Test Catalog

Test Id : HRSPF

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Horse Dander, IgE with Reflex to Horse Dander Component, IgE, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients with suspected horse dander allergy

Highlights

The determination of the relative amount of IgE antibody to total horse dander, and IgE antibodies to specific horse dander component, can aid in assessment of the potential strength and type of allergenic response to horse dander.

 

IgE antibody to total horse dander extract will initially be tested.

 

If detectable total horse dander IgE antibody is present, additional specific horse dander allergen antibody testing will be performed. This is comprised of testing for IgE antibodies to the potential allergen Equ c 1.

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
HRSPR Horse Dander Component, IgE, S No No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Testing begins with analysis of total horse dander IgE. If horse dander total IgE is negative (<0.10 kU/L), testing is complete.

 

If horse dander total IgE is 0.10 kU/L or more, then horse dander component (Equ c 1) testing is performed at an additional charge.

Method Name
A short description of the method used to perform the test

Fluorescent Enzyme Immunoassay (FEIA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Horse Dander Component Reflex, S

Aliases
Lists additional common names for a test, as an aid in searching

Component testing

Horse dander component

Equ c 1

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Testing begins with analysis of total horse dander IgE. If horse dander total IgE is negative (<0.10 kU/L), testing is complete.

 

If horse dander total IgE is 0.10 kU/L or more, then horse dander component (Equ c 1) testing is performed at an additional charge.

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.6 mL

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

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 90 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients with suspected horse dander allergy

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Testing begins with analysis of total horse dander IgE. If horse dander total IgE is negative (<0.10 kU/L), testing is complete.

 

If horse dander total IgE is 0.10 kU/L or more, then horse dander component (Equ c 1) testing is performed at an additional charge.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Horse (equine) allergen sensitization occurs in approximately 5 to 15% of individuals exposed to horses in occupational settings. The assessment of allergy to horses is dependent upon the presence of compatible clinical symptoms in the context of exposure, with support from identification of potential equine-specific IgE allergen antibodies, either by skin testing or in vitro serology testing. In vitro testing has generally focused on assessing for the presence of IgE antibodies to total horse allergen extracts.

 

There is a correlation between total horse IgE allergen antibodies and an increased likelihood of a clinical allergic response. Once an elevated antibody response to total horse dander IgE extract is established, assessment for the presence of specific IgE antibodies to the major equine component will be performed. This may yield additional, potentially useful information for the clinical assessment of allergy and sensitization. During horse component allergen IgE antibody testing, the presence of IgE antibodies specific for the potential allergenic individual protein, namely Equ c 1, is assessed. The determination of the relative amount of IgE antibody to specific component can aid in assessment of the potential strength and type of allergenic response.

 

While several horse allergens have been described, the lipocalin Equ c 1 is the major horse allergen, and antibodies to this allergen are present in 76% of individuals exhibiting allergy to horses. The main source of exposure of Equ c 1 is inhalation. However, individuals can be exposed by contact with contaminated clothing and, potentially, through horse bites. Mattresses containing horsehair may also be a potential route of exposure. Individuals who are allergic to horses may exhibit allergic rhinitis, conjunctivitis, asthma, anaphylaxis, and allergy to other foods and animals.(1) To date, the existence of completely hypoallergenic horse breeds has not been verified.

 

Sensitization to horses may also occur through cross-reactivity, with as many as 30% of individuals with pet allergy also reporting allergic reaction to horses. As many as 50% of individuals with cross-reactive allergen sensitization are caused by cross reactive to horse lipocalin as represented by Equ c 1. Cross-reactivity has been shown to exist between horse lipocalin allergen Equ c 1, cat lipocalin allergen Fel d4, and dog lipocalin allergen Can f 6.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Class

IgE kU/L

Interpretation

0

<0.10

Negative

0/1

0.10-0.34

Borderline/equivocal

1

0.35-0.69

Equivocal

2

0.70-3.49

Positive

3

3.50-17.4

Positive

4

17.5-49.9

Strongly positive

5

50.0-99.9

Strongly positive

6

> or =100

Strongly positive

Concentrations of 0.70 kU/L or more (class 2 and above) will flag as abnormally high.

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

When detectable total horse dander IgE antibody is present (> or =0.10 IgE kUa/L), additional specific component IgE antibody testing will be performed. If the specific allergenic horse dander component IgE is detectable (> or =0.10 IgE kUa/L), an interpretative report will be provided.

 

When the sample is negative for total horse dander IgE antibody (<0.10 IgE kUa/L), additional testing for specific horse dander component IgE antibodies will not be performed. Negative IgE results for total horse dander antibody may indicate a lack of sensitization to potential horse dander allergenic components.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Clinical correlation of results from in vitro IgE testing with a patient history of allergic or anaphylactic responses to horse dander is recommended.

-Negative results for IgE to total horse dander and any horse dander components do not completely exclude the possibility of clinically relevant allergic responses upon exposure to horse dander.

-Positive results for IgE to total horse dander or any potential horse dander allergenic components are not diagnostic for horse dander allergy and only indicate that the patient may be sensitized to horse dander or a cross-reactive allergen.

 

Testing for IgE antibodies may not be useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists or in patients whose medical management does not depend upon identification of allergen specificity. 

 

False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Arseneau AM, Hrabak TM, Waibel KH. Inhalant horse allergens and allergies: a review of the literature. Mil Med. 2012;177(7):877-882

2.Salo PM, Arbes SJ Jr, Jaramillo R, et al: Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134(2):350-359. doi:10.1016/j.jaci.2013.12.1071

3.Guida G, Nebiolo F, Heffler E, Bergia R, Rolla G: Anaphylaxis after a horse bite. Allergy. 2005;60(8):1088-1089

4.Saarelainen S, Rytkonen-Nissinen M, Rouvinen J, et al: Animal-derived lipocalin allergens exhibit immunoglobulin E cross-reactivity. Clin Exp Allergy. 2008 Feb;38(2):374-381

5.Chan SK, Leung DYM: Dog and cat allergies: Current state of diagnostic approaches and challenges. Allergy Asthma Immunol Res. 2018 Mar;10(2):97-105. doi: 10.4168/aair.2018.10.2.97

6.Chruszcz M, Mikolajczak K, Mank N, Majorek KA, Porebski PJ, Minor W: Serum albumins-unusual allergens. Biochim Biophys Acta. 2013;1830(12):5375-81

7.Nwaru BI, Suzuki S, Ekerljung L, et al: Furry animal allergen component sensitization and clinical outcomes in adult asthma and rhinitis. J Allergy Clin Immunol Pract..2019 Apr;7(4):1230-1238.e4

8.Hilger C, van Hage M, Kuehn A: Diagnosis of allergy to mammals and fish: Cross-reactive vs. specific markers. Curr Allergy Asthma Rep. 2017 Aug 22;17(9):64

Method Description
Describes how the test is performed and provides a method-specific reference

Specific IgE from the patient's serum reacts with the allergen of interest, covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia AB; Rev 06/2020)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86003

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
HRSPF Horse Dander Component Reflex, S 6143-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
HORS1 Horse Dander, IgE, S 6143-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports