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Comprehensive Guide to Immunologic Lab Tests

Learn about popular immunologic lab tests like agglutination reactions, ELISA, and flow cytometry. Understand the purpose, detection methods, and clinical applications of each test.

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Comprehensive Guide to Immunologic Lab Tests

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  1. Immunologic Laboratory Tests Kristine Krafts, M.D.

  2. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence • ELISA • Western blot • Flow cytometry

  3. Things to Remember About Each Test • What does it measure? • Where does the Ag-Ab interaction occur? • How is the Ag-Ab complex detected?

  4. Immunologic Lab Tests Outline • Agglutination reactions

  5. Agglutination Reactions: Purpose • Detection of Ag in the patient’s specimen • Examples: • testing for antibodies to infectious agents • testing for Hemophilus influenzae type B capsular antigen in CSF

  6. negative positive

  7. Immunologic Lab Tests Outline • Agglutination reactions • DAT

  8. DAT: Purpose • Detection of Ab on patient’s red cells • Also called the direct Coombs Test • Performed in patients with hemolytic anemia

  9. patient red cells + AHG = agglutination

  10. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT

  11. IAT: Purpose • Detection of antibodies to red cell antigens • Also called the indirect Coombs Test • Performed as part of pre-transfusion testing

  12. patient Ab donor RBC Ab-coated donor RBC + = + AHG agglutination =

  13. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence

  14. Immunofluorescence: Purpose • Detection of a specific antigen or antibody in a patient’s specimen • Examples: • detection of antigen in a patient’s biopsy specimen • detection of antibody in a patient’s serum

  15. Positive fluorescent antinuclear antibody test

  16. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence • ELISA

  17. ELISA: Purpose • Detection of antibodies in patient specimen • Examples: • home pregnancy tests • HIV tests • tests for some coagulation factors, cytokines, and autoantibodies

  18. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence • ELISA • Western blot

  19. Western Blot: Purpose • Detection of antibodies in patient specimen • Most common example: HIV test

  20. Enough bands = patient is “positive”

  21. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence • ELISA • Western blot • Flow cytometry

  22. Flow Cytometry: Purpose • Characterization of cell size, complexity, antigens • Examples: • diagnosis of leukemia and lymphoma • determination of CD4/CD8 counts in patients with HIV

  23. Immunologic Lab Tests Outline • Agglutination reactions • DAT • IAT • Immunofluorescence • ELISA • Western blot • Flow cytometry

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