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HelpTest Code SOFT:Z1000 Tetanus Toxoid IgG Antibody, Serum
Additional Codes
HOM: Misc Lab
Mayo Test ID: TTIGS
Reporting Name
Tetanus Toxoid IgG Ab, SUseful For
Assessing antibody response to the tetanus toxoid vaccine, which should be performed at least 3 weeks after immunization
Aiding in the evaluation of immunodeficiency
This test should not be used to diagnose tetanus infection.
Method Name
Enzyme Immunoassay (EIA)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 30 days | |
| Frozen | 30 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
Vaccinated: Positive (≥0.01 IU/mL)
Unvaccinated: Negative (<0.01 IU/mL)
Day(s) Performed
Monday through Friday
CPT Code Information
86317
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TTIGS | Tetanus Toxoid IgG Ab, S | 53935-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| TETG | Tetanus IgG Ab | 26643-7 |
| DEXTG | Tetanus IgG Value | 53935-3 |
Clinical Information
Tetanus results from contamination of wounds or lacerations with Clostridium tetani spores from the environment. The spores germinate to actively replicating bacterial cells localized within the wound and produce the heat-labile toxin tetanospasmin. Tetanospasmin attaches to peripheral nerve endings and travels to the central nervous system where it blocks inhibitory impulses to motor neurons and leads to severe, spastic muscle contractions, a classic characteristic of tetanus.
The disease is preventable by vaccination with tetanus toxoid (formaldehyde-treated tetanospasmin), which stimulates development of antitetanus toxoid antibodies. In the United States, tetanus toxoid is administered to children as part of the combined diphtheria, tetanus, and acellular pertussis (TDaP) vaccine.
Two to 3 weeks following vaccination, a patient's immunological response may be assessed by measuring the total antitetanus toxoid IgG antibody level in serum. An absence of antibody formation postvaccination may relate to immune deficiency disorders, either congenital or acquired, or iatrogenic due to immunosuppressive drugs.
Interpretation
Results greater than or equal to 0.01 suggest a vaccine response.
A tetanus toxoid booster should be strongly considered for patients with anti-tetanus toxoid IgG values between 0.01 and 0.5 IU/mL.
Some cases of tetanus, usually mild, have occasionally been observed in patients with a measurable serum level of 0.01 to 1.0 IU/mL.
Cautions
This test should not be used to diagnose tetanus infection. The diagnosis of tetanus is by clinical observation. A positive wound culture for the agent of tetanus, Clostridium tetani, may support, but does not confirm, the diagnosis. Toxin assays for tetanospasmin may be useful but are only available in a few laboratories.
The results obtained from this assay are not diagnostic proof of lack of protection against tetanus or the presence/absence of immunodeficiency.
Supportive Data
A total of 227 serum samples prospectively submitted to our laboratory for routine antitetanus toxoid IgG testing by the Binding Site Anti-Tetanus Toxoid IgG enzyme-linked immunosorbent assay (ELISA) were also evaluated by the EuroImmun Anti-Tetanus Toxoid IgG ELISA. Results are summarized in the table:
Table. Comparison of the EuroImmun and Binding Site Anti-Tetanus Toxoid IgG ELISAs
|
|
Binding Site IgG ELISA |
|
||
|
Positive |
Negative |
Total |
||
|
EuroImmun IgG ELISA |
Positive |
220 |
0 |
220 |
|
Negative |
6(a) |
1 |
7 |
|
|
|
Total |
226 |
1 |
227 |
a) 3 of the 6 samples tested positive by the anti-Tetanus Toxoid IgG Quantitative Multiplex Bead Assay at ARUP
% Positive Agreement: 97.4% (220/226); 95% CI: 94.2-98.9%
% Negative Agreement: 100% (1/1); 95% CI: 16.8-100%
% Overall Agreement: 97.4% (221/227); 95% CI: 94.2-98.9%
Clinical Reference
1. Boland Birch T, Bleck TP. Tetanus (Clostridium tetani). In Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2948-2953
2. Gergen PJ, McQuillan GM, Kiely M, et al. A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med. 1995;332(12):761-766
3. Bjorkholm B, Wahl M, Granstrom M, Hagberg L. Immune status and booster effects of low doses of tetanus toxoid in Swedish medical personnel. Scand J Infect Dis. 1994;26(4):471-475
4. Ramsay ME, Corbel MJ, Redhead K, et al. Persistence of antibody after accelerated immunization with diptheria/tetanus/pertussis vaccine. BMJ. 1991;302(6791):1489-1491
5. Rubin RL, Tang FL, Chan EK, et al. IgG subclasses of anti-tetanus toxoid antibodies in adult and newborn normal subjects and in patients with systemic lupus erythematosus, Sjogren's syndrome, and drug-induced autoimmunity. J Immunol. 1986;137(8):2522-2527
6. Simonsen O, Bentzon MW, Heron I. ELISA for the routine determination of antitoxic immunity to tetanus. J Biol Stand. 1986;14(3):231-239
Method Description
The Anti-Tetanus Toxoid enzyme-linked immunosorbent assay provides a quantitative in vitro assay for detecting human IgG-class antibodies to Tetanus toxoid. The test kit contains reagent wells coated with tetanus toxoid. In the first reaction step, diluted patient samples are incubated in the wells. In the case of positive samples, specific IgG antibodies will bind to the antigens. To detect the bound antibodies, a second incubation is carried out using an enzyme-labeled anti-human IgG (enzyme conjugate), catalyzing a color reaction.(Unpublished Mayo method)
Report Available
Same day/1 to 4 daysSpecimen Retention Time
14 daysTest Classification
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.Secondary ID
36667Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.