Research Biomarker Category Quest Diagnostics

Quest Diagnostics

21-Hydroxylase Antibodies

Optimal range: 0 - 0 %

This result is a qualitative determination of autoantibodies to 21-Hydroxylase (21-OH Abs) in patient serum. 21-OH Abs occur in autoimmune Addison's disease, whether isolated or part of type I or type II autoimmune polyglandular syndrome. This result should be used in conjunction with other clinical and laboratory findings and is not a substitute for functional testing required to diagnose adrenal insufficiency.

Acetylcholine Receptor Ganglionic (Alpha 3) AB

Optimal range: 0 - 53 pmol/L

Acetylcholine receptor (AChR) antibodies are autoantibodies produced by the immune system that mistakenly target proteins called acetylcholine receptors that are located on muscles that you can consciously or voluntarily control (known as skeletal muscle fibers). This test detects and measures AChR antibodies in the blood.

Ana Pattern

Optimal range: 0 - 0 %

Usually, the results of the ANA test are reported in titers and patterns. The titer gives information about how many times the lab technician diluted the blood plasma to get a sample of ANAs.

The pattern of the ANA test can give information about the type of autoimmune disease present and the appropriate treatment program

B2 GLYCOPROTEIN I (IGA)AB

Optimal range: 0 - 20 SAU

Beta-2 glycoprotein 1 antibody is an autoantibody that is associated with inappropriate blood clotting. This test detects and measures one class (IgA) of beta-2 glycoprotein 1 antibodies.

B2 GLYCOPROTEIN I (IGG)AB

Optimal range: 0 - 20 SGU

The antiphospholipid antibody syndrome (APS) is a clinical-pathologic correlation that includes a clinical event (e.g. thrombosis, pregnancy loss, thrombocytopenia) and persistent positive antiphospholipid antibodies (IgM or IgG ACA >40 MPL/GPL,IgM or IgG anti-b2GPI antibodies or a lupus anticoagulant).

B2 GLYCOPROTEIN I (IGM)AB

Optimal range: 0 - 20 SMU

The assay contributes to the diagnosis of antiphospholipid syndrome (APS). The clinical symptoms of APS alone are not sufficiently specific to make a definitive diagnosis. Laboratory tests thus play an important role in the diagnosis of the disease. In patients with APS, autoantibodies are formed that bind to phospholipids like cardiolipin or to phospholipid-binding proteins like beta-2-glycoprotein.

Detection of these autoantibodies is an integral part of the classification criteria issued by the International Society on Thrombosis and Hemostasis.

Beta-2-glycoprotein I is a 50 KD protein cofactor required by anti-cardiolipin antibodies (ACA) to bind to cardiolipin and other phospholipid molecules.

Beta 2 Transferrin

Optimal range: 0 - 0 %

The diagnosis of cerebrospinal fluid (CSF) rhinorrhea or otorrhea (leakage of CSF into the nose or ear canal, usually as a result of head trauma, tumor, congenital malformation, or surgery) is often difficult to confirm. Traditional chemical analyses (eg, glucose, protein, specific gravity) are unreliable. Radiographic studies, especially those involving the injection of dyes or radiographic compounds, are costly and may introduce additional risks to the patient.

CARNITINE ESTERS

Optimal range: 4 - 13 umol/L

Carnitine, Free

Optimal range: 19 - 48 umol/L

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient.

Carnitine, Total

Optimal range: 25 - 58 umol/L

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient.

CHROMOGRANIN A

Optimal range: 25 - 140 ng/mL

The Chromogranin A test may be used to help detect, diagnose, and/or monitor neuroendocrine tumors, especially carcinoid tumors.

COPEPTIN

Optimal range: 0 - 14 pmol/L

Cortisol, Free, Urine

Optimal range: 3.1 - 42.3 mcg/L

Cortisol is a steroid hormone synthesized from cholesterol by a multienzyme cascade in the adrenal glands. It is the main glucocorticoid in humans and acts as a gene transcription factor influencing a multitude of cellular responses in virtually all tissues. Cortisol plays a critical role in glucose metabolism, maintenance of vascular tone, immune response regulation, and in the body's response to stress. Its production is under hypothalamic-pituitary feedback control

CORTISOL,FREE,LC/MS,S

Optimal range: 0.04 - 0.93 mcg/dL

Cortisol, the main glucocorticoid (representing 75%-95% of the plasma corticoids), plays a critical role in glucose metabolism and in the body's response to stress.

