1:16 titer for Coxsackie B; should I be concerned?

[halcyon]

I called Lab Corp Customer service (1-888-522-2677) and they confirmed that 816869 is sent to ARUP but that 823361 is sent to Cambridge Biomedical. Rep confirmed 823361 is performed using Serum Neutralization Assay. I'd appreciate your thoughts if this is acceptable

Yeah sorry I forgot the echovirus code was for Cambridge Biomedical. It’s fine, they do use the correct methodology. I’ve had the test done both there and ARUP and the results matched.

 

[wigglethemouse]

I think I read that Dr Chia also uses the Cambridge Biomedical test for echovirus, which is also an antibody neutralization like ARUPs, so it is the same sort of test. So it probably would be OK to get your echovirus tested at Cambridge Biomedical.

Yeah sorry I forgot the echovirus code was for Cambridge Biomedical. It’s fine, they do use the correct methodology. I’ve had the test done both there and ARUP and the results matched.

Thanks, that was fast !

 

[Ema]

@Ema might be able to offer some suggestions here, as she recently had the same issues with trying to order the ARUP tests through LabCorp and Quest.

In this area, ARUP tests are ordered through Quest. LabCorp would not draw for them. LabCorp also does not draw for Mayo or any other specialty labs which is why I started going to Quest in the first place.

But these things do vary by location...do you happen to have a Quest location near to you? Maybe they would be more helpful?

 

[Hip]

Would you happen to know the Quest codes for these two ARUP tests, @Ema? Assuming that is that Quest have special codes for the ARUP tests.

I'd like to put the Quest and LabCorp codes in the enterovirus section of roadmap document, just to make it easier for people to order these ARUP tests.

 

[Ema]

Would you happen to know the Quest codes for these two ARUP tests, @Ema? Assuming that is that Quest have special codes for the ARUP tests.

I'd like to put the Quest and LabCorp codes in the enterovirus section of roadmap document, just to make it easier for people to order these ARUP tests.

I looked through my notes and I don't think they do have special codes that are specific to each commercial lab, unfortunately, which is how they ended up running them in-house twice. I think you just have to order them with the ARUP codes from the website and then confirm it about 16x.

 

[wigglethemouse]

I looked through my notes and I don't think they do have special codes that are specific to each commercial lab, unfortunately, which is how they ended up running them in-house twice. I think you just have to order them with the ARUP codes from the website and then confirm it about 16x.

I went to Labcorp for a new blood draw today and while the second test "Echovirus (Frozen) Serum Ab Panel LC - 823361 - send to Cambridge Biomedical" was accepted the first test "Coxsackie B Virus Abs LC - 816869 - send to ARUP" was not. Apparently 816869 is now a CSF only test that is sent to ARUP and the replacement code that they have for the serum version of the test is 096263 which is a Complement Fixation Test done by Labcorp, not Neutralization assay!
https://www.labcorp.com/test-menu/23301/coxsackie-virus-group-b-antibodies

This seems to be the same 010777 test I already had done last week except 010777 also includes a poliovirus AB test.
https://www.labcorp.com/test-menu/24666/enterovirus-antibodies-profile

I tried to say that the ARUP test code specifies serum or CSF as per
http://ltd.aruplab.com/tests/pub/0060055

so the Labcorp technician called their customer service line who confirmed that they only send out 816869 for CSF and not serum. I then asked if they could place a manual requisition for the test as per the ARUP customer service rep instructions
http://ltd.aruplab.com/tests/pub/0060055

but he said they needed to have a Labcorp code, not an ARUP code. So it looks like I'm stuck.

Ugggggggggggghhhhhhhhhhhhhhhh.

 

[bertiedog]

I had a very high titre result for Coxsackie(1:10,000) but it was done by Infectolab Germany about 3 years ago and I gather from @Hip that it is a pretty useless test. I live in the UK and if I wanted to be properly tested is there anyone in the UK who can do this?

Pam

 

[Hip]

I had a very high titre result for Coxsackie(1:10,000) but it was done by Infectolab Germany about 3 years ago and I gather from @Hip that it is a pretty useless test. I live in the UK and if I wanted to be properly tested is there anyone in the UK who can do this?

I am not sure what testing method Infectolab uses, so it's hard to comment on that result.

Dr Chia found that antibody testing using the neutralization method (as used by ARUP lab) was sensitive enough to detect the high titers found in ME/CFS patients. Other antibody testing methods like CFT are not sensitive.

I tried hard to find an antibody neutralization test in the UK, but could find none. However, there is one in Greece that you can post your serum sample to, which is the Hellenic Pasteur Institute. They do an antibody neutralization test for coxsackievirus B, for €68, which is much cheaper than ARUP.


The other way of testing for enterovirus (which is the most sensitive test), is to send a stomach biopsy sample to Chia's lab. He then tests if enterovirus are actually present in your tissues. Cost is $250.

 

[bertiedog]

am not sure what testing method Infectolab uses, so it's hard to comment on that result.

Armin S was the Director of that lab at the time just before he set his own up. Not sure if that helps or not!

Pam

 

[bertiedog]

I tried hard to find an antibody neutralization test in the UK, but could find none. However, there is one in Greece that you can post your serum sample to, which is the Hellenic Pasteur Institute. They do an antibody neutralization test for coxsackievirus B, for €68, which is much cheaper than ARUP.

Do you know if it can be ordered online by email contact? I did have a quick look at their website but couldn't find anything relating to this test.

Thanks again

Pam

 

[Hip]

There's no email address on their website, but I wrote (by regular post) to the lab director at the Hellenic Pasteur Institute, asking if they could accept blood serum samples from abroad, and what the cost was for the CVB antibody neutralization test. He replied that they could, and that the cost was €68.

 

[Thegriz]

went to Labcorp for a new blood draw today and while the second test "Echovirus (Frozen) Serum Ab Panel LC - 823361 - send to Cambridge Biomedical" was accepted the first test "Coxsackie B Virus Abs LC - 816869 - send to ARUP" was not. Apparently 816869 is now a CSF only test that is sent to ARUP and the replacement code that they have for the serum version of the test is 096263 which is a Complement Fixation Test done by Labcorp, not Neutralization assay!

Not sure if you got this figured out but just talked with labcorps about this issue.

Echovirus (Frozen) Serum Ab Panel LC - 823361 they confirmed this will work

Coxsackie B Virus Abs LC - 816869
this will not work as it is only csf

Solution
When getting the draw done give them this number "977180 serum SST" this code is for send out labs and will go to their referral department. The arup test number is 0060055. Which I believe your doctor needs to order this test.
They told me they send out labs all the time to ARUP and this will work. I have not tried yet but will and will update.

 

[wigglethemouse]

Solution
When getting the draw done give them this number "977180 serum SST" this code is for send out labs and will go to their referral department. The arup test number is 0060055. Which I believe your doctor needs to order this test.
They told me they send out labs all the time to ARUP and this will work. I have not tried yet but will and will update.

Be interested to hear how you get on! Are you going for a draw in the near future?

 

[Hip]

@Thegriz, thanks for trying to get to the bottom of this troublesome issue with LabCorp and Quest codes for the ARUP Lab coxsackievirus B and echovirus antibody tests.

So 977180 appears to be the LabCorp code for the ARUP Lab antibodies test, when providing a serum sample.

Coxsackie B Virus Abs LC - 816869
this will not work as it is only csf

That's strange, because this number of 816869 is the code Dr Chia uses to order the ARUP Lab coxsackievirus B antibody test.

I happen to have a copy of Dr Chia's LabCorp test requisition form that he filled out for an ME/CFS patient on this forum (see image below), and you can clearly see on this form that Chia uses LabCorp code 816869 to order the CVB antibody test.

You can also see from that form that Dr Chia uses LabCorp code 823361 for the ARUP Lab echovirus antibody test.

It's interesting that Dr Chia has handwritten on this form: "Please do not modify the test code on coxsackievirus B antibodies. Reference will accept serum". I wonder if that means Dr Chia knows that code 816869 is normally for cerebrospinal-fluid, but that ARUP will also accept serum.

Dr Chia's LabCorp Test Requisition Form

​

 

[Hip]

By the way, if anyone needs the Quest codes for the ARUP Lab CVB and echovirus antibody tests, these would appear to be:

Quest codes:
59117 Coxsackievirus B antibodies at ARUP Lab
59110 Echovirus antibodies at ARUP Lab

See this post.


Strange though that none of these LabCorp or Quest codes appear when you search on the:

LabCorp Test Menu, or
Quest Test Directory

 

[Thegriz]

The labcorp rep stated that 977180 would be a misc/ referral code and that would allow them to draw it because the 816869 is only csf and labcorps will not draw serum on that test. Even though arup will accept serum.

Talking directly to Arup they said just ask labcorp for a misc or referral code because they do send out labs all the time.

 

[Hip]

What a confusing business!

I am not sure how US health insurance works (I live in the UK), but is it not possible to deal with ARUP Lab directly, just by sending your serum sample to them? Might that be more reliable? Although you would have to find your own local phlebotomy service to draw the blood, but phlebotomy services are found everywhere.

 

[knackers323]

Numerous studies in the UK in 1980s and 90s, as well as more recent studies by John Chia, indicate that coxsackievirus B and echovirus can exist as a chronic low-level active non-cytolytic infection in the muscle tissues, intestinal tissues and brain tissues of ME/CFS patients.

If you perform enterovirus PCR testing on the blood, you often will get a negative result in ME/CFS; but if you perform PCR on infected tissues via biopsy (as the British researchers did), then it will often be positive. The high titers found on antibody neutralization tests are likely caused by these tissue infections.

@denlander I'm not sure if your still a member here or not, as it doesn't appear you have been online since around the time of this post, but I'd love to hear your comments on this if possible
Thanks

 

[Thegriz]

What a confusing business!

I am not sure how US health insurance works

Its ridiculous... the second I think I understand it, I learn something new and get screwed over in the process hah

 

[wigglethemouse]

I am not sure how US health insurance works

It's a mess. 60% of bankruptcies in the US are due to having a health condition.