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Test Code CHLM Chlamydia IgM, Immunofluorescence, Serum


Ordering Guidance


For suspected Chlamydia trachomatis infection, order either CTRNA / Chlamydia trachomatis, Nucleic Acid Amplification, Varies or CGRNA / Chlamydia trachomatis and Neisseria gonorrhoeae, Nucleic Acid Amplification, Varies.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.3 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Assessing IgM antibody levels to aid in the clinical diagnosis of Chlamydia pneumoniae or Chlamydia psittaci infections

Testing Algorithm

This test includes testing for Chlamydia pneumoniae IgM, and Chlamydia psittaci IgM

Method Name

Micro-Immunofluorescent Antibody (MIF) Assay

Reporting Name

Chlamydia IgM, IFA, S

Specimen Type

Serum

Specimen Minimum Volume

0.15 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 30 days
  Frozen  30 days

Reject Due To

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

Clinical Information

Members of the family Chlamydiaceae are small, nonmotile, gram-negative, obligate intracellular organisms that grow in the cytoplasm of host cells. While there are at least 9 species within the Chlamydia genus, 3 are clinically significant, including Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci.

 

The chlamydial life cycle can be divided into 2 distinct phases: an extracellular, nonreplicating, infectious stage and an obligate intracellular, replicating, noninfectious stage. The infectious form, or elementary body (EB), attaches to the target cell membrane and enters the cell via a phagosome. After cell entry, the EB reorganizes into reticulate particles (forming inclusion bodies) and binary fission begins. After 18 to 24 hours, reticulate particles condense to form EBs. These new EBs are released, beginning another infection cycle.

 

C psittaci is the causative agent of psittacosis, a disease characterized by pneumonia, headache, altered mentation, and hepatosplenomegaly. Psittacosis is acquired by airborne transmission from infected birds.

 

C pneumoniae (formerly known as Taiwan acute respiratory agent and, more recently, as Chlamydophila pneumoniae) causes pneumonia in humans. It is unique because it is a primary pathogen of humans, is spread from human to human, and apparently has no animal or bird host. C pneumoniae is responsible for approximately 10% of pneumonia cases.

Reference Values

Chlamydia pneumoniae

<1:10

 

Chlamydia psittaci

<1:10

Interpretation

Chlamydia pneumoniae, and Chlamydia psittaci

≥1:10

IgM endpoint titers of 1:10 or more are considered presumptive evidence of infection.

 

<1:10

IgM endpoint titers below 1:10 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.

Cautions

Specimens collected too early during primary infection may not contain detectable antibodies. If chlamydial infection is suspected, a second specimen should be collected 10 to 21 days later and tested in parallel with the original specimen.

 

During a primary Chlamydia infection, the early antibody response may be cross-reactive with multiple Chlamydia species.

 

This assay does not report antibodies detected against Chlamydia trachomatis. Sera from suspected cases of lymphogranuloma venereum (LGV) should be tested by a Lymphogranuloma Venereum Differentiation Antibody Panel. LGV testing is not performed by Mayo Clinic Laboratories; call 800-533-1710 for assistance with ordering.

 

Due to the limited sensitivity and specificity of Chlamydia serologic tests, patients with suspected C trachomatis infection should be tested by a molecular method (eg, CTRNA / Chlamydia trachomatis, Nucleic Acid Amplification, Varies or CGRNA / Chlamydia trachomatis and Neisseria gonorrhoeae, Nucleic Acid Amplification, Varies) to evaluate for current/active infection.

Day(s) Performed

Monday, Thursday

Report Available

Same day/1 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

86632 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHLM Chlamydia IgM, IFA, S 10849-8

 

Result ID Test Result Name Result LOINC Value
619390 C. pneumoniae IgM In Process
619391 C. psittaci IgM In Process