PROPERTIES
AND UNITS IN THE CLINICAL LABORATORY SCIENCES
XVI.
PROPERTIES AND UNITS IN CLINICAL ALLERGOLOGY
(Technical report IUPAC-IFCC 1999)
Prepared for publication by
Ivan Bruunshuus1, Lars K. Poulsen2 , Henrik Olesen1
1Office of
Laboratory Informatics, Copenhagen University Hospital (Rigshospitalet),
Copenhagen, Denmark
2Laboratory
of Medical Allergology, TA 7542, Copenhagen University Hospital
(Rigshospitalet), Copenhagen, Denmark
#The combined Memberships of the
Commission and the Committee during the preparation of this report (1992 to
1996) were as follows:
Chairman: 1998 - 1999 X. Fuentes-Arderiu
(Spain); 1996 - 1997 D. Kenny
(Ireland); 1989 - 1995 H. Olesen (Denmark). Members:
X.
Fuentes-Arderiu (Spain;
1991-1997); J.G. Hill (Canada; 1987-1997); D. Kenny (Ireland; 1994-1997); H.
Olesen (Denmark; 1985-1995); PL
Storring (United Kingdom; 1989-1995); P Soares de Araujo (Brazil; 1994-1997);
René Dybkær (Denmark; 1996-1997); Clem McDonald (USA; 1996-1997).
Please forward comments to: I. Bruunshuus, Office of Laboratory Informatics 76-6-1, Copenhagen
University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. E-mail:
[email protected]
Synopsis
The
subject field of clinical allergology deals
with many hundred different allergens from all parts of the human
environment and the number steadily increases. Not all of the allergens are
strictly defined in chemical terms and
procedures for detection of antibodies against the allergens in the human vary.
This document deals with the presentation of request and report on such
properties according to some international rules and the allocation of code
values representing the concept
delineated.
The coding scheme thus prepared is
imperfect and needs further elaboration as allergens become more well defined.
It is a step toward harmonization, in particular as concerns the coding system
applied.
The
net outcome is a coding scheme for use in electronic transmission.
Preface
The present document is the sixteenth part (XVI) of a series on
properties observed in the clinical laboratory sciences initiated in 1987.
The series will comprise the five general parts
(I-IV and XI) and a series of special parts:
I Syntax
and semantic rules [1]
II Kinds-of-property
[2]
III Elements (of properties) and their code
values
IV Properties and their code values
V Properties and units in Thrombosis and
Haemostasis
VI Properties and units in IOC prohibited
Drugs
VII Properties and units in Inborn Errors of
Metabolism
VIII Properties
and units in Clinical Bacteriology
IX Properties and units in Trace Elements
X Properties and units in General Clinical
Chemistry
XI Coding
systems - structure and guidelines [3]
XII Properties and units in Clinical
Pharmacology and Toxicology
XIII Properties
and units in Reproduction and Fertility
XVI Properties
and units in Clinical Allergology (this report)
The NCCLS code values are
reproduced with permission, from NCCLS publication
I/LA20-P [4].
Foreword and Scope
Basic research in biology and medicine and innovations in laboratory
methodology have greatly increased the range of properties available to medical
practitioners to help them in decisions on diagnosis, treatment and
prevention of disease.
The plethora is now such that
the individual doctor has insight in or understanding of only a limited number
of properties offered to him from the various clinical laboratory specialities.
In the laboratory, local terms
(jargon) may be well understood among colleagues, but they are not appropriate
for communication with the outside world. Likewise, a laboratory and its local
community of users, such as hospital or community physicians, may use a
"local dialect" of the language of clinical laboratory sciences which
is well understood by all concerned, but when the communication possibilities
are wider, even transnational, risks of serious misunderstanding arise.
In addition, the terminology
used by one laboratory speciality may vary even within the speciality, and may
be incomprehensible to another speciality. This is a minor inconvenience to the
laboratory specialities, each one essentially operating within its own area of
activity. However, for the user this is highly unsatisfactory and also it may
hinder treatment of the patient.
It is therefore essential to
promote clear, unambiguous, meaningful and fully informative communication.
Also coherence of statements made within and between medical specialities,
and uniformity in structure of
presentation is to be strived for. This will facilitate transfer of information
over cultural, alphabetic and language areas.
The purpose of this document
is to apply the syntax structures for request and report recommended by the
European standards ENV 1614:1995 [6]
and ENV 12435:1996 [7] and by IUPAC–IFCC
[1, 5], providing formats and names of properties observed in the domain of
Clinical Allergology, in order to facilitate unequivocal written or electronic
communication between health care professionals.
The
systematic names recommended here are primarily for the purpose of unambiguous
data exchange. Their use in routine language by clinicians or laboratory
practitioners is optional but encouraged.
Special Features
The term “arbitrary” in princible cannot be
related to a volume. In clinical chemistry however a less well defined
“inhouse” or a regional calibrator is often referred to and is expressed in
“arbitrary unit per litre” in order to enable comparison of patient data over
time and regionally. In each of these instances further information should be given
in the parenthesis “procedure”. This could be information on the calibrator
used, f.ex. “BCR/CRM148/149R“ or it could refer to the inlaboratory
document “procedure xx”. which is available on request (point 2.2.1 below).
In the examples given, a question mark, “?”, has
been used to represent the value of a result for properties including
quantities.
1.
Names
of component. Both in histamine release and for antibodies,
part of the name is from food, dust, poison or other parts of the human
environment. For identification of these complex materials, the NCCLS code
values have been added as a specification after the kind-of-property.
EXAMPLE 1
Basophilocytes(Blood)—
Candida albicans induced HR;
arbitrary
concentration(NCCLS/m5; procedure)
[NPU08867]
Basocs.(B)—Candida albicans induced HR;
arb.c.(NCCLS/m5; 0 1 2 3) = ?
The NCCLS code values are also
used for classification into lists for ease of
assembling panels by the individual clinical laboratory.
2. Kinds-of-property. These comprise:
2.1 arbitrary concentration
denoting an ordinal scale of the type 0 1 2; 0 1 2 3 4 5, etc.
EXAMPLE 2
Plasma—
Candida albicans antibody(Immunoglobulin
E);
arbitrary concentration (NCCLS/m5;
procedure)
[NPU11311]
P—Candida albicans antibody(IgE);
arb.c.(NCCLS/m5; 0 1) = ?
2.2 arbitrary substance
concentration, that is a ratio scale of the dimension L-3N, where
the unit is not traceable to SI.
2.2.1 When the calibrator used is
produced locally, arbitrary unit/litre applies.
EXAMPLE 3
Plasma—
Candida albicans antibody(Immunoglobulin
E);
arbitrary substance concentration(NCCLS/m5; procedure)
arbitrary
unit/litre
[NPU13064]
P—Candida albicans antibody(IgE);
arb.subst.c.(NCCLS/m5) = ? × 10³ arb.unit/l
2.2.2 When the calibrator is
traceable to an WHO international reference material, international unit/litre
applies.
EXAMPLE 4
Plasma—
Candida albicans antibody(Immunoglobulin
E);
arbitrary substance
concentration(WHO75/502; NCCLS/m5; procedure)
10³ international unit/litre
[NPU10865]
P—Candida albicans
antibody(IgE); arb.subst.c.(IRP 75/502; NCCLS/m5) = ? × 10³ int.unit/l
3. Specification after kind-of-property
These
may indicate the WHO international reference preparation(IRP) used for callibration,
inform on the NCCLS identifier for the component, inform on the procedure used
in that particular laboratory ("procedure 65" or "firm xx")
or indicate that a list of properties follows.
EXAMPLE 5
[NPU13456]P—Dust mite allergen
antibody(IgE); arb.c.(list; NCCLS/d; proc.)
[NPU11248] P—Acarus siro antibody(IgE); arb.c.(NCCLS/d70; proc.) = ?
[NPU11325] P—Dermatophagoides farinae antibody(IgE); arb.c.(NCCLS/d2; proc.) = ?
[NPU11326] P—Dermatophagoides microceras antibody(IgE); arb.c.(NCCLS/d3; proc.)
= ?
[NPU11327] P—Dermatophagoides pteronyssinus antibody(IgE); arb.c.(NCCLS/d1;
proc.) = ?
[NPU11353] P—Euroglyphus maynei antibody(IgE); arb.c.(NCCLS/d74; proc.) = ?
[NPU11373] P—Glycyphagus domesticus antibody(IgE); arb.c.(NCCLS/d73; proc.) = ?
[NPU11497] P—Lepidoglyphus destructor antibody(IgE); arb.c.(NCCLS/d71; proc.) =
?
[NPU11669] P—Tyrophagus putrescentiae antibody(IgE); arb.c.(NCCLS/d72; proc.) =
?
EXAMPLE 6
[NPU13457]P—Dust mite allergen antibody(IgE);
arb.subst.c.(list; NCCLS/d; proc.)
[NPU13001] P—Acarus siro antibody(IgE);
arb.subst.c.(NCCLS/d70; proc.) = ? × 10³ arb.unit/l
[NPU13078]
P—Dermatophagoides farinae
antibody(IgE); arb.subst.c.(NCCLS/d2; proc.) = ? × 10³ arb.unit/l
[NPU13079] P—Dermatophagoides
microceras antibody(IgE); arb.subst.c.(NCCLS/d3; proc.) = ? × 10³
arb.unit/l
[NPU13080]
P—Dermatophagoides pteronyssinus
antibody(IgE); arb.subst.c.(NCCLS/d1; proc.) = ? × 10³ arb.unit/l
[NPU13106] P—Euroglyphus maynei antibody(IgE); arb.subst.c.(NCCLS/d74; proc.) =
? × 10³ arb.unit/l
[NPU13126] P—Glycyphagus domesticus antibody(IgE); arb.subst.c.(NCCLS/d73;
proc.) = ? × 10³ arb.unit/l
[NPU13250] P—Lepidoglyphus destructor antibody(IgE); arb.subst.c.(NCCLS/d71;
proc.) = ? × 10³ arb.unit/l
[NPU13422] P—Tyrophagus putrescentiae antibody(IgE); arb.subst.c.(NCCLS/d72;
proc.) = ? × 10³ arb.unit/l
EXAMPLE 7
[NPU13458]P—Dust mite allergen antibody(IgE);
arb.subst.c.(list; IRP 75/502; NCCLS/d; proc.)
[NPU10802] P—Acarus siro antibody(IgE); arb.subst.c.(IRP 75/502; NCCLS/d70;
proc.) = ? × 10³ int.unit/l
[NPU10879] P—Dermatophagoides farinae antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d2; proc.) = ? × 10³ int.unit/l
[NPU10880] P—Dermatophagoides microceras antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d3; proc.) = ? × 10³ int.unit/l
[NPU10881] P—Dermatophagoides pteronyssinus antibody(IgE);
arb.subst.c.(IRP 75/502; NCCLS/d1; proc.) = ? × 10³ int.unit/l
[NPU10907] P—Euroglyphus maynei antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d74; proc.) = ? × 10³ int.unit/l
[NPU10927] P—Glycyphagus domesticus antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d73; proc.) = ? × 10³ int.unit/l
[NPU11051] P—Lepidoglyphus destructor antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d71; proc.) = ? × 10³ int.unit/l
[NPU11223] P—Tyrophagus putrescentiae antibody(IgE); arb.subst.c.(IRP 75/502;
NCCLS/d72; proc.) = ? × 10³ int.unit/l
4. General approach
The NCCLS coding scheme comprises 361 allergens.
The approach, in a particular case of allergy, is to request a property that
concerns a mixture of allergens at first.
If the outcome is
affirmative, then to request the properties included in the mixture,
individually.
