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Test Code PYR Pyruvic Acid, Blood

Reporting Name

Pyruvic Acid, B

Useful For

Screening for possible disorders of mitochondrial metabolism, when used in conjunction with blood lactate collected at the same time, to determine the lactate-to-pyruvate ratio

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole blood


Additional Testing Requirements


This test does not calculate the lactate:pyruvate ratio. To obtain this information, both this test and LACS1 / Lactate, Plasma must be ordered. The ratio can be calculated from the results obtained from these tests. A separate specimen must be obtained for lactate testing, see LACS1 / Lactate, Plasma.



Specimen Required


Call 800-533-1710 or 507-266-5700 to order special collection tube.

 

Patient Preparation: Fasting (at least 4 hours)

Supplies: Perchloric Acid-Pyruvate Tube (T012)

Container/Tube: Special collection tube containing 2.5 mL of 6% perchloric acid

Specimen Volume: Exactly 1 mL

Collection Instructions:

1. Special collection tube must be prechilled prior to collection.

2. Draw enough blood directly into syringe to add exactly 1 mL of blood to the prechilled special collection tube.

3. Taking care to not spill any of the preservative, cautiously remove the cap from the tube.

4. Immediately transfer blood, once drawn, to the prechilled, special collection tube, recap, and shake vigorously to mix.

Additional Information:

1. Check expiration date before using. Supplied collection tube expires 14 months after preparation.

2. If perchloric acid (preservative) spills, obtain a new, prechilled tube.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Refrigerated 15 days PYRUVATE

Reference Values

0.08-0.16 mmol/L

 

NIH Unit

0.7-1.4 mg/dL

Day(s) Performed

Monday, Wednesday

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

84210

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PYR Pyruvic Acid, B 14121-8

 

Result ID Test Result Name Result LOINC Value
8657 Pyruvic Acid, B 14121-8
7729 Pyruvic Acid, B 2905-8

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 November 29, 2023. 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 November 29, 2023. 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 November 29, 2023. Available at http://ommbid.mhmedical.com/content.aspx?bookid=2709&sectionid=225088339

4. Parikh S, Goldstein A, Koenig MK, et al. Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society. Genet Med. 2015;17(9):689-701. doi:10.1038/gim.2014.177

Report Available

2 to 5 days

Method Name

Spectrophotometry (SP)