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HelpTest Code GCT Galactosemia Reflex, Blood
Reporting Name
Galactosemia Reflex, BUseful For
Preferred test for diagnosis, carrier detection, and determination of genotype of galactose-1-phosphate uridyltransferase deficiency, the most common cause of galactosemia
Differentiating Duarte variant galactosemia from classic galactosemia
Confirming results of newborn screening programs
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| GALZ | Galactosemia, Full Gene Analysis | Yes | No |
Testing Algorithm
Testing begins with galactose-1-phosphate uridyltransferase (GALT) enzyme analysis. If GALT activity is greater than or equal to 24.5 nmol/h/mg of hemoglobin, testing is complete. No molecular test will be performed. If GALT activity is less than 24.5 nmol/h/mg of hemoglobin, galactosemia full gene sequencing will be performed at an additional charge.
For more information see Galactosemia Testing Algorithm
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole Blood EDTAOrdering Guidance
This test is appropriate for the diagnosis of, and routine carrier screening for, galactose-1-phosphate uridyltransferase deficiency.
This assay is not appropriate for monitoring dietary compliance. For dietary monitoring, order GAL1P / Galactose-1-Phosphate, Erythrocytes.
Necessary Information
Patient's age is required.
Specimen Required
Multiple whole blood tests for galactosemia can be performed on one specimen. Prioritize order of testing when submitting specimens. For a list of tests that can be ordered together, see Galactosemia-Related Test List.
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Green top (sodium heparin) or yellow top (ACD)
Specimen Volume: 5 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Refrigerated (preferred) | 28 days | |
| Ambient | 14 days |
Special Instructions
Reference Values
≥24.5 nmol/h/mg of hemoglobin
Day(s) Performed
Monday, Wednesday, Friday
Test 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.CPT Code Information
82775
81406 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GCT | Galactosemia Reflex, B | 24082-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8333 | Gal-1-P Uridyltransferase, RBC | 24082-0 |
| 2296 | Interpretation (GALT) | 59462-2 |
| 58115 | Reviewed By | 18771-6 |
Interpretation
The laboratory provides an interpretation of the results, including galactose-1-phosphate uridyltransferase enzyme activity and genotype, if necessary. This interpretation provides an overview of the results and their significance, a correlation to available clinical information, elements of differential diagnosis, and recommendations for additional testing.
In any specimen where enzyme activity is less than 24.5 nmol/h/mg of hemoglobin GALT full gene sequencing will be performed. For testing algorithm and more information, see Galactosemia Testing Algorithm.
The GALT gene maps to chromosome 9p13. Several disease-causing variants are common in patients with classic galactosemia (G/G genotype). The most frequently observed is the Q188R classic variant. This alteration accounts for 60% to 70% of classic galactosemia alleles. The S135L variant is the most frequently observed in African Americans and accounts for approximately 50% of the altered alleles in this population. The K285N variant is common in those of eastern European descent and accounts for 25% to 40% of the alleles in this population. The L195P variant is observed in 5% to 7% of classical galactosemia. The 5-kilobase deletion is common in individuals of Ashkenazi Jewish descent. The Duarte variant (N314D and -119_-116delGTCA) is observed in 5% of the general US population.
Clinical Reference
1. Berry GT. Classic galactosemia and clinical variant galactosemia. In: Adam MP, Everman DB, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 2000. Updated March 11, 2021. Accessed September 10, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK1518/
2. Walter JH, Fridovich-Keil JL. Galactosemia. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA. Eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill; 2019. Accessed September 10, 2024. Available at https://ommbid.mhmedical.com/content.aspx?bookid=2709§ionid=%20225081023
3. Carlock G, Fischer ST, Lynch ME, et al. Developmental outcomes in Duarte galactosemia. Pediatrics. 2019;143(1):e20182516. doi:10.1542/peds.2018-2516
Report Available
4 to 7 daysMethod Name
Enzyme Reaction followed by Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing-Spanish (T826)
2. If not ordering electronically, complete, print, and send an Biochemical Genetics Test Request (T798) with the specimen.