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Epic Code LAB8000 Parvovirus B19 Antibodies, IgG and IgM, Serum

Additional Codes

Mayo Code: PARVS

Reporting Name

Parvovirus B19 Ab, IgG and IgM, S

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Clinical Information

Parvovirus B19 is the causative agent of fifth disease (ie, erythema infectiosum, slapped cheek syndrome), which usually produces a mild illness characterized by an intensive erythematous maculopapular facial rash. Most outbreaks of parvovirus infection are acquired by direct contact with respiratory secretions and primarily occur in the spring. Close contact between individuals is responsible for infection in schools, day care centers, and hospitals. The virus has also been associated with fetal damage (hydrops fetalis), aplastic crisis, and arthralgia. Infection during pregnancy presents the risk of transmission to the fetus that may cause intrauterine death. The rate of fetal death following maternal infection ranges between 1% and 9%.

 

Parvovirus B19 preferentially replicates in erythroid progenitor cells.(1) Infection with parvovirus B19 occurs early in life, and the virus is transmitted by respiratory secretion and occasionally by blood products. The prevalence of parvovirus B19 IgG antibodies increases with age. The age-specific prevalence of antibodies to parvovirus is 2% to 9% of children under 5 years, 15% to 35% in children 5 to 18 years of age, and 30% to 60% in adults (19 years or older).

 

Most acute infections with parvovirus B19 are diagnosed in the laboratory by serologically detecting IgG and IgM class antibodies to the virus using an enzyme-linked immunosorbent assay testing.

Useful For

Serologic detection of recent or past parvovirus B19 infection

Highlights

This assay may be used to determine the serostatus of patients at risk for infection with parvovirus B19.

 

Results may be used, alongside clinical evaluation and other laboratory findings, to determine if the patient has recent or past infection with parvovirus B19.

Specimen Type

Serum


Ordering Guidance


This test is intended for patients with at least 7 days of symptoms or asymptomatic individuals with recent exposure to parvovirus B19.

 

For patients with acute, symptomatic presentation, order either  PARVP / Parvovirus B19, Molecular Detection, PCR, Plasma or PARVO / Parvovirus B19, Molecular Detection, PCR, Varies.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL


Laboratory Test Directory Note:

COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject
Heat-inactivated specimen Reject

Day(s) Performed

Monday through Friday

Reference Values

IgG: Negative

IgM: Negative

Interpretation

Parvovirus B19 IgM

Parvovirus B19 IgG

Interpretation

Negative

Negative

No antibody to Parvovirus B19 detected. Acute infection cannot be ruled out as antibody levels may be below the limit of detection. If clinically indicated, a second serum should be submitted in 14 to 21 days.

Negative

Positive

Results suggest past infection.

Equivocal

Positive or negative

Recommend follow-up testing in 10 to 14 days if clinically indicated.

Positive

Positive, negative or equivocal

Results suggest recent infection and should be interpreted in the context of clinical presentation.

 

The presence of IgM class antibodies suggests recent infection. The presence of IgG antibodies only is indicative of past exposure.

 

Both IgG and IgM may be present at or soon after onset of illness and reach peak titers within 30 days. Because IgG antibody may persist for years, diagnosis of acute infection is made by the detection of IgM antibodies.

Cautions

Specimens collected prior to seroconversion may yield negative IgM or IgG antibody results, while specimens collected after IgM antibody levels have begun to decline may yield negative IgM antibody results. Follow-up testing of convalescent samples may be beneficial to establish infection status.

 

The continued presence or absence of antibodies cannot be used to determine the success or failure of therapy.

 

Test results of specimens from immunocompromised patients may be difficult to interpret.

 

Testing should not be performed as a screening procedure for the general population. Testing should only be done when clinical evidence suggests the diagnosis of parvovirus B19-associated disease.

 

The performance of this test has not been established on neonates and immunocompromised patients.

 

Specimens containing antinuclear antibodies may produce equivocal or positive test results in the IgM assay.

 

Epstein-Barr virus-positive specimens may produce positive or equivocal test results in the IgM assay.

 

Assay performance characteristics have not been established for matrices other than serum.

Clinical Reference

1. Brown KE, Young NS: Parvovirus B19 in human disease. Ann Rev Med. 1997;48:59-67

2. Markenson GR, Yancey MK: Parvovirus B19 infections in pregnancy. Semin Perinatol. 1998;22(4):309-317

3. Summers J, Jones SE, Anderson MJ: Characterization of the genome of the agent of erythrocyte aplasia permits its classification as a human parvovirus. J Gen Virol. 1983;64;(Pt 11):2527-2532

4. Qui J, Soderlund-Venermo M, Young NS. Human Paravoviruses. Clin Microbiol. Rev. 2017 Jan;30(1):43-113. doi: 10.1128/CMR.00040-16

Method Name

Enzyme Immunoassay (EIA)

Method Description

Antibody to parvovirus B19 is detected by a sandwich enzyme immunoassay (EIA) for the detection of IgG or IgM class antibodies in serum or plasma (Biotrin). Specific parvovirus B19 antibodies in specimens bind to antigen-coated microtiter wells. Following a wash step, peroxidase-labeled rabbit-antihuman IgG is added that binds to parvovirus antibody. The antigen-antibody complex is detected by the addition of substrate, which turns blue in the presence of the enzyme peroxidase.(Anderson LJ, Tsou R, Parker RA, et al: Detection of antibodies and antigens of human parvovirus B19 by enzyme-linked immunosorbent assay. J Clin Microbiol. 1986;24[4]:522-526. Package insert: Parvovirus B19 IgG and IgM Enzyme Immunoassay. DiaSorin, Biotrin; 10/2012)

Report Available

Same day/1 to 3 days

Test Classification

This test has been modified from the manufacturer's instructions. 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 US Food and Drug Administration.

CPT Code Information

86747 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PARVS Parvovirus B19 Ab, IgG and IgM, S 34950-6

 

Result ID Test Result Name Result LOINC Value
PARVG Parvovirus B19 Ab, IgG, S 29660-8
PARVM Parvovirus B19 Ab, IgM, S 40658-7
PARVN Parvovirus B19 Ab Interpretation 58737-8

Profile Information

Test ID Reporting Name Available Separately Always Performed
PARVG Parvovirus B19 Ab, IgG, S No Yes
PARVM Parvovirus B19 Ab, IgM, S No Yes
PARVN Parvovirus B19 Ab Interpretation No Yes

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.