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24811 Aspergillus (Galactomannan) Antigen, Serum (ASPAG)

Aspergillus (Galactomannan) Antigen, Serum (ASPAG)
Test Code: ASPAGSO
Synonyms/Keywords
​Ref Lab Code: 84356, Aspergillosis, Galactomannan, Invasive Aspergillosis, Platelia Aspergillus Ag
Useful For
An aid in the diagnosis of invasive aspergillosis and assessing response to therapy
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​ ​1.5 mL ​1 mL ​
Collection Processing Instructions
1. Avoid exposure of specimen to atmosphere.
2. Send specimen in original tube. Do not aliquot.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​Refrigerated (preferred) ​14 days
​ ​Frozen ​14 days
Rejection Criteria
Hemolysis Mild OK; Gross reject
​Lipemia Mild OK; Gross reject​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​ Monday through Friday, Sunday ​ ​1 day
Enzyme Immunoassay (EIA)​
Reference Lab
Mayo Clinic Laboratories
Test Information
Invasive aspergillosis (IA) is a severe infection that occurs in patients with prolonged neutropenia, following transplantation or in conjunction with aggressive immunosuppressive regimens (eg, prolonged corticosteroid usage, chemotherapy). The incidence of IA is reported to vary from 5% to 20% depending on the patient population. IA has an extremely high mortality rate of 50% to 80% due in part to the rapid progression of the infection (ie, 1-2 weeks from onset to death). Approximately 30% of cases remain undiagnosed and untreated at death.
 
Definitive diagnosis of IA requires histopathological evidence of deep-tissue invasion or a positive culture. However, this evidence is often difficult to obtain due to the critically ill nature of the patient and the fact that severe thrombocytopenia often precludes the use of invasive procedures to obtain a quality specimen. The sensitivity of culture in this setting also is low, reportedly ranging from 30% to 60% for bronchoalveolar lavage fluid. Accordingly, the diagnosis is often based on nonspecific clinical symptoms (unexplained fever, cough, chest pain, dyspnea) in conjunction with radiologic evidence (computed tomography [CT] scan); and definitive diagnosis is often not established before fungal proliferation becomes overwhelming and refractory to therapy.
 
Recently, a serologic assay was approved by the Food and Drug Administration for the detection of galactomannan, a molecule found in the cell wall of Aspergillus species. Serum galactomannan can often be detected a mean of 7 to 14 days before other diagnostic clues become apparent, and monitoring of galactomannan can potentially allow initiation of preemptive antifungal therapy before life-threatening infection occurs.
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​<0.5 index
Interpretation
A positive result supports a diagnosis of invasive aspergillosis (IA). Positive results should be considered in conjunction with other diagnostic procedures, such as microbiologic culture, histological examination of biopsy specimens, and radiographic evidence. See Cautions.
 
A negative result does not rule out the diagnosis of IA. Repeat testing is recommended if the result is negative but IA is suspected. Patients at risk of IA should have a baseline serum tested and should be monitored twice a week for increasing galactomannan antigen levels.
 
Galactomannan antigen levels may be useful in the assessment of therapeutic response. Antigen levels decline in response to antimicrobial therapy.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​87305 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 84356, Aspergillosis, Galactomannan, Invasive Aspergillosis, Platelia Aspergillus Ag
Ordering Applications
Ordering Application Description
​Centricity ​Aspergillus Ag, Serum (84356)
​Cerner ​Aspergillus Ag, Serum (84356)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ ​Serum Separator Tube (SST) ​ ​1.5 mL ​1 mL ​
Collection Processing
1. Avoid exposure of specimen to atmosphere.
2. Send specimen in original tube. Do not aliquot.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​Refrigerated (preferred) ​14 days
​ ​Frozen ​14 days
Rejection Criteria
Hemolysis Mild OK; Gross reject
​Lipemia Mild OK; Gross reject​
Useful For
An aid in the diagnosis of invasive aspergillosis and assessing response to therapy
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​<0.5 index
Interpretation
A positive result supports a diagnosis of invasive aspergillosis (IA). Positive results should be considered in conjunction with other diagnostic procedures, such as microbiologic culture, histological examination of biopsy specimens, and radiographic evidence. See Cautions.
 
A negative result does not rule out the diagnosis of IA. Repeat testing is recommended if the result is negative but IA is suspected. Patients at risk of IA should have a baseline serum tested and should be monitored twice a week for increasing galactomannan antigen levels.
 
Galactomannan antigen levels may be useful in the assessment of therapeutic response. Antigen levels decline in response to antimicrobial therapy.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​ Monday through Friday, Sunday ​ ​1 day
Enzyme Immunoassay (EIA)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​87305 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.