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86177
bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat
proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to
sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Useful For: Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease
and to define the allergens responsible for eliciting signs and symptoms. Testing also may be useful to
identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm
sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of
allergic reactions to insect venom allergens, drugs, or chemical allergens.
Interpretation: Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased
likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be
responsible for eliciting signs and symptoms. The level of IgE antibodies in serum varies directly with the
concentration of IgE antibodies expressed as a class score or kU/L.
Reference Values:
Class IgE kU/L Interpretation
0 Negative
1 0.35-0.69 Equivocal
2 0.70-3.49 Positive
3 3.50-17.4 Positive
4 17.5-49.9 Strongly positive
5 50.0-99.9 Strongly positive
6 > or =100 Strongly positive Reference values
apply to all ages.
Clinical References: Homburger HA: Allergic diseases. In Clinical Diagnosis and Management by
Laboratory Methods. 21st edition. Edited by RA McPherson, MR Pincus. New York, WB Saunders
Company, 2007, Chapter 53, Part VI, pp 961-971
Synovial Sarcoma (SS), 18q11.2 (SS18 or SYT) Rearrangement,
FISH, Tissue
Clinical Information: Synovial sarcoma (SS) is a malignant soft tissue tumor that predominantly
occurs in the lower limbs of children and young adults. This tumor accounts for approximately 5% to 10%
of soft tissue tumors, has a poor prognosis, and may occur in other areas of the body such as head and
neck, heart, abdominal wall, mediastinum, and lung, in addition to the extremities. Histologically, SS is
grouped either into the monophasic subtype consisting of mostly spindle cells or the biphasic subtype
consisting of epithelial and spindle cells. Depending on the site of origin, the differential diagnosis of SS
can include mesothelioma, fibrosarcoma, solitary fibrous tumor, leiomyosarcoma, malignant peripheral
nerve sheath tumors, epithelioid sarcoma, and clear cell sarcoma. In addition, when the SS is poorly
differentiated, the differential diagnosis broadens to include the small round-blue cell tumors (Ewing
sarcoma, alveolar rhabdomyosarcoma, and neuroblastoma). Accurate diagnosis of SS is important for
appropriate clinical management of patients. Although immunohistochemical (IHC) markers can be
helpful in the correct diagnosis of these various tumor types, recent molecular studies have shown the
superior specificity of molecular markers in differentiating SS from other tumors. A recurrent,
tumor-specific translocation t(X;18)(p11.2;q11.2) is observed in approximately 90% of synovial
sarcomas. A single gene, SS18 (SYT), has been implicated on 18q11.2, while 1 of 3 related genes, SSX1,
SSX2, or infrequently SSX4, is usually involved on Xp11.2. The prevalence of SS18-SSX1 is about twice
that of SS18-SSX2 in most studies. Detection of these transcripts is usually performed by reverse
transcriptase-PCR (RT-PCR) (#83361 Synovial Sarcoma by Reverse Transcriptase PCR, Paraffin), which
allows specific identification of SS18-SSX1 or SS18-SSX2. Identification of the SS18-SSX1 fusion is
associated with an unfavorable outcome with significantly shorter overall survival when compared to the
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