Test Code PSYR Psychosine, Whole Blood
Ordering Guidance
This test is recommended for individuals of all ages, infancy through adulthood, for diagnosis or long-term monitoring of patients who have been treated or who are at risk of developing Krabbe disease.
If a result is needed within 24 hours, order PSY / Psychosine, Blood Spot.
Shipping Instructions
Must be sent refrigerated.
Necessary Information
1. Patient’s age is required.
2. Date of hematopoietic stem cell transplantation (HSCT), if performed.
Specimen Required
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Green top (sodium heparin, lithium heparin)
Specimen Volume: 2 mL
Useful For
Aiding in the biochemical diagnosis of Krabbe disease using whole blood specimens
Follow-up of individuals affected with Krabbe disease
Follow-up testing after an abnormal newborn screening result for Krabbe disease
Monitoring of individuals at risk to develop late onset Krabbe disease
Monitoring of individuals with Krabbe disease after hematopoietic stem cell transplantation
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Psychosine, RBCSpecimen Type
Whole bloodSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated | 7 days |
Reference Values
Normal <5 pmol/g Hb
Interpretation
An elevation of psychosine is indicative of Krabbe disease or saposin A cofactor deficiency.
Clinical Reference
1. Newborn Screening ACT Sheet [Decreased galactocerebrosidase, elevated psychosine] Krabbe Disease (infantile form). American College of Medical Genetics and Genomics; 2021. Updated May 2022. Accessed June 10, 2024. Available at www.acmg.net/PDFLibrary/Krabbe-Infantile.pdf
2. Newborn Screening ACT Sheet [Decreased galactocerebrosidase, mildly elevated psychosine] Krabbe Disease (late-onset form). American College of Medical Genetics and Genomics; 2021. Updated May 2022. Accessed June 10, 2024. Available www.acmg.net/PDFLibrary/Krabbe-Later-Onset.pdf
3. Kwon JM, Matern D, Kurtzberg J, et al. Consensus guidelines for newborn screening, diagnosis and treatment of infantile Krabbe disease. Orphanet J Rare Dis. 2018;13(1):30. doi:10.1186/s13023-018-0766-x
4. Orsini JJ, Escolar ML, Wasserstein MP, et al. Krabbe disease. In: Adam MP, Mirzaa GM, Pagon R, eds. GeneReviews [Interntet]. University of Washington, Seattle; 2000. Updated October 11, 2018. Accessed August 31, 2023. Available at www.ncbi.nlm.nih.gov/books/NBK1238/
5. Turgeon CT, Orsini JJ, Sanders KA, et al. Measurement of psychosine in dried blood spots-a possible improvement to newborn screening programs for Krabbe disease. J Inherit Metab Dis. 2015;38(5):923-929
6. Wenger DA, Escolar ML, Luzi P, Rafi MA. Krabbe disease (globoid cell leukodystrophy). In: Valle D, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill; 2019. Accessed August 31, 2023. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225546481&bookid=2709
7. Guenzel AJ, Turgeon CT, Nickander KK, et al. The critical role of psychosine in screening, diagnosis, and monitoring of Krabbe disease. Genet Med. 2020;22(6):1108-1118. doi:10.1038/s41436-020-0764-y
8. Thompson-Stone R, Ream MA, Gelb M, et al. Consensus recommendations for the classification and long-term follow up of infants who screen positive for Krabbe disease. Mol Genet Metab. 2021;134(1-2):53-59. doi:10.1016/j.ymgme.2021.03.016
Day(s) Performed
Tuesday, Thursday
Report Available
3 to 7 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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 |
---|---|---|
PSYR | Psychosine, RBC | 93687-2 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
606152 | Interpretation (PSYR) | 59462-2 |
606145 | Psychosine, RBC | 93687-2 |
606151 | Reviewed By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.
Testing Algorithm
If the patient has abnormal newborn screening result for Krabbe disease, immediate action should be taken. Refer to the appropriate American College of Medical Genetics and Genomics Newborn Screening ACT Sheet.(1,2)