Clinical Significance:
Immunodeficiency states can be acquired or congenital. 

1. The pathogenesis of acquired immunodeficiency syndrome (AIDS) is largely due to the decrease in the number of T-cells that bear the CD4 receptor. Progressive depletion of CD4+ T-cells is associated with an increased likelihood of severe HIV disease and an unfavorable prognosis. It has been recommended that CD4+ T-cell levels be monitored every 3-6 months in all HIV-infected persons.
2. Flow cytometry can also be useful in the diagnosis of congenital immunodeficiency, as many of these patients have decreased production of T-cells, B-cells, and/or NK cells, which are easily quantitated by flow cytometry.
3. Chronic Lyme infections are known to suppress the immune system, and they typically impact a specific subset of the natural killer cells, the CD57 subset. When Lyme disease is active, the CD57 count is typically suppressed.

Who should be tested?
Patients with suspected acquired or congenital immunodeficiency

Antibody Panels:

•  Acquired panel:  CD45, CD3, CD4, CD8, CD4/CD8 ratio
• Congenital panel:  CD45, CD3, CD4, CD8, CD4/CD8 ratio, CD19, CD56
• Lyme Disease panel:  CD45, CD3, CD8, CD57
• Other antibodies available per request

Specimens:
1-2 ml peripheral blood in EDTA (20°C)

Forms:
Dahl-Chase Flow Cytometry requisition form along with demographic sheet
CBC results obtained from the same tube

Transport:
Specimens need to be delivered within 24 hours.
Flow Cytometry lab should be notified of coming specimen (call 207-941-8282)
Uniship courier pick-up available.

CPT codes:
86360 for CD4/CD8 Count (Acquired Immunodeficiency)
86355, 86357, 86359, 86360 for T, B, and NK (Congenital Immunodeficiency)
86356, 86357, 86359 for Lyme Disease (CD57 evaluation)

Test performed:
Monday through Saturday

Test reported:
Faxed or mailed with 24 hours after sample is received.