useful for
Suggests tests for potentially useful clinical conditions or settings
useful for
Suggests tests for potentially useful clinical conditions or settings
Clarification of CD19 deficiency in patients with suspected CD19 deficiency (humoral immune deficiency)
Confirmation of the complete absence of B cells in presumptive primary humoral immunodeficiency using CD19 and CD20 markers
Quantitative assessment of therapeutic B-cell depletion (absolute number of cells/mcL) in each clinical setting, including malignancies, autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and membranous glomerulonephritis, and treatment or prevention of acute humoral rejection in cross-matched kidney transplant recipients
this test isnot availableAssess the B-cell response as part of the initiation of anti-CD20 monoclonal antibody therapy (rituximab, ofatumumab, and tositumomab) for any hematological malignancy or other clinical condition (e.g., autoimmunity). Whether the target molecule (CD20) should be expressed.
Methodenname
A brief description of the method used to conduct the test
Methodenname
A brief description of the method used to conduct the test
flowCell numbers
Available in New York State
Displays the status of New York State approval and whether tests can be ordered for New York State customers.
Available in New York State
Displays the status of New York State approval and whether tests can be ordered for New York State customers.
And
report name
Displays a shorter or abbreviated version of the test's published name
report name
Displays a shorter or abbreviated version of the test's published name
CD20, B cells
sample type
Describe validated test sample types
sample type
Describe validated test sample types
whole blood EDTA
Ordering information
This is the right test if the suspicion of a primary humoral or combined immunodeficiency, which leads to the loss of B cells, needs to be specifically confirmed or if a CD19 deficiency is to be assessed.
If you only want to quantify total CD19 or CD20+ B cells, please order TBBS/Quantitative Lymphocyte Subgroups: T, B and Natural Killer (NK) Cells, Blood or B Cells, CD20B/CD20 on Blood separately .avoidFor this purpose, order a detailed analysis of the B-cell subsets.
this testshould notArrangement for comprehensive assessment of peripheral B cell subsets. For assessment of memory B cell subsets, transitional B cells, mature and immature B cells, order IABCS/B Cell Phenotyping for Immunodeficiency and Competence Assessment, Blood.
this testshould notUsed to assess the presence of CD20 on malignant or non-malignant B cells. Instead, the following test should be used, the assessment of CEE20/CD20 cell expression, which varies from person to person.
Shipping Instructions
The samples are collected and packed as close as possible to the time of delivery.It is recommended that samples arrive within 24 hours of collection.
Information Requested (Provided).
Pickup date is required.
need samples
Define the optimal sample required to perform the test and the preferred volume to complete the test
need samples
Define the optimal sample required to perform the test and the preferred volume to complete the test
Container/Tube:Lavendeloberteil (EDTA)
sample size: 3 ml
Pickup notice:Send the whole blood sample in the original tube.Don't split evenly.
More information:
1. Secondary aliquots are discarded.
2.The test is cancelledIf the surrounding area has not received the sample.
3.For continuous monitoring, it is recommended that samples be collected at the same time each day.
sample volume
Define the sample volume required by the testing laboratory to provide clinically relevant results. The minimum quantity is sufficient for a test.
sample volume
Define the sample volume required by the testing laboratory to provide clinically relevant results. The minimum quantity is sufficient for a test.
1 ml
rejected because of
Identify sample types and conditions that may result in sample rejection
rejected because of
Identify sample types and conditions that may result in sample rejection
| severe hemolysis | refuse |
| total lipidemia | refuse |
| secondary aliquot tube | refuse |
Information on sample stability
Provide a description of the temperature required to transport the sample to the performing laboratory and also provide alternative acceptable temperatures
Information on sample stability
Provide a description of the temperature required to transport the sample to the performing laboratory and also provide alternative acceptable temperatures
| sample type | Temperature | Time | special container |
|---|---|---|---|
| whole blood EDTA | Vicinity | 4 Roofs | Small or pink top/EDTA |
useful for
Suggests tests for potentially useful clinical conditions or settings
useful for
Suggests tests for potentially useful clinical conditions or settings
Clarification of CD19 deficiency in patients with suspected CD19 deficiency (humoral immune deficiency)
Confirmation of the complete absence of B cells in presumptive primary humoral immunodeficiency using CD19 and CD20 markers
Quantitative assessment of therapeutic B-cell depletion (absolute number of cells/mcL) in each clinical setting, including malignancies, autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and membranous glomerulonephritis, and treatment or prevention of acute humoral rejection in cross-matched kidney transplant recipients
this test isnot availableAssess the B-cell response as part of the initiation of anti-CD20 monoclonal antibody therapy (rituximab, ofatumumab, and tositumomab) for any hematological malignancy or other clinical condition (e.g., autoimmunity). Whether the target molecule (CD20) should be expressed.
clinical information
Discuss physiological, pathophysiological and general clinical aspects related to laboratory testing
clinical information
Discuss physiological, pathophysiological and general clinical aspects related to laboratory testing
CD20 (Cluster of differentiation 20) is a protein expressed on the surface of B cells, beginning in the pre-B cell stage, on mature B cells in the bone marrow and in the periphery. CD20 is not expressed on hematopoietic stem cells, primary B cells, or normal plasma cells. (1) Plasmablasts and stimulated plasma cells can express CD20. (2) CD20 is normally expressed on B cells and CD19 is another B cell differentiation marker. CD20 appears to play a role in B cell development, differentiation, B cell receptor (BCR) signaling and cell cycle initiation. (3) CD20 is not shed from the surface of B cells and is not internalized upon binding to anti-CD20. (3) Certain primary humoral immunodeficiencies such as X-linked agammaglobulinemia and autosomal recessive agammaglobulinemia, characterized by the complete absence or large reduction in peripheral immunodeficiency B cells expressing CD20 and CD19 (another marker of B cell differentiation).
variantCD19The gene has been shown to be involved in primary humoral immunodeficiency, sometimes classified as common variant immunodeficiency (CVID). (4) This defect occurs in less than 1% to 2% of patients with CVID and appears to be inherited in an autosomal recessive manner. (4) Since these patients have a normal number of B cells, CD19 is not expressed on the cell surface (4), so CD20 can be used as a marker to identify these patients. Hereditary CD20 deficiency (autosomal recessive inheritance) is also associated with primary humoral immunodeficiency. In this disease, B cells can be identified by CD19 expression. (5)
The opposite is true in patients receiving rituximab, ofatumumab, and other anti-CD20 monoclonal antibodies to treat certain cancers, autoimmune diseases, or for B-cell depletion to prevent humoral rejection in positive crossmatch kidney transplants. These reagents block available CD20 binding sites such that the antibodies used in this flow cytometry assay do not recognize the CD20 molecule on B cells. The simultaneous use of the CD19 marker can provide information about the extent of B cell depletion when using this specific therapy strategy.
It is known that the absolute number of lymphocyte subsets is influenced by many biological factors including hormones, environment and temperature. Studies of the diurnal variation in lymphocyte counts showed that CD4 T cell counts gradually increased throughout the day, while CD8 T cell and CD19+ B cell counts increased throughout the day. 8:30 a.m. and 12:00 p.m., no change in 12:00 p.m. and 12:00 p.m. On the other hand, the number of natural killer cells remained constant throughout the day. (6) Circadian changes in circulating T-cell numbers have been shown to be inversely correlated with plasma cortisol concentrations. (7-9) In fact, cortisol and catecholamine levels control the distribution and hence the number of naïve and effector CD4 and CD8 T cells. (7) It is generally accepted that CD4 T-cell counts are lower in the morning than in the evening (10) and lower than in the evening in summer. (11) These data therefore suggest that timing and consistency of blood collection are critical in serial monitoring of lymphocyte subsets in patients.
Reference
Additional information describing the reference range and interpreting the test results. Where appropriate, age and gender based ranges may be included. Unless otherwise noted, intervals are from Mayo. If an explanatory report is available, this is displayed in the reference value field.
Reference
Additional information describing the reference range and interpreting the test results. Where appropriate, age and gender based ranges may be included. Unless otherwise noted, intervals are from Mayo. If an explanatory report is available, this is displayed in the reference value field.
%CD19 B cells
> or =19 years old: 4.6-22.1%
CD19 absolut
> or =19 years: 56.6-417.4 cells/mcL
%CD20 B cells
> or =19 years old: 5.0-22.3%
CD20 Absolutely
> or =19 years old:74.4-441.1 cells/mcL
CD45 absolutely
18-55 years old: 0.99-3.15 thou/mcL
> 55 years: 1.00–3.33 thousand thousand milliliters
explain
Provides information to help interpret test results
explain
Provides information to help interpret test results
In individuals who are not receiving anti-CD20 monoclonal antibody therapy or who have variable clinical features of primary humoral immunodeficiency, the presence of CD20+ B cells with a corresponding lack of CD19 staining can and should indicate underlying CD19 deficiency to be further investigated.
The absence of CD20 and CD19 markers on B cells in the blood of individuals not treated with anti-CD20 monoclonal antibodies is consistent with the depletion of both mature and immature peripheral B cells, suggesting an underlying underlying primary immunodeficiency.
Patients who have undergone anti-CD20 antibodies to deplete B cells may develop abnormal B cell populations expressing CD19 or CD20 after reconstitution due to a phenomenon known as trogocytosis.
Precautions
Discuss situations that can cause diagnostic confusion, including improper specimen collection and handling, poor test selection, and interfering substances
Precautions
Discuss situations that can cause diagnostic confusion, including improper specimen collection and handling, poor test selection, and interfering substances
When serially monitoring a patient's lymphocyte subsets, the timing and consistency of blood collection is critical. View clinical information.
clinical reference
Extensive reading for advice of a clinical nature
clinical reference
Extensive reading for advice of a clinical nature
1. Nadler LM, Ritz J, Hardy R, et al: A unique cell surface antigen recognizes lymphoid malignancies of B-cell origin. J Clinical investing. 1981;67:134
2. Robillard N, Avet-Loiseau H, Garand R, et al: CD20 is associated with small mature plasma cell morphology and t(11;14) in multiple myeloma. Blood. 2003;102(3):1070-1071
3. Pescovitz MD: Rituximab, an anti-CD20 monoclonal antibody: history and mechanism of action. Bin J Transplant. 2006;6:859-866
4. van Zelm MC, Reisli I, van der Burg M, et al: Antibody deficiency syndrome due to mutations in the CD19 gene. N England Medical Journal. 2006;354:1901-1912
5. Kuijpers TW, Bende RJ, Baars PA, et al. CD20 deficiency in humans leads to impaired T-cell dependent antibody responses. J Clinical investing. 2010 Jan;120(1):214-222. Number: 10.1172/JCI40231
6. Carmichael KF, Abayomi A: Analysis of circadian changes in lymphocyte subsets in healthy subjects and their implications for HIV surveillance and treatment. 15th International AIDS Conference, Bangkok, Thailand, 2004, Abstract B11052
7. Dimitrov S, Benedict C, Heutling D, et al: Cortisol and adrenaline control opposing circadian rhythms in T cell subsets. Blood. year 200921. Major;113(21):5134-5143
8. Dimitrov S, Lange T, Nohroudi K, Born J: Sleep regulation of the number and function of circulating antigen-presenting cells. sleep. 2007;30:401-411
9. Kronfol Z, Nair M, Zhang Q, et al.: Circadian immune response in healthy subjects: relationship to hypothalamic-pituitary-adrenal axis hormones and sympathetic neurotransmitters.psychological medicine.1997;59:42-50
10. Malone JL, Simms TE, Gray GC, et al: Sources of variation in repeated T helper lymphocyte counts in HIV-1 infected patients: Variations in total lymphocyte counts and circadian cycles are important. J AIDS. 1990; 3:144-151
11. Paglieroni TG, PV Netherlands: Circular variation in lymphocyte subsets, reexamined. blood transfusion. 1994;34:512-516
12. Angel ER, Walter JE. Rituximab and eculizumab in nonmalignant hematological diseases: risk of infection, vaccination recommendations and the need for antimicrobial prophylaxis. Hematology at the Soc Hematol Educ Program. December 4, 2020; 2020(1): 312-318. doi:10.1182/hematology.2020000171
method description
Describes how the test is performed and provides references to specific methods
method description
Describes how the test is performed and provides references to specific methods
The test is performed using flow cytometry and is a single tube whole blood test that contains antibodies to CD45, CD19 and CD20. After staining with specific antibodies, erythrocytes were lysed and samples analyzed by flow cytometry on a Becton Dickinson (BD) Canto flow cytometer with fluorescence-activated cell sorting (FACS). Absolute counts were determined using tubes from BD Trucount (BD BioSciences). Percentage and absolute numbers of CD19 and CD20+ B cells are given. The absolute CD45 values are given. (unpublished mayo method)
PDF reporter
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PDF reporter
Indicates whether the report contains additional documents with charts, images, or other rich information
NO
days to complete
Enter the date the test was performed. This field indicates the date the sample must arrive at the testing laboratory to begin the testing process and includes any sample preparation and processing time prior to testing. Some tests are listed as being performed sequentially, meaning the analysis is performed multiple times a day.
days to complete
Enter the date the test was performed. This field indicates the date the sample must arrive at the testing laboratory to begin the testing process and includes any sample preparation and processing time prior to testing. Some tests are listed as being performed sequentially, meaning the analysis is performed multiple times a day.
Monday to Sunday
Results Monday through Friday
Report back
Time intervals (when samples are received from the Mayo Clinic laboratory for actionable results) include default setting days and weekends. It usually takes the first day to get results. The last day is the time available and reserved for any retesting that may be required.
Report back
Time intervals (when samples are received from the Mayo Clinic laboratory for actionable results) include default setting days and weekends. It usually takes the first day to get results. The last day is the time available and reserved for any retesting that may be required.
Today/1 to 2 days
storage time of the sample
Describes the length of time samples are retained in the laboratory after testing before being discarded
storage time of the sample
Describes the length of time samples are retained in the laboratory after testing before being discarded
4 Roofs
Implementation of the laboratory mediation
Indicates the location of the laboratory where the test was performed
Implementation of the laboratory mediation
Indicates the location of the laboratory where the test was performed
Rochester
cost
Several factors determine how much you will be charged for the test. Please contact your US or international regional manager for information on establishing a fee schedule or for resources to optimize your test selection.
cost
Several factors determine how much you will be charged for the test. Please contact your US or international regional manager for information on establishing a fee schedule or for resources to optimize your test selection.
- Authorized users can log inTest prizeGet detailed fee information.
- Customers who can't get a trial price, please feel free to contact usCustomer service24 hours a day, 7 days a week.
- Prospective customers should contact their account manager. For assistance please contactCustomer service。
test classification
Provides information on medical device classification for laboratory test kits and reagents. Tests may be classified as Food and Drug Administration (FDA) approved or approved and used according to the manufacturer's directions, or as a product that has not been fully reviewed and approved by the FDA and then labeled as an Analyte Specific Reagent (ASR). ) product.
test classification
Provides information on medical device classification for laboratory test kits and reagents. Tests may be classified as Food and Drug Administration (FDA) approved or approved and used according to the manufacturer's directions, or as a product that has not been fully reviewed and approved by the FDA and then labeled as an Analyte Specific Reagent (ASR). ) product.
The test was developed using analyte-specific reagents. Its performance characteristics have been evaluated by the Mayo Clinic in a CLIA-compliant manner. This test has not been recognized or approved by the US Food and Drug Administration.
CPT code information
Provides guidance for determining the appropriate current procedure terminology (CPT) code information for each test or profile. The CPT Codes listed reflect Mayo Clinic Laboratories' interpretation of the CPT Code requirements. It is each laboratory's responsibility to determine the correct CPT code for billing purposes.
CPT codes are provided by Executive Labs.
CPT code information
Provides guidance for determining the appropriate current procedure terminology (CPT) code information for each test or profile. The CPT Codes listed reflect Mayo Clinic Laboratories' interpretation of the CPT Code requirements. It is each laboratory's responsibility to determine the correct CPT code for billing purposes.
CPT codes are provided by Executive Labs.
86355
86356
LOINC® information
Provides hints about the Logical Observation Identifier Name and Code (LOINC) value, which determines the sequence and result code for this test. LOINC values are provided by the performing laboratory.
LOINC® information
Provides hints about the Logical Observation Identifier Name and Code (LOINC) value, which determines the sequence and result code for this test. LOINC values are provided by the performing laboratory.
| Test-ID | Test order name | Order the LOINC value |
|---|---|---|
| CD20B | CD20, B cells | 100994-3 |
| result number | Test result name | Result LOINC value Applies only to results expressed in units of measurement originally reported by the performing laboratory. These values do not apply to results converted to other units of measurement. |
|---|---|---|
| 29579 | %CD19 B cells | 8117-4 |
| 29581 | CD19 absolut | 8116-6 |
| 29580 | %CD20 B cells | 8119-0 |
| 29582 | CD20 Absolutely | 9558-8 |
| 89584 | CD45 absolutely | 27071-0 |
| 29583 | Comment | 48767-8 |