Test Code IABCS B-Cell Phenotyping Profile for Immunodeficiency and Immune Competence Assessment, Blood
Reporting Name
Immune Assessment B Cell Subsets, BUseful For
Screening for common variable immunodeficiency (CVID) and hyper-IgM syndromes
Assessing B-cell subset reconstitution after stem cell or bone marrow transplant
Assessing response to B-cell-depleting immunotherapy
Identifying defects in transmembrane activator and calcium modulator and cyclophilin ligand (CAML) interactor (TACI) and B-cell-activating factor receptor (BAFF-R) in patients presenting with clinical symptoms and other laboratory features consistent with CVID
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TBBS | QN Lymphocyte Subsets: T, B, and NK | Yes | Yes |
IABC | Immune Assessment B Cell Subsets, B | No | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CVID | CVID Confirmation Flow Panel | Yes | No |
Testing Algorithm
If immune assessment B-cell subsets test is abnormal, then confirmation will be performed at an additional charge.
When multiple specimen types are required to perform a panel of tests, the laboratory will perform the tests for which the appropriate specimen type was received and the laboratory will cancel those for which the appropriate specimen was not received. Please be advised that this may change the degree of interpretation received with the report. If only the refrigerate EDTA sample is received, this test will be canceled and converted to RBCS / Relative B-Cell Subset Analysis Percentage which provides the relative B-cell subset values without quantitation.
Performing Laboratory

Specimen Type
Whole Blood EDTAAdvisory Information
Shipping Instructions
Specimens are required to be received in the laboratory weekdays and by 4 p.m. on Friday. Draw and package specimen as close to shipping time as possible.
It is recommended that specimens arrive within 24 hours of draw.
Samples arriving on the weekend and observed holidays may be canceled.
Necessary Information
1. Date of draw is required.
2. Ordering physician's name and phone number are required.
Specimen Required
Two separate EDTA specimens are required: 1 refrigerated and 1 at ambient transport temperature.
For serial monitoring, we recommend that specimen draws be performed at the same time of day.
Specimen Type: Whole blood for TBBS / Quantitative Lymphocyte Subsets: T, B, and NK
Container/Tube: 4 mL Lavender top (EDTA)
Specimen Volume: 3 mL
Collection Instructions:
1. Send specimen in original tube. Do not aliquot.
2. Label specimen as blood for TBBS / Quantitative Lymphocyte Subsets: T, B, and NK.
Specimen Stability Information: Ambient <52 hours
Specimen Type: Whole blood for IABC / B-Cell Phenotyping Screen for Immunodeficiency and Immune Competence Assessment, Blood
Container/Tube: Lavender top (EDTA)
Specimen Volume:
≤14 years: 4 mL
>14 years: 10 mL
Collection Instructions:
1. Send specimen in original tube. Do not aliquot.
2. Label specimen as blood for IABC / B-Cell Phenotyping Screen for Immunodeficiency and Immune Competence Assessment, Blood.
Specimen Stability Information: Refrigerated <48 hours
Specimen Minimum Volume
TBBS: 1 mL
IABC
≤14 years: 3 mL
>14 years: 5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole Blood EDTA | Varies | 48 hours | PURPLE OR PINK TOP/EDTA |
Reference Values
The appropriate age-related reference values will be provided on the report.
Day(s) and Time(s) Performed
Monday through Friday
Specimens are required to be received in the laboratory on weekdays and by 4 p.m. on Friday. No weekend processing.
