Code LAB7044 Leishmaniasis (Visceral) Antibody, Serum

Additional Codes

 

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
LEISHMANIASIS-VISCERAL AB LAB7044 LEISH LEIS

 

Reporting Name

Leishmaniasis (Visceral) Ab, S

Useful For

Aiding in the diagnosis of active visceral leishmaniasis

 

This test should not be used as the sole criteria for diagnosis.

Method Name

Immunochromatographic Strip Assay

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.2 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject

Reference Values

Negative

Reference values apply to all ages.

Day(s) Performed

Tuesday, Thursday

CPT Code Information

86717

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LEIS Leishmaniasis (Visceral) Ab, S 7958-2

 

Result ID Test Result Name Result LOINC Value
86219 Leishmaniasis (Visceral) Ab, S 7958-2

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

Clinical Information

Visceral leishmaniasis (kala azar) is a disseminated intracellular protozoal infection that targets primarily the reticuloendothelial system (liver, spleen, bone marrow) and is caused by Leishmania donovani, Leishmania chagasi, or Leishmania infantum (L donovani complex).

 

Transmission is by the bite of sandflies. Clinical symptoms include fever, weight loss, and splenomegaly; pancytopenia and hypergammaglobulinemia are often present. Most (90%) new cases each year arise in rural areas of India, Nepal, Bangladesh, Sudan, and Brazil, but the disease has a worldwide distribution, including the Middle East.

 

Definitive diagnosis has required the microscopic documentation of characteristic intracellular amastigotes in stained smears from culture of aspirates of tissue (spleen, lymph node) or bone marrow. The detection of serum antibodies to the recombinant K39 antigen of L donovani is an alternative noninvasive sensitive (95%-100%) method for the diagnosis of active, visceral leishmaniasis.

Interpretation

Negative:

Negative results indicate the absence of antibodies to members of the Leishmania donovoni complex. Repeat testing in 2 to 3 weeks if clinically indicated. Immunocompromised patients frequently have low or undetectable antibodies to Leishmania species.

 

Positive:

Positive results indicate the presence of antibodies to members of the L donovoni complex, the causative agents of visceral leishmaniasis. Results should not be used as the sole criterion for diagnosis or treatment of visceral leishmaniasis and should not be used to diagnose other forms of leishmaniasis. False-positive reactions due to malaria infection have been reported.

Cautions

This test indicates only the presence of antibodies and should not be used as the sole criteria for diagnosis.

 

False-positive results may occur in patients with malaria or in the presence of rheumatoid factor.

 

Specimens containing glycerol or other viscous materials may interfere with the test.

 

Patients coinfected with HIV and Leishmania may fail to produce antibodies.

Supportive Data

Manufacturer's reported sensitivity and specificity (for endemic areas) are 90% or more and 93% to 100% respectively (InBios Kalazar Detect Rapid Test product insert). Validation studies in the Mayo Clinic Division of Clinical Microbiology provided a sensitivity of 94% (panel of 16 known positives) and specificity of 100% (panel of 50 normal blood donors plus 16 positives for other parasitic infections).

Method Description

Immunochromatographic strip assay for the qualitative detection of antibodies to the Leishmania donovani complex in serum. The test strip membrane is coated on the bottom with a band of recombinant K39 antigen and on the top with immobilized antiprotein A antibody to detect IgG. A protein A-gold conjugate is used as the detection reagent. For this test, 20 mcL of serum is added to the test strip. The appearance of both a control and test band is considered a positive result.(Carvalho SF, Lemos EM, Corey R, Dietze R. Performance of recombinant K39 antigen in the diagnosis of Brazilian visceral leishmaniasis. Am J Trop Med Hyg. 2003;68:321-324; package insert: Kalazar Detect Rapid Test for Visceral Leishmaniasis. InBios International, Inc; 05/01/2018)

Report Available

Same day/1 to 4 days

Specimen Retention Time

14 days

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.