EXAMPLE 8
Initially:
|
NPU14814 |
|
P— |
Occupational
allergen antibody(IgE); arb.c.(NCCLS/(m3; m6; g15; g12); 0 1) = 1 |
|
Then: |
|
|
|
|
NPU11259 |
|
P— |
Alternaria alternata antibody(IgE); arb.c.(NCCLS/m6; 0 1) = 0 |
|
NPU11277 |
|
P— |
Aspergillus fumigatus antibody(IgE);
arb.c.(NCCLS/m3; 0 1) = 1
|
|
NPU11423 |
|
P— |
Wheat grass antibody(IgE);
arb.c.(NCCLS/g15; 0 1) = 0 |
|
NPU09341 |
|
P— |
Rye antibody(IgE); arb.c.(NCCLS/g12; 0 1) = 0
|
|
Or: |
|
|
|
|
NPU13012 |
|
P— |
Alternaria alternata antibody(IgE); arb.subst.c.(NCCLS/m6; Firm
A) = 0 × 10³ arb.unit/l |
|
NPU13030 |
|
P— |
Aspergillus fumigatus antibody(IgE); arb.subst.c.(NCCLS/m3; Firm A) = 200 × 10³ arb.unit/l |
|
NPU13176 |
|
P— |
Wheat grass antibody(IgE);
arb.subst.c.(NCCLS/g15; Firm A) = 0 × 10³ arb.unit/l |
|
NPU09343 |
|
P— |
Rye antibody(IgE);
arb.subst.c.(NCCLS/g12; Firm A) = 0 × 10³ arb.unit/l |
|
Or: |
|
|
|
|
NPU10813 |
|
P— |
Alternaria alternata antibody(IgE); arb.subst.c.(IRP 75/502; NCCLS/m6; Firm B) = 0 × 10³
int.unit/l |
|
NPU10831 |
|
P— |
Aspergillus fumigatus antibody(IgE); arb.subst.c.(IRP 75/502; NCCLS/m3; Firm B) = 300 × 10³
int.unit/l |
|
NPU10977 |
|
P— |
Wheat grass antibody(IgE);
arb.subst.c.(IRP 75/502; NCCLS/g15; Firm B) = 0 × 10³
int.unit/l |
|
NPU09342 |
|
P— |
Rye antibody(IgE); arb.subst.c.(IRP
75/502; NCCLS/g12; Firm B) = 0 × 10³ int.unit/l |
|
For completion |
|
|
|
|
NPU13471 |
|
P— |
Fungus-antistof(IgE);
arb.k.(liste; NCCLS/m; proc.) |
|
NPU11259 |
|
P— |
Alternaria alternata antibody(IgE); arb.c.(NCCLS/m6; proc.) = ? |
|
NPU11260 |
|
P— |
Alternaria tenuis antibody(IgE); arb.c.(NCCLS/m6; proc.) = ? |
|
NPU11277 |
|
P— |
Aspergillus fumigatus antibody(IgE);
arb.c.(NCCLS/m3; proc.) = ? |
|
NPU11279 |
|
P— |
Aureobasidium pullulans antibody(IgE); arb.c.(NCCLS/m12; proc.) = ? |
|
NPU11299 |
|
P— |
Botrytis cinerea antibody(IgE); arb.c.(NCCLS/m7; proc.) = ? |
|
NPU11311 |
|
P— |
Candida albicans antibody(IgE); arb.c.(NCCLS/m5; proc.) = ? |
|
NPU11314 |
|
P— |
Cephalosporum acremonium antibody(IgE); arb.c.(NCCLS/m202; proc.) = ? |
|
NPU11322 |
|
P— |
Cladosporium herbarum antibody(IgE); arb.c.(NCCLS/m2; proc.) = ? |
|
NPU11323 |
|
P— |
Curvularia lunata
antibody(IgE); arb.c.(NCCLS/m16; proc.) = ? |
|
NPU11348 |
|
P— |
Epicoccum purpurascens
antibody(IgE); arb.c.(NCCLS/m14; proc.) = ? |
|
NPU11362 |
|
P— |
Fusarium moniliforme
antibody(IgE); arb.c.(NCCLS/m9; proc.) = ? |
|
NPU11399 |
|
P— |
Helminthosporium halodes
antibody(IgE); arb.c.(NCCLS/m8; proc.) = ? |
|
NPU11525 |
|
P— |
Mucor racemosus
antibody(IgE); arb.c.(NCCLS/m4; proc.) = ? |
|
NPU13484 |
|
P— |
Penicillium expansum antibody(IgE); arb.c.(NCCLS/m28; proc.) = ? |
|
NPU11570 |
|
P— |
Penicillium notatum antibody(IgE); arb.c.(NCCLS/m1; proc.) = ? |
|
NPU11572 |
|
P— |
Penicillium roqueforti antibody(IgE); arb.c.(NCCLS/m30; proc.) = ? |
|
NPU11575 |
|
P— |
Phoma betae
antibody(IgE); arb.c.(NCCLS/m13; proc.) = ? |
|
NPU11581 |
|
P— |
Pityrosporum orbiculare antibody(IgE); arb.c.(NCCLS/m70; proc.) = ? |
|
NPU11582 |
|
P— |
Pityrosporum ovale antibody(IgE); arb.c.(NCCLS/m40; proc.) = ? |
|
NPU11599 |
|
P— |
Rhizopus nigricans antibody(IgE); arb.c.(NCCLS/m11; proc.) = ? |
|
NPU11600 |
|
P— |
Rhodotorula rubra antibody(IgE); arb.c.(NCCLS/m35; proc.) = ? |
|
NPU11642 |
|
P— |
Stemphylium botryosum antibody(IgE); arb.c.(NCCLS/m10; proc.) = ? |
|
NPU11663 |
|
P— |
Trichoderma viride antibody(IgE); arb.c.(NCCLS/m15; proc.) = ? |
|
NPU11664 |
|
P— |
Trichosporon pullulans antibody(IgE); arb.c.(NCCLS/m203; proc.) = ? |
|
NPU11665 |
|
P— |
Tricophyton rubrum antibody(IgE); arb.c.(NCCLS/m205; proc.) = ? |
|
NPU11670 |
|
P— |
Ulocladium chartarum
antibody(IgE); arb.c.(NCCLS/m204; proc.) = ? |
|
NPU11677 |
|
P— |
Ustilago nuda/tritici
antibody(IgE); arb.c.(NCCLS/m201; proc.) = ? |
Elements of an Entry
The terms recommended are given in bold, that is: the term for the type
property, the unit, and the code value.
