T- and B-Lymphocyte Differential Profile

CPT: 86355; 86359; 86360
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Test Details

Test Includes

Percentage CD3+; absolute CD3+ (T cells); percentage CD3+CD4+; absolute CD3+CD4+ (helper/inducer); percentage CD3+CD8+; absolute CD3+CD8+ (suppressor/cytotoxic); percentage CD19+; absolute CD19+ (B cells); CD4:CD8 ratio; absolute lymphocyte count; CBC with differential and platelet count

Use

Enumeration of lymphocyte subsets for classification and diagnosis of primary immunodeficiency diseases and for evaluating and monitoring AIDS patients

Methodology

Flow cytometry

Reference Interval

Reference intervals for adults have been established by the laboratory. See table.

Reference Intervals for Lymphocyte Immunophenotyping

CD

Age

95% Confidence Interval

Percentage

Cells/mm³

Minimum

Maximum

Minimum

Maximum

Pediatric reference intervals are from Comans-Bitter WM, de Groot R, van den Beemd R, et al. Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations. J Pediatrics. 1997 Mar; 130(3):388-393.

CD3+

Neonates

28

76

600

5000

1 wk to 2 m

60

85

2300

7000

2 to 5 m

48

75

2300

6500

5 to 9 m

50

77

2400

6900

9 to 15 m

54

76

1600

6700

15 to 24 m

39

73

1400

8000

2 to 5 y

43

76

900

4500

5 to 10 y

55

78

700

4200

10 to 16 y

52

78

800

3500

Adults

58

86

622

2402

CD3+CD4+

Neonates

17

52

400

3500

1 wk to 2 m

41

68

1700

5300

2 to 5 m

33

58

1500

5000

5 to 9 m

33

58

1400

5100

9 to 15 m

31

54

1000

4600

15 to 24 m

25

50

900

5500

2 to 5 y

23

48

500

2400

5 to 10 y

27

53

300

2000

10 to 16 y

25

48

400

2100

Adults

31

59

359

1519

CD3+CD8+

Neonates

10

41

200

1900

1 wk to 2 m

9

23

400

1700

2 to 5 m

11

25

500

1600

5 to 9 m

13

26

600

2200

9 to 15 m

12

28

400

2100

15 to 24 m

11

32

400

2300

2 to 5 y

14

33

300

1600

5 to 10 y

19

34

300

1800

10 to 16 y

9

35

200

1200

Adults

12

36

109

897

T4:T8 ratio

Adults

0.92

3.72

CD19+

Neonates

5

22

40

1100

1 wk to 2 m

4

26

600

1900

2 to 5 m

14

39

600

3000

5 to 9 m

13

35

700

2500

9 to 15 m

15

39

600

2700

15 to 24 m

17

41

600

3100

2 to 5 y

14

44

200

2100

5 to 10 y

10

31

200

1600

10 to 16 y

8

24

200

600

Adults

3

25

12

640

Additional Information

Primary immunodeficiencies result from congenital defects of the immune system. Acquired immunodeficiency syndrome (AIDS) results from infection with the HIV-1 retrovirus. The purpose of flow cytometric enumeration is to determine whether select lymphocyte subsets are reduced or absent in order to support the diagnosis of numeric cellular immunodeficiency rather than immunodeficiency due to cellular dysfunction.

HIV-1 infection results in a decrease of CD4 T cells, an increase of CD8 T cells, a decrease in the CD4:CD8 ratio, and a progressive destruction of immune function. In HIV-1 seropositive patients, enumeration of CD4 T cells may be used for prognostic purposes and to monitor disease progression and antiretroviral therapy.

Specimen Requirements

Specimen

Whole blood

Volume

Fill tube(s) to capacity.

Container

Lavender-top (EDTA) tube and yellow-top (ACD-A) or (ACD-B) tube

Collection

Invert tube 8 to 10 times immediately after collection. To preserve cellular viability, collect specimen so it will arrive in the laboratory within 48 hours of collection. Indicate date and time of venipuncture on the tube(s) and on the test request form.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

2 days

Refrigerated

Unstable

Frozen

Unstable

Freeze/thaw cycles

Unstable

Causes for Rejection

Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen

Clinical Information

References

Giorgi J, Kesson A, Chou CC. Immunodeficiency and infectious diseases. In: Rose N, deMacario E, Fahey J, et al, eds. Manual of Clinical Laboratory Immunology. 4th ed. Washington, DC: ASM Press;1992:chap 25.
Stevens RA, Lempicki RA, Natarajan V, et al. General immunologic evaluation of patients with immunodeficiency virus infection. In: Detrick B, Hamilton RG, Folds JD, et al, eds. Manual of Molecular and Clinical Laboratory Immunology. 7th ed. Washington, DC: ASM Press;2006:chap 95.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
096917 T + B-Lymphocyte Differential 059478 Abs.CD19+ Lymphs /uL 8116-6
096917 T + B-Lymphocyte Differential 059525 Absolute CD 3 /uL 8122-4
096917 T + B-Lymphocyte Differential 059526 Absolute CD 4 Helper /uL 24467-3
096917 T + B-Lymphocyte Differential 059551 Abs. CD 8 Suppressor /uL 14135-8
096917 T + B-Lymphocyte Differential 059501 % CD19+ Lymphs % 8117-4
096917 T + B-Lymphocyte Differential 059527 % CD 3 Pos. Lymph. % 8124-0
096917 T + B-Lymphocyte Differential 059543 % CD 4 Pos. Lymph. % 8123-2
096917 T + B-Lymphocyte Differential 059568 % CD 8 Pos. Lymph. % 8101-8
096917 T + B-Lymphocyte Differential 059576 CD4/CD8 Ratio 54218-3
096917 T + B-Lymphocyte Differential 005025 WBC x10E3/uL 6690-2
096917 T + B-Lymphocyte Differential 005033 RBC x10E6/uL 789-8
096917 T + B-Lymphocyte Differential 005041 Hemoglobin g/dL 718-7
096917 T + B-Lymphocyte Differential 005058 Hematocrit % 4544-3
096917 T + B-Lymphocyte Differential 015065 MCV fL 787-2
096917 T + B-Lymphocyte Differential 015073 MCH pg 785-6
096917 T + B-Lymphocyte Differential 015081 MCHC g/dL 786-4
096917 T + B-Lymphocyte Differential 105007 RDW % 788-0
096917 T + B-Lymphocyte Differential 015172 Platelets x10E3/uL 777-3
096917 T + B-Lymphocyte Differential 015107 Neutrophils % 770-8
096917 T + B-Lymphocyte Differential 015123 Lymphs % 736-9
096917 T + B-Lymphocyte Differential 015131 Monocytes % 5905-5
096917 T + B-Lymphocyte Differential 015149 Eos % 713-8
096917 T + B-Lymphocyte Differential 015156 Basos % 706-2
096917 T + B-Lymphocyte Differential 115398 Immature Cells N/A
096917 T + B-Lymphocyte Differential 015909 Neutrophils (Absolute) x10E3/uL 751-8
096917 T + B-Lymphocyte Differential 015917 Lymphs (Absolute) x10E3/uL 731-0
096917 T + B-Lymphocyte Differential 015925 Monocytes(Absolute) x10E3/uL 742-7
096917 T + B-Lymphocyte Differential 015933 Eos (Absolute) x10E3/uL 711-2
096917 T + B-Lymphocyte Differential 015941 Baso (Absolute) x10E3/uL 704-7
096917 T + B-Lymphocyte Differential 015108 Immature Granulocytes % 38518-7
096917 T + B-Lymphocyte Differential 015911 Immature Grans (Abs) x10E3/uL 51584-1
096917 T + B-Lymphocyte Differential 015945 NRBC % 58413-6
096917 T + B-Lymphocyte Differential 015180 Hematology Comments: 18314-5
096917 T + B-Lymphocyte Differential 000000 HIV Confidential N/A
Reflex Table for Immature Granulocytes
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 015111 Please note: 015111 Please note: N/A
Reflex Table for Immature Grans (Abs)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 015111 Please note: 015111 Please note: N/A
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115247 Neutrophils % 23761-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115250 Lymphs % 737-7
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115251 Monocytes % 744-3
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115252 Eos % 714-6
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115253 Basos % 707-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115398 Immature Cells N/A
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115254 Neutrophils Absolute X10E3/uL 753-4
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115255 Lymphs (Absolute) X10E3/uL 732-8
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115256 Monocytes(Absolute) X10E3/uL 743-5
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115257 Eos (Absolute Value) X10E3/uL 712-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115258 Baso(Absolute) X10E3/uL 705-4
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115260 Differential Comment 18723-7
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 005034 RBC Comment 6742-1
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 015171 Platelet Comment 9317-9

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