Test Code PIPA Pipecolic Acid, Serum
Reporting Name
Pipecolic Acid, SUseful For
Differentiating between disorders of peroxisomal biogenesis (eg, Zellweger syndrome) and disorders with loss of a single peroxisomal function
Detecting abnormal elevations of pipecolic acid in serum
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
SerumNecessary Information
Patient's age is required.
Specimen Required
Patient Preparation: Fasting 12 hours or more. (Collect specimens from infants and small children just before next feeding)
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Frozen (preferred) | 94 days | |
Refrigerated | 14 days |
Special Instructions
Reference Values
<6 months: ≤6.0 nmol/mL
6 months-<1 year: ≤5.9 nmol/mL
1-17 years: ≤4.3 nmol/mL
≥18 years: ≤7.4 nmol/mL
Day(s) Performed
Tuesday
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
82542
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PIPA | Pipecolic Acid, S | 32334-5 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
81326 | Pipecolic Acid, S | 32334-5 |
29962 | Interpretation | 59462-2 |
29964 | Reviewed By | 18771-6 |
Interpretation
Elevated pipecolic acid levels are seen in disorders of peroxisomal biogenesis; normal levels are seen in disorders with loss of a single peroxisomal function.
Abnormal levels of pipecolic acid should be interpreted together with the results of other biochemical markers of peroxisomal disorders, such as plasma C22-C26 very long-chain fatty acids, phytanic acid, and pristanic acid (POX / Fatty Acid Profile, Peroxisomal [C22-C26], Serum); red blood cell plasmalogens (PGRBC / Plasmalogens, Blood); and bile acid intermediates (BAIPD / Bile Acids for Peroxisomal Disorders, Serum).
Clinical Reference
1. Gartner J, Rosewich H, Thoms S. The peroxisome biogenesis disorders. In: Valle D, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill Medical; 2019. Accessed November 02, 2023. Available at https://ommbid.mhmedical.com/content.aspx?bookid=2709§ionid=22554226
2. Wanders RJA, Barth PG, Heymans HAS. Single peroxisomal enzyme deficiencies. In: Valle D, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill Medical; 2019. Accessed November 02, 2023. Available at https://ommbid.mhmedical.com/content.aspx?bookid=2709§ionid=225542524
3. Peduto A, Baumgartner MR, Verhoeven NM, et al. Hyperpipecolic acidaemia: a diagnostic tool for peroxisomal disorders. Mol Genet Metab. 2004;82(3):224-230
4. Braverman N, Raymond G, Rizzo WB, et al. Peroxisome biogenesis disorders in the Zellweger spectrum: An overview of current diagnosis, clinical manifestations, and treatment guidelines. Mol Genet Metab. 2016;117(3):313-321
Report Available
3 to 9 daysMethod Name
Gas Chromatography Mass Spectrometry (GC-MS)
Testing Algorithm
For more information see Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm
Forms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.