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Test ID 8041 Cutaneous Immunofluorescence, Biopsy

Useful For

Confirming a diagnosis of bullous pemphigoid, cicatricial pemphigoid, variants of pemphigoid, all types of pemphigus, dermatitis herpetiformis, linear IgA bullous dermatosis, chronic bullous disease of childhood, epidermolysis bullosa acquisita, porphyria cutanea tarda, bullous eruption of lupus erythematosus, herpes gestationis, and atypical or mixed forms of bullous disease, systemic lupus erythematosus, discoid lupus erythematosus, or other variants, vasculitis, lichen planus, and other inflammatory diseases.

Testing Algorithm

See Celiac Disease Diagnostic Testing Algorithm in Special Instructions.

Method Name

Direct Immunofluorescence Staining of Cryostat-Prepared Skin Biopsy Sections for IgG, IgM, IgA, C3, and Fibrinogen Deposition

Reporting Name

Cutaneous Immunofluorescence, Bx

Specimen Type

Tissue

Forms: If not ordering electronically, submit a General Request Form (T239) with the specimen.

 

Biopsy site; whether biopsy was obtained from sun-exposed vs. unexposed skin; whether it is from perilesional, involved, or uninvolved skin; and date of collection are required.

 

Specimen Type: Tissue

Sources: Skin, oral mucosa, conjunctiva, or esophagus

 

Two or more biopsies from same site and sent in 1 specimen vial will be processed as 1 specimen. Two or more biopsies from different sites require separate orders and separate specimen vials.

 

Transport Medium Method

Container/Tube: Transport medium (Michels or Zeus media) (Supply T321)

Specimen Volume: 4 mm

Collection Instructions:

1. Collect punch biopsy of uninvolved or involved skin as per complete instructions in Collection and Transport in Cutaneous Immunofluorescence Testing in Special Instructions.

2. Skin or mucosal specimen can be sent.

3. Immediately drop specimen into provided vial of transport medium and seal tightly.

Specimen Stability Information: Ambient (preferred)/Refrigerated

Additional Information: The practical value of using transport medium is recognized for direct immunofluorescence testing.

 

Snap-Frozen Method

Container/Tube: Plastic vial

Specimen Volume: 4 mm

Collection Instructions:

1. Collect punch biopsy of uninvolved or involved skin as per complete instructions in Collection and Transport in Cutaneous Immunofluorescence Testing in Special Instructions.

2. Skin or mucosal specimen can be sent.

3. Immediately drop specimen into liquid nitrogen and allow to freeze thoroughly (do not allow specimen to desiccate). If liquid nitrogen is not available, specimen may be frozen by placing it on a small square of aluminum foil on a block of dry ice. Liquid nitrogen is preferred.

4. Immediately wrap specimen carefully in aluminum foil. At no time should the specimen be allowed to thaw. Wrap as you would a party favor or a piece of taffy candy.

5. Place the wrapped specimen into the pre-labeled plastic vial and seal tightly.

Specimen Stability Information: Frozen

Specimen Minimum Volume

NA

Specimen Stability Information

Specimen Type Temperature Time
Tissue Varies

Clinical Information

Skin or mucosal tissue from patients with autoimmune bullous diseases, connective tissue disease, vasculitis, lichen planus, and other inflammatory conditions often contains bound immunoglobulin, complement, and/or fibrinogen.

 

Biopsy specimens are examined for the presence of bound IgG, IgM, IgA, third component of complement (C3), and fibrinogen.

Reference Values

Report includes description and interpretation of staining patterns. See Results of IF Testing in Cutaneous Immunofluorescence Testing in Special Instructions.

Cautions

In most cases, diagnosis should be confirmed by correlating the results of immunofluorescence testing with clinical information and histologic studies.

 

Not useful for diagnosis of malignancies involving the skin.

Day(s) Performed

Monday through Friday; 7 a.m.-5 p.m.

Report Available

2 days (not reported on Saturday or Sunday)

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88346

88350x4

NY State Approved

N/A