Laboratory Medicine | Immunology/Serology Lab

• Dennis J. Dietzen, Ph.D., Assistant Director  h | c
• Gregory A. Storch, M.D.  h | c

The joint clinical immunology/serology laboratory performs diagnostic testing for Barnes-Jewish and St. Louis Children's Hospitals. It provides a full range of assays which can be grouped in seven major areas:

1. serologic markers of autoimmune disease
2. analysis of the complement system
3. serodiagnosis of infectious disease
4. CSF markers of multiple sclerosis
5. special protein studies for monoclonal protein detection
6. diagnosis of immunodeficiencies
7. allergen testing

The Laboratory welcomes questions and consultations concerning all aspects of clinical diagnostic immunology.

Serologic markers of autoimmune disease include

• Anti-nuclear antigens (ANA) by immuofluorescence
• Anti-DNA by immunofluorescence and ELISA
• Extractable nuclear antigens and anti-cardiolipin antibodies by ELISA
• Rheumatoid factor by nephelometry
• Anti-mitochondrial and smooth muscle antibodies by immunofluorescence
• Anti-gliadin, tissue transglutaminase, and endomysial antibodies by ELISA and immunofluorescence

Analysis of the complement system includes

• Determination of total hemolytic complement
• C3, C4, and C1 esterase inhibitor levels by nephelometry

Serodiagnosis of infectious disease includes

• Viral and fungal antibody measurement by a variety of methods including ELISA, immunofluorescence, complement fixation, and immunodiffusion
• Immune status to determine exposure by immunofluorescence, agglutination, or ELISA
• Syphilis testing by non-treponemal (VDRL) and specific treponemal (FTA) tests

CSF markers of multiple sclerosis include

• Quantitative immunoglobulins in both CSF and serum (IgG, IgA, IgM)
• Qualitative analysis of CSF for oligoclonal bands by electrophoresis and isoelectric focusing

Special protein studies performed include

• Quantitation of IgG, IgA, IgM, IgE by nephelometry
• Serum and urine protein electrophoresis
• Immunofixation of all abnormal serum and urine specimens
• Cryoglobulin studies on serum
• Quantitation of alpha-1-antitrypsin, ceruloplasmin, C-reactive protein, haptoglobulin, prealbumin, and transferrin by nephelometry

Diagnosis of immunodeficiencies includes

• Quantitation of IgG, IgA, IgM, and IgG subclasses by nephelometry
• Lymphocyte transformation
• Cytokine production by ELISA
• Inducible T-cell markers by flow cytometry

Diagnosis of allergen specificities includes

• Quantitation of IgE by solid phase assay
• Allergen-specific IgE (RAST) testing