Double Negative T-cells

Diagnostic Use

Although present in other conditions, most ALPS patients have elevated CD4/CD8 double negative T-cells (DNTs) in the context of normal or elevated lymphocyte counts.

Department

Immunology

Delphic Registration Code

DNTC

Laboratory Handling

Registration

Phone lab and send direct to immunology or after hours place into immunology bin at room temperature

Turnaround Time

3 days

Specimen Type

• Whole Blood

Specimen Requirements

Tube/Container Type:

Preferred

• EDTA (Lavender Cap)

Preferred Sample Volume (ml)

1

No of Samples Required

2

Paediatric Specimen Requirements

Tube/Container Type:

Preferred

• EDTA (Lavender Cap)

Preferred Sample Volume (ml)

0.5

Additional Specimen Information

Please contact laboratory before sending sample and control. (03) 364 0413

Patient Specimen: 1 mL EDTA + same from healthy unrelated adult ctrl

Paediatric Specimen: 0.5 mL EDTA + same from healthy unrelated adult ctrl

Aliquot Instructions

Sample Type

• Whole Blood

Minimum Volume (ml)

5

Transport to Lab

Ambient (8 - 24 degrees Celsius)

Additional Referral/Aliquot Information

Ambient temperature within 24h

Reference Intervals

<1.5% = normal
1.5-2.5% = borderline
>2.5% = abnormal

Results are given as % CD4^–/CD8^– double negative cells (as a percentage of theCD3⁺TCRαβ⁺ population).

Test Method

Flow cytometry is used to enumerate CD3+TCRαβ+CD4-CD8- DNT cells in whole blood as a screening test for ALPS.

Non-Funded Test Cost

$293.11 (Exclusive of GST)

Billing Code

8783

Additional Costing Information

Genetic testing for ALPS (sequencing of CD95, FasL, Casp10, Casp8, SH2D1A and promoter regions) is available at Dept of Immunology, Camelia Botnar Laboratories, Great Ormond St. Hospital (contact Kimberly Gilmour Kimberly.Gilmour@gosh.nhs.uk) although there may also be centres in Australia.
To confirm a functional defect in the Fas (CD95) pathway, apoptosis testing is now available at Canterbury Health Laboratories
Biomarkers from serum (sFasL, Vit B12, IL-18, IL-10) may also be useful in the diagnosis of ALPS1,2. These are not currently available at CHL.
1. Oliveira et al. Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop. Blood. 2010 Oct;116:35-40.
2. Caminha et al. Using biomarkers to predict the presence of FAS mutations in patients with features of the autoimmune lymphoproliferative syndrome. J Allergy Clin Immunol. 2010;125:946-949.

Contact Information

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