CPT Code Information
T- and B-Cell Quantitation by Flow Cytometry
86355-B cells, total count
86357-Natural killer (NK) cells, total count
86359-T cells, total count
86360-Absolute CD4/CD8 count with ratio
B-Cell Phenotyping Screen for Immunodeficiency and Immune Competence Assessment, Blood
86356 x7 - Mononuclear cell antigen, quantitative
Common Variable Immunodeficiency Confirmation Flow Panel
88184-Flow cytometry, first marker (if appropriate)
88185 x 2-Flow cytometry, each additional marker (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
IABCS | Immune Assessment B Cell Subsets, B | 90416-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
30296 | CD19+ % of total Lymphocytes | 8117-4 |
3321 | CD45 Total Lymph Count | 27071-0 |
3316 | % CD3 (T Cells) | 8124-0 |
29094 | CD20+ % of total Lymphocytes | 8119-0 |
3322 | CD3 (T Cells) | 8122-4 |
30298 | CD27+ % of CD19+ B cells | 89358-6 |
3319 | % CD4 (T Cells) | 8123-2 |
30300 | CD27+ IgM+ IgD+ % of CD19+ B cells | 89352-9 |
3325 | CD4 (T Cells) | 24467-3 |
30302 | CD27+ IgM- IgD- % of CD19+ B cells | 89350-3 |
3320 | % CD8 (T Cells) | 8101-8 |
30304 | CD27+ IgM+ IgD- % of CD19+ B cells | 89348-7 |
3326 | CD8 (T Cells) | 14135-8 |
30306 | IgM+ % of CD19+ B cells | 89346-1 |
3318 | % CD19 (B Cells) | 8117-4 |
30308 | CD38+ IgM- % of CD19+ B cells | 89344-6 |
30310 | CD38+ IgM+ % of CD19+ B cells | 89341-2 |
3324 | CD19 (B Cells) | 8116-6 |
4054 | % CD16+CD56 (NK cells) | 8112-5 |
30312 | CD21+ % of CD19+ B cells | 89356-0 |
30314 | CD21- % of CD19+ B cells | 89355-2 |
4055 | CD16+CD56 (NK cells) | 20402-4 |
3327 | 4/8 Ratio | 54218-3 |
30297 | CD19+ | 8116-6 |
29095 | CD20+ | 9558-8 |
6657 | Comment | 80722-2 |
30299 | CD27+ | 89353-7 |
30301 | CD27+ IgM+ IgD+ | 89351-1 |
30303 | CD27+ IgM- IgD- | 89349-5 |
30305 | CD27+ IgM+ IgD- | 89347-9 |
30307 | IgM+ | 89345-3 |
30309 | CD38+ IgM- | 89343-8 |
30311 | CD38+ IgM+ | 89357-8 |
30313 | CD21+ | 25164-5 |
30315 | CD21- | 89354-5 |
30316 | Interpretation | 80722-2 |
Method Description
Quantitative Lymphocyte Subsets: T, B, and NK:
The T, B, and natural killer (NK)-cell surface marker assay uses monoclonal antibodies to identify the various membrane antigens, and flow cytometry to enumerate the number of cells expressing these differentiation antigens. CD14 is used to exclude monocytes, thereby improving accuracy and enhancing the purity of the lymphocyte population. The results are reported as the percent of lymphocytes that are total T cells (CD3+), CD3+CD4+ T cells, CD3+CD8+ T cells, natural killer (CD16+56+, CD3-), and B-lymphocytes (CD19+), and the absolute number of each cell type per mL of blood. The assay is a 7-color no-wash procedure and the absolute counts are calculated from internal bead standards. In addition, the total lymphocyte count and the CD4:CD8 ratio are reported.(Hoffman RA, Kung PC, Hansen WP, Goedstien G: Simple and rapid measurement of human T lymphocytes and their subclasses in peripheral blood. Proc Natl Acad Sci USA, 1980:77:4914-4917; US Department of Health and Human Services: Guidelines for performance of CD4+ T-cell determinations in persons with human immunodeficiency virus infection. MMWR Morb Mortal Wkly Rep 1997;46 no. RR-2 pp 1-29).
Immune Assessment B Cell Subsets, Blood:
Peripheral blood mononuclear cells (PBMC) are isolated from whole blood using a Ficoll gradient and used in the staining protocol. The assay involves a multicolor 5-tube panel for the following antibodies: CD45, CD19, CD20, CD27, IgD, IgM, CD38, and CD21. After the staining with specific antibody, the cells are washed and fixed with paraformaldehyde and then analyzed by flow cytometry on a Becton Dickinson FACS Canto instrument. The cell-surface expression is denoted as the percent of CD19+ B cells expressing each of the specific markers. CD19+ and CD20+ B cells are expressed as a percent of the total lymphocytes (CD45+). The absolute counts for the B-cell subsets are derived from flow cytometry analysis of whole blood using monoclonal antibodies to identify CD45, CD3, CD4, CD8, CD19, and CD16+CD56+. CD14 is used to exclude monocytes, thereby improving accuracy and enhancing the purity of the lymphocyte population. The assay is a 7-color, lyse-no wash procedure and the absolute counts are calculated from internal bead standards. The absolute lymphocyte count per microliter is used to calculate the absolute counts of the various B-cell subsets in this assay (Unpublished Mayo method).
Common Variable Immunodeficiency Confirmation Flow Panel:
Peripheral blood mononuclear cells are isolated and stained with CD19, transmembrane activator and calcium modulator and cyclophilin ligand (CAML) interactor (TACI), and B-cell-activating factor receptor (BAFF-R), each conjugated to a fluorochrome. After the staining with specific antibody, the cells are washed, fixed with paraformaldehyde, and then analyzed by flow cytometry on a Becton Dickinson FACS Canto instrument. The cell-surface expression is denoted as the percent of CD19+ B cells expressing TACI and BAFF-R.(Unpublished Mayo method)
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Method Name
TBBS: Flow Cytometry
IABC: Fluorescent Flow Cytometry