1
Name of system and
parenthetic specification spelled out in full, and followed by a long dash (em
dash).
2
Alphanumeric
chemical prefixes to component name.
3
Recommended name of
component and parenthetic specification. Shifted to the left for
alphabetical sorting and searching, and
followed by a semicolon.
4 Kind-of-property and parenthetic specification.
5 Unit.
6 Other term(s).
7 Note(s) with any further information.
8
[NPUXXXXX]
Coding scheme identifier and code
value, intended for interlaboratory transmission between databases.
9 Example in abbreviated form.
References
1. IUPAC–
IFCC (International Union of Pure and Applied Chemistry–International
Federation of Clinical Chemistry), Commission/Committee on Quantities and Units
(in Clinical Chemistry). Properties and units in the clinical laboratory
sciences. I. Syntax and semantic rules. Recommendations 1995. Prepared for
publication by Olesen H. Pure & Appl
Chem 1995; 67: 1563-74. Eur J Clin
Chem Clin Biochem 1995; 33: 627-36. Clin
Chim Acta 1996; 245: S5-S21.
2. IUPAC–IFCC
(International Union of Pure and Applied Chemistry–International Federation of
Clinical Chemistry), Commission/Committee on Nomenclature, Properties and
Units. Properties and units in the clinical laboratory sciences. II.
Kinds-of-property. Recommendations 1996. Prepared for publication by Kenny D,
Olesen H. Eur J Clin Chem Clin Biochem
1997; 35: 317-44.
3. IUPAC–IFCC
(International Union of Pure and Applied Chemistry– International Federation of
Clinical Chemistry), Commission-Committee on Nomenclature,
Properties and Units. Properties and units in the clinical laboratory sciences.
XI. Coding systems - structure and guidelines. (Technical report 1997).
Prepared for publication by H Olesen, D Kenny, R Dybkær, I Ibsen, I Bruunshuus,
X Fuentes-Arderiu, G Hill, P Soares de Araujo, C McDonald. Pure and Appl
Chem 1997; 35: 317-44.
4. NCCLS.
Evaluation Methods and Performance Characteristics of Immunological Assays for
Human Immunoglobulin E (IgE) Antibodies of Defined Allergen Specificities;
Proposed Guideline. NCCLS document I/LA20-P (ISBN 1-56238-304-3), NCCLS, 940
West Valley Road, Suite 1400, Wayne, Pennsylvania 19087, 1996.
5. IUPAC–IFCC
(International Union of Pure and Applied Chemistry–International Federation of
Clinical Chemistry), Commission/Committee on Quantities and Units(in Clinical
Chemistry), 1995. Compendium of terminology and nomenclature of properties in
clinical laboratory sciences. Recommendations 1995. Prepared for publication by
J.C. Rigg, S.S. Brown, R. Dybkaer, H. Olesen. Oxford: Blackwell Science, 290
pp.
6. CEN/TC
251, 1995. European standard ENV 1614:1995. Medical informatics. Structure for
nomenclature, classification and coding
of properties in clinical laboratory sciences.
7. CEN/TC
251, 1996. European standard ENV 12435:1996. Medical informatics. Expression of
the results of measurement in health sciences.
Index of Abbreviations
IFCC International Federation of Clinical
Chemistry
IRP International Reference Preparation
IUPAC International
Union of Pure and Applied Chemistry
NCCLS National
Committee for Clinical Laboratory Standards
SI International System of Units
WHO World Health Organization