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Test Code EPO Erythropoietin, Serum

Reporting Name

Erythropoietin (EPO), S

Useful For

An aid in distinguishing between primary and secondary polycythemia

 

Differentiating between appropriate secondary polycythemia (eg, high-altitude living, pulmonary disease, tobacco use) and inappropriate secondary polycythemia (eg, tumors)

 

Identifying candidates for erythropoietin (EPO) replacement therapy (eg, those with chronic kidney disease)

 

Evaluating patients undergoing EPO replacement therapy who demonstrate an inadequate hematopoietic response

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.6 mL serum

Collection Instructions:

1. Morning collection, 7:30 a.m. to 12 p.m. is preferred due to diurnal variation. For more information see Cautions.

2. Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

Serum: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  7 days

Reference Values

2.6-18.5 mIU/mL

Day(s) Performed

Monday through Friday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82668

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EPO Erythropoietin (EPO), S 15061-5

 

Result ID Test Result Name Result LOINC Value
EPO Erythropoietin (EPO), S 15061-5

Interpretation

In the appropriate clinical setting (eg, confirmed elevation of hemoglobin >18.5 g/dL, persistent leukocytosis, persistent thrombocytosis, unusual thrombosis, splenomegaly, and erythromelalgia), polycythemia vera is unlikely when erythropoietin (EPO) levels are elevated but is likely when EPO levels are suppressed.

 

Erythropoietin levels are also increased in patients with anemia of bone marrow failure, iron deficiency, or thalassemia.

 

Patients who have either a poor or no erythropoietic response to EPO therapy but high-normal or high EPO levels may have additional, unrecognized causes for their anemia. If no contributing factors can be identified after adequate further study, the possibility that the patient may have developed EPO-antibodies should be considered. This can be a serious clinical situation that can result in red cell aplasia and should prompt expeditious referral to a specialist skilled in diagnosing and treating this disorder.

Clinical Reference

1. Tefferi A. Diagnosing polycythemia vera: a paradigm shift. Mayo Clin Proc. 1999;74:159-162

2. Hoagland HC. Myelodysplastic (preleukemia) syndromes: the bone marrow factory failure problem. Mayo Clin Proc. 1995;70:673-677

3. Casadeval N. Pure red cell aplasia and anti-erythropoietin antibodies in patients treated with epoetin. Nephrol Dial Transplant. 2003;18 Suppl. 8:viii37-viii41

4. Fisher JW. Erythropoietin: physiology and pharmacology update. Exp Biol Med. 2003;228:1-14

5. Strippoli GF, Navaneethan SD, Craig JC. Haemoglobin and haematocrit targets for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2006;(4):CD003967. Published 2006 Oct 18. doi:10.1002/14651858.CD003967.pub26. Tefferi A. Polycythemia vera and essential thrombocythemia: 2012 update on diagnosis, risk stratification, and management. Am J Hematol. 2012;87:285-293. doi:10.1002/ajh.23135

7. Moore E, Bellomo R. Erythropoietin (EPO) in acute kidney injury. Ann Intensive Care. 2011;1(1):3. doi:10.1186/2110-5820-1-3

8. Macdougall I. Anaemia and chronic renal failure. Medicine. 2011;39(7):425-428. doi:10.1016/j.mpmed.2011.04.009

9. Schoener B, Borger J. Erythropoietin Stimulating Agents. In: StatPearls [Internet]. StatPearls Publishing; Updated July 24, 2024. Accessed September 19, 2025. Available at www.ncbi.nlm.nih.gov/books/NBK536997/

10. Patil SM, Khodnapur JP, Das KK, Podder A. The role of serum erythropoietin (EPO) and vascular endothelial growth factor (VEGF) in pulse wave velocity (PWV) among hypertensive patients: A cross-sectional study. Cureus. 2024;16(6):e62416. doi:10.7759/cureus.62416

Report Available

1 to 3 days

Method Name

Immunoenzymatic Assay

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Benign Hematology Test Request (T755)

-Kidney Transplant Test Request