Test Catalog

Test Id : MSFGN

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Fibrillary Glomerulonephritis Confirmation, Mass Spectrometry, Paraffin Tissue

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing fibrillary glomerulonephritis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

A pathology consultation is typically not required. If the results of this test do not support the clinical findings, PATHC / Pathology Consultation may be added if appropriate, upon client approval.

Method Name
A short description of the method used to perform the test

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Fibrillary GN Confirm, LC MS/MS

Aliases
Lists additional common names for a test, as an aid in searching

GPFGNMS

GPMSCBB

ISFGNMSST

FGN

DNAJB9

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

A pathology consultation is typically not required. If the results of this test do not support the clinical findings, PATHC / Pathology Consultation may be added if appropriate, upon client approval.

Specimen Type
Describes the specimen type validated for testing

AMYLOID

Necessary Information

1. Preliminary pathology report and history are required.

2. A brief explanatory note, or consultative letter, is recommended.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Pathology Packaging Kit (T554)

Specimen Type: Formalin-fixed or B5-fixed, paraffin-embedded tissue block

Collection Instructions:

1. Do not send fixed tissue slides. Testing can only be done on paraffin-embedded tissue blocks.

2. Attach the green pathology address label included in the kit to the outside of the transport container.

Forms

If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Fixed tissue slides
wet or frozen tissue
Cytological smears
Nonformalin fixed tissue
Nonparaffin embedded tissue 		Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
AMYLOID Ambient (preferred)
Refrigerated

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing fibrillary glomerulonephritis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

A pathology consultation is typically not required. If the results of this test do not support the clinical findings, PATHC / Pathology Consultation may be added if appropriate, upon client approval.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Fibrillary glomerulonephritis (FGN) is a rare kidney disease with fibrillary deposits in the glomeruli that contain polyclonal IgG and complement, indicating immune complex deposition. Although usually Congo-red negative, recently cases with weak Congo-red positivity have been observed, making the distinction from amyloid more challenging. Liquid chromatography tandem mass spectrometry (LC-MS/MS) performed on microdissected glomeruli from patients with FGN demonstrates a unique proteomic profile including the protein DNAJB9 (Mayo Clinic unpublished observations). The presence of DNAJB9 was found to be highly sensitive and specific for FGN, distinguishing it from other glomerular diseases, including amyloid, immunotactoid glomerulopathy, and immune complex-mediated proliferative glomerulonephritis. The presence of DNAJB9, in the appropriate clinical and pathological context, can be useful to establish a diagnosis of FGN.

Interpretation
Provides information to assist in interpretation of the test results

An interpretation will be provided.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Said SM, Sethi S, Valeri AM, et al. Renal amyloidosis: origin and clinicopathologic correlations of 474 recent cases. Clin J Am Soc Nephrol. 2013;8(9):1515-1523

2. Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen HR 3rd, Dogan A. Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood. 2009;114(24):4957-4959

3. Rosenstock JL, Markowitz GS, Valeri AM, Sacchi G, Appel GB, D'Agati VD. Fibrillary and immunotactoid glomerulonephritis: Distinct entities with different clinical and pathologic features. Kidney Int. 2003;63(4):1450-1461

4. Casanova S, Donini U, Zucchelli P, Mazzucco G, Monga G, Linke RP. Immunohistochemical distinction between amyloidosis and fibrillar glomerulopathy. Am J Clin Pathol. 1992;97(6):787-795

5. Rosenmann E, Eliakim M. Nephrotic syndrome associated with amyloid-like glomerular deposits. Nephron. 1977;18(5):301-308

6. Nasr SH, Vrana JA, Dasari S, et al. DNAJB9 is a specific immunohistochemical marker for fibrillary glomerulonephritis. Kidney Int Rep. 2017;3(1):56-64

7. Dasari S, Alexander MP, Vrana JA, et al. DnaJ Heat Shock Protein Family B Member 9 is a Novel Biomarker for Fibrillary GN. J Am Soc Nephrol. 2018;29(1):51-56

Method Description
Describes how the test is performed and provides a method-specific reference

Affected areas are removed from paraffin-embedded tissues by laser microdissection. Protein digestion is performed, followed by liquid chromatography tandem mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

7 to 15 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

Until reported

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82542

88380

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
MSFGN Fibrillary GN Confirm, LC MS/MS In Process
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
BA0389 Interpretation 59465-5
BA0390 Participated in the Interpretation No LOINC Needed
BA0391 Report electronically signed by 19139-5
BA0392 Material Received 81178-6
BA0393 Disclaimer 62364-5
BA0394 Case Number 80398-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports