Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis

Wallach’s

Interpretation
of
Diagnostic Tests

Pathways to Arriving at a Clinical Diagnosis

TENTH EDITION

Wallach’s

Interpretation
of
Diagnostic Tests

Pathways to Arriving at a Clinical Diagnosis

TENTH EDITION

Edited by

Mary A. Williamson, MT (ASCP), PhD

Vice President, Scientific Affairs & Laboratory Operations

ACM Medical Laboratory

Rochester, New York

Former Assistant Professor

Department of Pathology

University of Massachusetts Medical School

Worcester, Massachusetts

L. Michael Snyder, MD

Professor

Department of Medicine and Pathology

University of Massachusetts Medical School

UMass Memorial Medical Center

Worcester, Massachusetts

Chief Medical Officer

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Executive Editor:
Rebecca Gaertner
Senior Product Development Editor:
Kristina Oberle
Production Project Manager:
Alicia Jackson
Design Coordinator:
Joan Wendt
Senior Manufacturing Coordinator:
Beth Welsh
Marketing Manager:
Stephanie Manzo
Prepress Vendor:
SPi Global

Printed in China

Copyright © 2015 Wolters Kluwer

© 2011, 2007 by LIPPINCOTT WILLIAMS & WILKINS, a Wolters Kluwer Business, © 2000 by Lippincott Williams & Wilkins, © 1996, 1992 and 1986 by Jacques Wallach, MD, © 1978, 1974 and 1970 by Little, Brown and Company

Two Commerce Square
2001 Market Street
Philadelphia, PA 19103 USA
LWW.com

All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
[email protected]
, or via our website at
lww.com
(products and services).

Library of Congress Cataloging-in-Publication Data
Wallach's interpretation of diagnostic tests. — Tenth edition / edited by Mary A. Williamson, L. Michael Snyder.
    p. ; cm.
  Includes bibliographical references and index.
ISBN 978-1-4511-9176-9 (paperback : alk. paper)
I. Williamson, Mary A., editor. II. Snyder, L. Michael, editor.
  [DNLM: 1. Clinical Laboratory Techniques. 2. Diagnostic Techniques and Procedures. QY 25]
RB38.2
616.07'56—dc23

2014012353

Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations.
    The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.
    Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice.

9 8 7 6 5 4 3 2 1

I am deeply grateful to my parents Priscilla and Thomas Williamson for their unconditional love. Sincere thanks to Joanne Saksa for her gracious hospitality and warmest gratitude to Brenda DeMay, for her unconditional love and continually encouraging me to challenge myself.

I am most indebted to Dr. L. Michael Snyder, a true mentor throughout the years who has taught me that anything is possible— even the Boston Red Sox can win the World Series! Special thanks to all of the authors for their hard work and commitment, especially Liberto Pechet, a true gentleman.
Mary A. Williamson, MT(ASCP), PhD

To my wife Barbara, and children Cathe, Lizzy, and John for their tireless understanding and support throughout the years.

To my assistant Suzanne O’Brien for her dedication and help with the textbook.

I would also like to acknowledge Dr. Mary Williamson, for without her commitment, dedication and hard work, we would not have met the target date for completion of the tenth edition.
L. Michael Snyder, MD

Contributors

M. Rabie Al-Turkmani, BPharm, PhD

Assistant Professor

Department of Pathology

University of Massachusetts Medical School

Associate Director, Immunology, Immunoassay & Hematology Laboratories

UMass Memorial Medical Center

Worcester, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Vishesh Chhibber

Medical Director, Transfusion Medicine

North Shore University Hospital

Hofstra North Shore-LIJ School of Medicine North Shore-LIJ Health System

Manhasset, New York

Marzena M. Galdzicka, PhD, MP(ASCP)
^CM
, DABCC

Clinical Assistant Professor

Department of Pathology

University of Massachusetts Medical School

Shrewsbury, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Edward I. Ginns, MD, PhD, DABCC

Professor of Neurology, Pathology, Pediatrics and Psychiatry

Director, Lysosomal Disorders Treatment and Research Program

University of Massachusetts Medical School

Shrewsbury, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Amanda J. Jenkins, PhD

Associate Professor

Department of Pathology

University of Massachusetts Medical School

Director, Toxicology

UMass Memorial Medical Center

Worcester, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Charles R. Kiefer, PhD

Associate Professor

Department of Pathology

University of Massachusetts Medical School

Director, Andrology Laboratory

Director, Clinical Assay Research

UMass Memorial Medical Center

Worcester, Massachusetts

Patricia Minehart Miron, PhD

Clinical Associate Professor of Pathology and Pediatrics

University of Massachusetts Medical School

Director, Cytogenetics

UMass Memorial Medical Center

Worcester, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Michael J. Mitchell, MD

Clinical Associate Professor

Department of Pathology

University of Massachusetts Medical School

Director, Microbiology

UMass Memorial Medical Center

Worcester, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Liberto Pechet, MD

Professor Emeritus

Departments of Pathology and Medicine

University of Massachusetts Medical School

Worcester, Massachusetts

Lokinendi V. Rao, PhD

Clinical Associate Professor

Department of Pathology

University of Massachusetts Medical School

Laboratory Director, UMass Memorial Clinical Laboratories

UMass Memorial Medical Center

Worcester, Massachusetts

Scientific Director,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Craig S. Smith, MD

Assistant Professor

Department of Medicine

University of Massachusetts Medical School

Director, Cardiac Intensive Care

Division of Cardiology

UMass Memorial Medical Center

Worcester, Massachusetts

L. Michael Snyder, MD

Professor

Department of Medicine and Pathology

University of Massachusetts Medical School

UMass Memorial Medical Center

Worcester, Massachusetts

Chief Medical Officer,

Quest Diagnostics MA, LLC

Marlborough, Massachusetts

Juliana G. Szakacs, MD, MSW

Director of Pathology and Laboratory Medicine

Harvard Vanguard Medical Associates

Boston, Massachusetts

Mary A. Williamson, MT (ASCP), PhD

Vice President, Scientific Affairs & Laboratory Operations

ACM Medical Laboratory

Rochester, New York

Former Assistant Professor

Department of Pathology

University of Massachusetts Medical School

Worcester, Massachusetts

Hongbo Yu, MD, PhD

Associate Professor

Department of Pathology

University of Massachusetts Medical School

Director, Hematopathology and Hematopathology Fellowship Program

Director, Flow Cytometry Laboratory

UMass Memorial Medical Center

Worcester, Massachusetts

Tribute to Jacques Wallach