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Test Code PYRC Pyruvate, Spinal Fluid

Reporting Name

Pyruvic Acid, CSF

Useful For

Investigating possible disorders of mitochondrial metabolism, when used in conjunction with cerebrospinal fluid lactate, collected at the same time, to determine the lactate-to-pyruvate (L:P) ratio

 

Evaluating patients with neurologic dysfunction and normal blood L:P ratios

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

CSF


Additional Testing Requirements


This test does not calculate the lactate:pyruvate ratio. To obtain this information, both this test and LASF1 / Lactic Acid, Spinal Fluid must be ordered. The ratio can be calculated from the results obtained from these tests.



Specimen Required


Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 0.6 mL

Collection Instructions: Send specimen from vial 4.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Refrigerated (preferred) 7 days
  Frozen  14 days
  Ambient  7 days

Reference Values

0.06-0.19 mmol/L

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
PYRC Pyruvic Acid, CSF 14122-6

 

Result ID Test Result Name Result LOINC Value
83356 Pyruvic Acid, CSF 14122-6

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 in acutely ill patients.

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 September 11, 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 September 11,, 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. Accessed September 11, 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

4 to 8 days

Method Name

Spectrophotometry (SP)

Testing Algorithm

For more information see: Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm