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Test Code LAPYP Lactate Pyruvate Panel, Plasma


Ordering Guidance


This test does not measure D-lactate, an uncommon, often undiagnosed cause of lactic acidosis. If D-lactate testing is needed, order DLAU / D-Lactate, Urine (preferred) or DLAC / D-Lactate, Plasma.

 

Analytes from this test are included in test MMPP / Mitochondrial Metabolites, Plasma. If ordered together, this test may be canceled.



Specimen Required


Collection Container/Tube:

Preferred: Green top (Sodium heparin)

Acceptable: Green top (Lithium heparin)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot plasma into a plastic vial.


Forms

If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.

Useful For

Diagnosing and monitoring patients with lactic acidosis

 

Monitoring lactate-to-pyruvate ratios

Method Name

Gas Chromatography Mass Spectrometry (GC-MS)

Reporting Name

Lactate Pyruvate Panel, P

Specimen Type

Plasma

Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Frozen (preferred) 90 days
  Ambient  7 days
  Refrigerated  7 days

Reference Values

Lactic Acid

≤ 4000.0 nmol/mL

 

Pyruvic Acid

≤ 350.0 nmol/mL

Interpretation

An elevated lactate-to-pyruvate (L:P) ratio may indicate inherited disorders of the respiratory chain complex, tricarboxylic acid cycle disorders, and pyruvate carboxylase deficiency. Respiratory chain defects usually result in L:P ratios above 20.

 

A low L:P ratio (disproportionately elevated pyruvic acid) may indicate an inherited disorder of pyruvate metabolism. Defects of the pyruvate dehydrogenase complex result in L:P ratios below 10.

 

The L:P ratio is characteristically normal in other patients. An artifactually high ratio can be found if the patient is acutely ill.

 

Cerebrospinal fluid (CSF) L:P ratio may assist in evaluation of patients with neurologic dysfunction and normal blood L:P ratios. Blood and CSF specimens should be collected at the same time.

Clinical Reference

1. Munnich A, Rotig A, Cormier-Daire V, Rustin P. Clinical presentation of respiratory chain deficiency. 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 July 5, 2024. Available at http://ommbid.mhmedical.com/content.aspx?bookid=2709&sectionid=225086827

2. Robinson BH. Lactic acidemia: Disorders of pyruvate carboxylase and pyruvate dehydrogenase. 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 July 5, 2024. Available at http://ommbid.mhmedical.com/content.aspx?bookid=2709&sectionid=225087140

3. Shoffner JM. Oxidative phosphorylation diseases. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill; 2019 Accessed July 5, 2024. Available at http://ommbid.mhmedical.com/content.aspx?bookid=2709&sectionid=225088339

Day(s) Performed

Wednesday

Report Available

3 to 9 days

Performing 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

83605

84210

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LAPYP Lactate Pyruvate Panel, P 101656-7

 

Result ID Test Result Name Result LOINC Value
616797 Interpretation 59462-2
616794 Lactic acid 2524-7
616795 Pyruvic acid 32338-6
616796 Reviewed by 18771-6