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Test Code MPSWB Mucopolysaccharidosis, Blood


Specimen Required


Patient Preparation: Do not administer low-molecular weight heparin prior to collection.

Container/Tube:

Preferred: Lavender top (EDTA)

Acceptable: Yellow top (ACD)

Specimen Volume: 2 mL


Forms

1. Biochemical Genetics Patient Information (T602)

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

Useful For

Supporting the biochemical diagnosis of mucopolysaccharidoses type I, II, III, IV, or VI

 

Quantification of heparan sulfate, dermatan sulfate, and keratan sulfate in whole blood specimens

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Mucopolysaccharidosis, B

Specimen Type

Whole blood

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Ambient (preferred) 7 days
  Refrigerated  7 days

Reference Values

DERMATAN SULFATE (DS)

Newborn-≤2 weeks: ≤200 nmol/L

>2 weeks: ≤130 nmol/L

 

HEPARAN SULFATE (HS)

Newborn-≤2 weeks: ≤96 nmol/L

>2 weeks: ≤95 nmol/L

 

TOTAL KERATAN SULFATE (KS)

≤5 years: ≤1900 nmol/L

6-10 years: ≤1750 nmol/L

11-15 years: ≤1500 nmol/L

>15 years: ≤750 nmol/L

Interpretation

Elevations of dermatan sulfate and/or heparan sulfate may be indicative of one of the mucopolysaccharidoses types I, II, III, or VI.

 

Elevations of keratan sulfate may be indicative of mucopolysaccharidoses type IV.

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 June 10, 2024. Available at www.acmg.net/PDFLibrary/MPSI-ACT-Sheet.pdf

2. de Ruijter J, de Ru MH, Wagemans T, et al. Heparan sulfate and dermatan sulfate derived disaccharides are sensitive markers for newborn screening for mucopolysaccharidoses types I, II and III. Mol Genet Metab. 2012;107(4):705-710

3. de Ru MH, van der Tol L, van Vlies N, et al. Plasma and urinary levels of dermatan sulfate and heparan sulfate derived disaccharides after long-term enzyme replacement (ERT) in MPS I: correlation with the timing of ERT and with total urinary excretion of glycosaminoglycans. J Inherit Metab Dis. 2013;36(2):247-255

4. Osago H, Shibata T, Hara N, et al. Quantitative analysis of glycosaminoglycans, chondroitin/dermatan sulfate, hyaluronic acid, heparan sulfate, and keratan sulfate by liquid chromatography-electrospray ionization-tandem mass spectrometry. Anal Biochem. 2014 15;467:62-74

5. Peck DS, Lacey JM, White AL et al. Incorporation of second-tier biomarker testing improves the specificity of newborn screening for mucopolysaccharidosis type I. Int J Neonatal Screen. 2020;6(1):10. doi:10.3390/ijns6010010

6. Clarke LA, Dickson P, Ellinwood NM, Klein TL. Newborn screening for mucopolysaccharidosis I: Moving forward learning from experience. Int J Neonatal Screen. 2020;6(4):91. doi:10.3390/ijns6040091

Day(s) Performed

Monday, Wednesday, Friday

Report Available

3 to 5 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

83864

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MPSWB Mucopolysaccharidosis, B 94586-5

 

Result ID Test Result Name Result LOINC Value
BA2873 Interpretation (MPSWB) 59462-2
BA2870 Dermatan Sulfate 90233-8
BA2871 Heparan Sulfate 90235-3
BA2872 Total Keratan Sulfate 90236-1
BA2874 Reviewed By 18771-6

Testing Algorithm

If the patient has abnormal newborn screening result for mucopolysaccharidosis type I, immediate action should be taken. Refer to the appropriate American College of Medical Genetics and Genomics Newborn Screening ACT Sheet.(1)

 

For more information, see the following:

 Newborn Screen Follow-up for Mucopolysaccharidosis Type I.

-Newborn Screening Follow up for Mucopolysaccharidosis type II