The majority of cortisol circulates bound to corticosteroid-binding globulin (CBG) and albumin. Normally, less than 5% of circulating cortisol is free (unbound). Only free cortisol can access the enzyme transporters in liver, kidney, and other tissues that mediate metabolic and excretory clearance.

Both hypercortisolism (Cushing disease) and hypocortisolism (Addison disease) can cause disease.

ESTERIFIED/FREE RATIO

Optimal range: 0.13 - 0.42 Ratio

Carnitine, an amino acid synthesized in animal tissues from lysine and methionine by an iron-ascorbate dependent pathway, functions as a carrier of fatty acids across cell membranes.

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary).

Primary systemic carnitine deficiency (CDSP), also known as carnitine uptake defect (CUD) is an autosomal recessive disorder that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter.

The incidence of CDSP is approximately 1 in 50,000. The clinical presentation and age of onset of CDSP can vary, but typical findings include hypoketotic hypoglycemia, hepatomegaly, cardiomyopathy, skeletal myopathy, and weakness.

If diagnosed early, treatment with carnitine can reverse many of the clinical symptoms.

Secondary carnitine deficiency occurs in some disease states, in patients on carnitine-poor diets, or secondary to medications including valproic acid. It is also found in a number of metabolic disorders affecting fatty acid and organic acid metabolism. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitines are excreted in the urine, leading to a depletion of carnitine in the patient.

ESTRADIOL (Quest)

Optimal range: 0 - 357 pg/mL

GLUCOSE-6-PHOSPHATE DEHYDROGENASE

Optimal range: 7 - 20.5 U/g Hgb

GLUCOSE-6-PHOSPHATE DEHYDROGENASE helps red blood cells (RBCs) function normally. It also protects them from potentially harmful byproducts that can accumulate when your body is fighting infection or as the result of certain medications. A lack of GLUCOSE-6-PHOSPHATE DEHYDROGENASE may make RBCs more vulnerable to breaking down in a process called hemolysis.

Glutamic Acid Decarboxylase 65 AB

Optimal range: 0 - 5 IU/ml

This test is intended for the semiquantitative determination of glutamic acid decarboxylase (GAD) antibody in human serum; it is useful as an aid in the diagnosis of type 1 diabetes mellitus (autoimmune mediated diabetes).

HISTAMINE RELEASE (CHRONIC URTICARIA)

Optimal range: 0 - 16 %

Chronic Urticaria (CU) is a common skin disorder affecting 1 to 6% of the general population.

HISTAMINE, PLASMA

Optimal range: 0 - 1.8 ng/mL

Useful for evaluating for diseases of immediate hypersensitivity or mast cell proliferation (mastocytosis).

IGF 1, LC/MS

Optimal range: 52 - 328 ng/mL

IMMUNOGLOBULIN M

Optimal range: 50 - 300 mg/dL

Immunoglobulin M (IgM), which is found mainly in the blood and lymph fluid, is the first antibody to be made by the body to fight a new infection. Expressed on the surface of B cells (monomer) and in a secreted form (pentamer) with very high avidity (forms multiple binding sites with antigen). Eliminates pathogens in the early stages of B-cell mediated (humoral) immunity before there is sufficient IgG.

Immunoglobulin Subclass 4

Optimal range: 4 - 86 mg/dL

IgG immunoglobulins are composed of four subtypes named IgG1, IgG2, IgG3 and IgG4. Each subclass is present in the serum in different concentrations, varies with age, and has different roles for immune response. Abnormal levels of one or more subclasses may be associated with certain conditions.

This marker helps to evaluate sinopulmonary infections, asthma; immunotherapy hyposensitization; and allergies.

LH

Optimal range: 0.5 - 76.3 mIU/ml

Lithium

Optimal range: 0.6 - 1.2 mmol/L

This test measures the amount of lithium in the blood.

Lithium is used to treat manic-depressive disorders and the manic phase of affective disorders, including mania. The therapeutic window is relatively small. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity.

Lithium is a naturally occurring element that is also one of the principal drugs used as a mood stabilizer and antipsychotic in people suffering from bipolar mood disorder. While this drug is very effective in treating this condition, it has a very narrow therapeutic range, which means that the level of lithium in the blood needs to be controlled in a range which is effective. Too much lithium can results in lithium toxicity, and too little lithium is be subtherapeutic.

