Test Code PUPYP Purines and Pyrimidines Panel, Plasma
Ordering Guidance
The preferred test to rule-out inherited disorders of purine and pyrimidine metabolism is PUPYU / Purines and Pyrimidines Panel, Random, Urine.
This test does not evaluate succinyladenosine. If succinyladenosine analysis is needed, order PUPYU / Purines and Pyrimidines Panel, Random, Urine.
Necessary Information
Patient's age is required.
Specimen Required
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Centrifuge at 4° C and aliquot plasma into plastic vial.
2. Send plasma frozen.
Useful For
Evaluating patients with symptoms suspicious for disorders of purine and pyrimidine metabolism
Monitoring patients with disorders of purine and pyrimidine metabolism
Laboratory evaluation of primary and secondary hyperuricemias
Assessing tolerance for fluoropyrimidine drugs used in cancer treatment
Aiding in the diagnosis of individuals with suspected dihydropyrimidine dehydrogenase deficiency
Special Instructions
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Purines and Pyrimidines Panel, PSpecimen Type
PlasmaSpecimen Minimum Volume
0.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma | Frozen | 90 days |
Reference Values
Age range |
0-1 years |
>1-4 years |
5-18 years |
>18 years |
Uracil |
≤2 |
≤2 |
≤2 |
≤2 |
Thymine |
≤2 |
≤2 |
≤2 |
≤2 |
Adenine |
≤3 |
≤3 |
≤3 |
≤3 |
Hypoxanthine |
≤35 |
≤17 |
≤15 |
≤15 |
Xanthine |
≤6 |
≤6 |
≤6 |
≤3 |
Dihydroorotic |
≤2 |
≤2 |
≤2 |
≤2 |
Uric Acid |
100-450 |
150-500 |
150-500 |
150-500 |
Deoxythymidine |
≤2 |
≤2 |
≤2 |
≤2 |
Deoxyuridine |
≤2 |
≤2 |
≤2 |
≤2 |
Uridine |
≤14 |
≤9 |
≤9 |
≤9 |
Deoxyinosine |
≤2 |
≤2 |
≤2 |
≤2 |
Deoxyguanosine |
≤2 |
≤2 |
≤2 |
≤2 |
Inosine |
≤2 |
≤2 |
≤2 |
≤2 |
Guanosine |
≤2 |
≤2 |
≤2 |
≤2 |
Dihydrouracil |
≤3 |
≤3 |
≤3 |
≤3 |
Dihydrothymine |
≤2 |
≤2 |
≤2 |
≤2 |
N-carbamoyl- beta-alanine |
≤2 |
≤2 |
≤2 |
≤2 |
N-carbamoyl- beta-aminoisobutryic acid |
≤2 |
≤2 |
≤2 |
≤2 |
All results reported as nmol/mL
Interpretation
Abnormal concentrations of measurable compounds will be reported along with an interpretation. The interpretation of an abnormal metabolite pattern includes an overview of the results and of their significance, a correlation to available clinical information, possible differential diagnosis, recommendations for additional biochemical testing and confirmatory studies (enzyme assay, molecular analysis), name, and phone number of contacts who may provide these studies, and a phone number of the laboratory directors in case the referring physician has additional questions.
Clinical Reference
1. Jinnah HA, Friedmann T. Lesch-Nyhan disease and its variants. 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 January 4, 2024. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225089443
2. Nyhan WL, Hoffmann GF, Al-Aqeel AI, Barshop BA. Introduction to the disorders of purine and pyrimidine metabolism. Atlas of Inherited Metabolic Diseases. 4th ed. CRC Press; 2020:495-495
3. Balasubramaniam S, Duley JA, Christodoulou J. Inborn errors of purine metabolism: clinical update and therapies. J Inherit Metab Dis. 2014;37:669-686
4. Balasubramaniam S, Duley JA, Christodoulou J. Inborn errors of pyrimidine metabolism: clinical update and therapy. J Inherit Metab Dis. 2014;37:687-698
Day(s) Performed
Tuesday
Report Available
3 to 9 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 |
---|---|---|
PUPYP | Purines and Pyrimidines Panel, P | 79665-6 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
92310 | Interpretation (PUPYP) | 79659-9 |
92292 | Uracil | 75152-9 |
92293 | Thymine | 75121-4 |
606842 | Adenine | 75131-3 |
92294 | Hypoxanthine | 75135-4 |
92295 | Xanthine | 75144-6 |
92296 | Dihydroorotic | 79654-0 |
92297 | Uric Acid | 14933-6 |
92298 | Deoxythymidine | 48162-2 |
92299 | Deoxyuridine | 47957-6 |
92300 | Uridine | 75159-4 |
92301 | Deoxyinosine | 75127-1 |
92302 | Deoxyguanosine | 75134-7 |
92303 | Inosine | 75150-3 |
92304 | Guanosine | 79670-6 |
92305 | Dihydrouracil | 79682-1 |
92306 | Dihydrothymine | 79669-8 |
92307 | N-carbamoyl-B-alanine | 79656-5 |
92308 | N-carbamoyl-B-aminoisobutyric acid | 79582-3 |
92309 | Reviewed By | 18771-6 |
Testing Algorithm
For 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.