Ordering Recommendation

Most useful to detect antibodies during acute phase of disease; recommend concurrent testing with IgG E. chaffeensis. PCR testing is preferred; refer to Tick-Borne Disease Panel by PCR, Blood (2008670) or Ehrlichia and Anaplasma Species by PCR (2007862).

Mnemonic
E CH M
Methodology

Semi-Quantitative Indirect Fluorescent Antibody

Performed

Tue, Fri

Reported

1-5 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Serum Separator Tube.

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens. Mark specimens plainly as acute or convalescent.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Contaminated, hemolyzed, or severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Reference Interval

< 1:16  Negative-No significant level of Ehrlichia chaffeensis IgM antibody detected.
≥ 1:16  Positive-Presence of IgM antibody to Ehrlichia chaffeensis detected, suggestive of current or recent infection.

Interpretive Data

While the presence of IgM antibodies suggests current or recent infection, low levels of IgM antibodies may occasionally persist for more than 12 months post-infection. A single IgM result should be interpreted with caution.

Compliance Category

Laboratory Developed Test (LDT)

Note

Human ehrlichiosis is a tick-borne disease caused by rickettsial-like agents. Two forms, human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE), have been described. HME is often referred to as "spotless" or rashless Rocky Mountain spotted fever, and has been reported in various regions of the United States. The causative agent of HME has been identified as Ehrlichia chaffeensis. Infected individuals produce specific antibodies to Ehrlichia chaffeensis which can be detected by an immunofluorescent antibody (IFA) test.

Hotline History
N/A
CPT Codes

86666

Components
Component Test Code* Component Chart Name LOINC
0051003 Ehrlichia chaffeensis Antibody, IgM 48850-2
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Aliases
  • E. Chaffeensis
  • HME (Human Monocytic Ehrlichiosis)
  • Tick Borne Diseases
Ehrlichia chaffeensis Antibody, IgM by IFA