LKM-1 Antibody (IgG)

Optimal range: 0 - 20 u

Liver Kidney Microsomal (LKM-1) Antibody (IgG)

The presence of LKM-1 antibodies can be used in conjunction with clinical findings and other laboratory tests to aid in the diagnosis of autoimmune liver diseases such as autoimmune hepatitis (AIH-2).

LUPUS ANTICOAGULANT

Optimal range: 0 - 0.01 Units

Neuron Specific Enolase (NSE)

Optimal range: 0 - 10.8 ng/mL

Neuron-specific enolase (NSE) is an enzyme that is found in the cytoplasm of neurons and neuroendocrine cells. The production of NSE occurs late in neural differentiation, thus making NSE an index of neural maturation.

NT PROBNP

Optimal range: 0 - 253 pg/mL

NT-proBNP is a diagnostic screening tool to differentiate between people with normal and reduced left ventricular systolic function.

Parathyroid Hormone, intact

Optimal range: 16 - 77 pg/mL

Interpretive Guide	Intact PTH	Calcium
Normal Parathyroid	Normal	Normal
Hypoparathyroidism	Low or Low Normal	Low
Hyperparathyroidism Primary Secondary Tertiary	Normal/ High High High	High Normal/ Low High
Non-Parathyroid Hypercalcemia	Low/ Low Normal	High

PARTIAL THROMBOPLASTIN TIME, ACTIVATED

Optimal range: 22 - 34 seconds

PREGNENOLONE, LC/MS

Optimal range: 22 - 237 ng/dL

Pregnenolone is a chemical substance that is a precursor to all steroid hormones.

PROGESTERONE, LC/MS

Optimal range: 0 - 0.3 ng/mL

PROSTAGLANDIN D2 (PG D2), URINE

Optimal range: 0 - 0 ng/liter

Prostaglandin E2, Serum/Plasma

Optimal range: 200 - 400 pg/mL

Prostaglandins are lipid autacoids derived from arachidonic acid. They both sustain homeostatic functions and mediate pathogenic mechanisms, including the inflammatory response.

PROSTAGLANDINS (PG D2), SERUM/PLASMA

Optimal range: 35 - 115 pg/mL

PROSTAGLANDINS: (PLASMA/SERUM)

Optimal range: 80 - 240 pg/mL

PROTHROMBIN ANTIBODY (IGG)

Optimal range: 0 - 20 G units

Soluble Liver Antigen (SLA) Autoantibody

Optimal range: 0 - 20.1 u

Anti-soluble liver antigen antibodies are detected in 10% - 30% of patients with type 1 autoimmune hepatitis (AIH), but not in patients with type 2 AIH, primary sclerosing cholangitis or primary biliary cirrhosis.

T3 REVERSE, LC/MS/MS

Optimal range: 8 - 25 ng/dL

T3, FREE

Optimal range: 2.3 - 4.2 pg/mL

TESTOSTERONE,BIOAVAILABLE

Optimal range: 0.5 - 8.5 ng/dL

Total Glutathione

Optimal range: 373 - 838 uM

Glutathione is an antioxidant, a type of chemical which helps to boost your immune system as well as prevent and reverse cellular damage. Unlike most antioxidants which come from the food you eat, glutathione is naturally produced by the body in the liver. Glutathione plays a number of roles in overall health including boosting the immune system, helping to break down nutrients in food, and protecting against chronic diseases such as Alzheimer's, Parkinsons, diabetes, some types of cancer, and heart disease.

TRYPTASE

Optimal range: 0 - 10.99 mcg/L

Tryptase is an enzyme that is released, along with histamine and other chemicals, from mast cells when they are activated as part of a normal immune response as well as in allergic (hypersensitivity) responses.

TSI - Thyroid-Stimulating Immunoglobulin, Serum

Optimal range: 0 - 140 %

TSI stands for thyroid stimulating immunoglobulin. TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts of thyroid hormone into the blood. A TSI test measures the amount of thyroid stimulating immunoglobulin in your blood.

Z SCORE (FEMALE)

Optimal range: -2 - 2 SD

A Z-score compares your bone density to the average bone density of people your own age and gender.

For example, if you are a 50-year-old female, a Z-score compares your bone density to the average bone density of 50-year-old females.

Z SCORE (MALE)

Optimal range: -2 - 2 SD

A Z-score compares your bone density to the average bone density of people your own age and gender.

For example, if you are a 50-year-old female, a Z-score compares your bone density to the average bone density of 50-year-old females.