Specialty Testing in Immunology

The Clinical Immunology Laboratory at the University of Washington is a CLIA-certified and CAP-accredited laboratory with more than 40 years of experience performing both routine and esoteric serologic testing. The laboratory is overseen by two board-certified clinical pathologists and two board-certified rheumatologists, who also provide clinical interpretation of test results. The laboratory is staffed by highly trained Medical Laboratory Scientists that are credentialed by the American Society for Clinical Pathology. The laboratory performs a wide range of assays to aid in the diagnosis, management, and monitoring of problems associated with immunological disorders.

Detection of Anti-Merkel Cell Polyomavirus Antibodies

We perform a multiplexed immunoassay that detects and quantifies Merkel cell polyomavirus small T (SmT) oncoprotein antibodies. SmT antibodies are present in the blood of 50% of patients when they have clinically detectable Merkel cell carcinoma (MCC). In patients who make oncoprotein antibodies, titers are expected to decrease significantly within 3 months of successful treatment of MCC. A significant rise in titer or stabilization above 2000 STU may be associated with persistent or recurrent MCC. Select the test below to learn more.

• Anti Merkel Cell Panel [AMERK]

Monoclonal Gammopathy Diagnosis and Monitoring

We offer serum and urine gel electrophoresis and immunofixation to detect, monitor, and quantitate monoclonal gammopathies. We also can perform an immunoshift assay to remove the interference from the therapeutic monoclonal antibody daratumumab when it comigrates with a patient’s monoclonal component. Additionally, we offer testing for serum free light chains, total IgA, total IgM, total IgG, and blood/serum/plasma viscosity. Select a test type below to learn more.

• Protein Electrophoresis Reflexive Panel [ELPP]
• Myeloma, Minimal Residual Protein Detection Panel [ELPMCP]
• Protein Electrophoresis Reflexive Panel, 24hr Urine [UELPP]
• Free Light Chains [FLC]
• Immunoglobulin G [IGG]
• Immunoglobulin A [IGA]
• Immunoglobulin M [IGM]
• Viscosity, Whole Blood [WBVSG]
• Viscosity, Plasma [PLVISG]
• Viscosity, Serum [SRVISG]

Autoimmune Testing

We perform a wide range of autoimmune testing, including immunofluorescence for antinuclear antibodies (ANA), immunofluorescence for anti-neutrophil cytoplasmic antibodies (ANCA), and multiplexed immunoassays to detect ANA- and ANCA-related autoantigens (anti chromatin, ribosomal P, Sm, Sm/RNP, RNP, SSA/Ro, SSB/La, Centromere B, Scl70, Jo1, PR3, MPO, and GBM). For samples that are ANA-positive (homogenous or homogenous/speckled) by immunofluorescence but negative or indeterminate for all specific ANA-related antibodies, follow-up testing can be performed to detect dense fine speckled 70 (DFS70) antibodies. Isolated DFS70 positivity is observed in ANA-positive healthy individuals but occurs in less than 1% of individuals with ANA-associated rheumatic disease. Select a test type below to learn more.

• ANA Differentiator Panel [ANADP]
• Anti Neutrophil Cytoplasm Panel [ANCAP]
• ANA Comprehensive ID Panel - outside clients [ANACID]

We also offer immunofluorescence testing for anti-endomysial, anti-mitochondrial, anti-parietal, anti-smooth muscle, and anti-liver/kidney microsome antibodies. Select a test type below to learn more.

• Anti Endomysial, IgA (by IFA) [AEMYA]
• Anti Mitochondrial Antibody [AMITO]
• Anti Parietal Cell Antibody [APCA]
• Anti Smooth Muscle Antibody [ASMA]
• Anti LKM Antibody [ALKMA]

We offer testing for anti-RNA Polymerase III antibodies (systemic sclerosis), antiphospholipid antibodies, Celiac-related antibodies, anti-CCP antibodies (rheumatoid arthritis), rheumatoid factor, and syphilis disease.

• Anti RNA Polymerase III [ARNAP3]
• Anti Phospholipid Panel [APLSP]
• Celiac Serology Reflex Panel [CELRP]
• Anti C. Citrullinated Peptide2 [ACCP2]
• Rheumatoid Factor [RF]
• Serologic Syphilis Screen [SYPHSC]

For patients in whom there is a concern for autoimmune myositis, we offer testing for a variety of myositis-related autoantibodies.

• Myositis Antibody Extended Screen Panel [MYOAB2]

For patients with systemic lupus erythematosus (SLE), we can perform serum testing to detect high avidity anti-double-stranded DNA (dsDNA) antibodies. The presence of anti-dsdNA antibodies is highly specific for SLE, and measurement of these antibody levels may provide valuable information for disease monitoring. Several investigators have found that high avidity antibodies are more specific for SLE and are associated with renal involvement and more active disease. Additionally, we offer serum and CSF testing to detect anti-neuronal cell antibodies. Anti-neuronal cell antibody levels may help in the diagnosis of neuropsychiatric SLE. Select a test type below to learn more.

• ANTI ds DNA [DNAEL]
• Anti Neuronal Cell Antibody [ANEUR]
• Anti Neuronal Cell Antibody, CSF [CANEUR]

Allergy Testing

In addition to offering tests for total IgE antibodies and tryptase, we perform a broad range of standalone and panel allergen testing. Select a test type below to learn more or search for specific allergen(s) of interest.

• Immunoglobulin E, Total [IGET]
• Tryptase [TRYPT]
• Please search the UW Laboratory Test Guide for "allergy" to find tests for specific allergens.