Test Code IDUAW Alpha-L-Iduronidase, Leukocytes
Ordering Guidance
This test is preferred for diagnostic testing. For carrier detection, order IDUA / Mucopolysaccharidosis Type I, IDUA Gene Sequencing with Deletion/Duplication, Varies.
Shipping Instructions
For optimal isolation of leukocytes, it is recommended the specimen arrives refrigerated within 6 days of collection to be stabilized. Collect specimen Monday through Thursday only and not the day before a holiday. Specimen should be collected and packaged as close to shipping time as possible.
Specimen Required
Container/Tube:
Preferred: Yellow top (ACD solution B)
Acceptable: Yellow top (ACD solution A) or lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
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. Biochemical Genetics Patient Information (T602)
3. If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.
Useful For
Diagnosis of mucopolysaccharidosis I, Hurler, Scheie, and Hurler-Scheie syndromes in leukocytes
This test is not useful for determining carrier status.
Testing Algorithm
Additional information is available:
- Lysosomal Disorders Diagnostic Algorithm, Part 1
-Newborn Screen Follow-up for Mucopolysaccharidosis Type I Decreased Alpha-L-Iduronidase Activity
Special Instructions
Method Name
Flow Injection Analysis-Tandem Mass Spectrometry (FIA-MS/MS)
Reporting Name
Alpha-L-Iduronidase, LeukocytesSpecimen Type
Whole Blood ACDSpecimen Minimum Volume
4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | 
|---|---|---|
| Whole Blood ACD | Refrigerated (preferred) | 6 days | 
| Ambient | 6 days | 
Reference Values
≥2.06 nmol/hour/mg protein
An interpretive report will be provided.
Interpretation
Results below 2.06 nmol/hour/mg protein in properly submitted specimens are consistent with alpha-L-iduronidase deficiency (mucopolysaccharidosis I). Further differentiation between Hurler, Scheie, and Hurler-Scheie syndromes is dependent upon the clinical findings.
Normal results (≥2.06 nmol/hour/mg protein) are not consistent with alpha-L-iduronidase deficiency.
Clinical Reference
1. Newborn Screening ACT Sheet [alpha-L-iduronidase deficiency with or without glycosaminoglycan (GAG) accumulation] Mucopolysaccharidosis Type I (MPS I). American College of Medical Genetics and Genomics; 2023. Updated November 2023. Accessed July 22, 2025. Available at www.acmg.net/PDFLibrary/MPSI-ACT-Sheet.pdf
2. Clark LA, Atherton AM, Burton BK, et al. Mucopolysaccharidosis type I newborn screening: Best practices for diagnosis and management. J Pediatr. 2017;182:363-370
3. Martins AM, Dualibi AP, Norato D, et al. Guidelines for the management of mucopolysaccharidosis type I. J Pediatr. 2009:155(4 Suppl):S32-S46
4. Enns GM, Steiner RD, Cowan TM: Lysosomal disorders: mucopolysaccharidoses. In: Sarafoglou K, Hoffmann GF, Roth KS, eds. Pediatric Endocrinology and Inborn Errors of Metabolism. McGraw-Hill, Medical Publishing Division; 2009:721-730
5. Clarke LA: Mucopolysaccharidosis type I. In: Adam MP, Ardinger HH, Pagon RA, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 2002. Updated April 11, 2024. Accessed July 22, 2025. Available at www.ncbi.nlm.nih.gov/books/NBK1162/
6. Elliott S, Buroker N, Cournoyer JJ, et al. Pilot study of newborn screening for six lysosomal storage diseases using tandem mass spectrometry. Mol Genet Metab. 2016;118(4):304-309
Day(s) Performed
Preanalytical processing: Monday through Saturday.
Testing performed: Monday, Thursday
Report Available
2 to 5 daysPerforming Laboratory
 Mayo Clinic Laboratories in Rochester
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
82657
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value | 
|---|---|---|
| IDUAW | Alpha-L-Iduronidase, Leukocytes | 24057-2 | 
| Result ID | Test Result Name | Result LOINC Value | 
|---|---|---|
| 606276 | Alpha-L-Iduronidase, Leukocytes | 24057-2 | 
| 606277 | Interpretation | 59462-2 | 
| 606278 | Reviewed By | 18771-6 |