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Epic Code LAB1230896 Phosphatidylethanol Confirmation, Blood

Additional Codes

Mayo: PETH

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Verifying abstinence or use of ethanol especially in liver transplant candidates/patients

Specimen Type

Whole Blood EDTA


Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 mL

Collection Instructions:

1. Do not use alcohol to clean arm. Use alternatives such as Betadine or ChloraPrep to cleanse arm before collecting any specimen.

2. Do not centrifuge.

3. Send whole blood specimen in original tube. Do not aliquot.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Frozen (preferred) 28 days
  Refrigerated  14 days

Reject Due To

Gross lipemia OK
Gross icterus OK

Day(s) Performed

Monday through Sunday

Reference Values

Negative (<10 ng/mL)

 

PEth 16:0/18:1 (POPEth): Lower limit of quantification =10 ng/mL

PEth 16:0/18:2 (PLPEth): Lower limit of quantification =10 ng/mL

Clinical Information

Phosphatidylethanol (PEth) is a direct biomarker for alcohol (ethanol) intake. In presence of ethanol, phosphatidylcholine is converted to PEth on the red blood cell membrane by the phospholipase D enzyme. PEth homologues (16:0/18:1 [POPEth: 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol] and 16:0/18:2 [PLPEth: 1-palmitoyl-2-linoleoyl-sn-glycero-3-phosphoethanol]) levels correlate with the amount of alcohol consumed within the previous 2 weeks and may be detected in the blood up to 2 to 4 weeks after excessive alcohol consumption. POPEth and PLPEth comprise approximately 60% of all observed PEth homologues in the blood.(1)

Cautions

No significant cautionary statements

Interpretation

POPEth (1-Palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol):

A result of 20 ng/mL to 200 ng/mL is considered evidence of moderate ethanol consumption, while results over 200 ng/mL indicate heavy ethanol consumption. However, the Center for Substance Abuse Treatment advises caution in interpretation and use of biomarkers alone to assess alcohol use. Results should be interpreted in the context of all available clinical and behavioral information.(2)

 

PLPEth (1-Palmitoyl-2-linoleoyl-sn-glycero-3-phosphoethanol):

There are no current clinical reference limits for this phosphatidylethanol (PEth) homologue.

 

PEth 16:0/18:1 (POPEth)

Less than 10 ng/mL: Not detected

10-19 ng/mL: Abstinence or light alcohol consumption (<2 drinks per day for several days a week)

20-200 ng/mL: Moderate alcohol consumption (up to 4 drinks per day for several days a week)

Greater than 200 ng/mL: Heavy alcohol consumption or chronic alcohol use (at least 4 drinks per day several days a week)

 

PEth 16:0/18:2 (PLPEth): Reference ranges are not well established.

Reporting Name

Phosphatidylethanol Confirmation, B

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Method Description

The received whole blood sample is diluted and mixed with internal standard and clinical laboratory reagent water, extracted using supported liquid extraction, and analyzed by an in-house developed liquid chromatography tandem mass spectrometry method.(Unpublished Mayo method)

CPT Code Information

80321

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PETH Phosphatidylethanol Confirmation, B 101506-4

 

Result ID Test Result Name Result LOINC Value
617481 PEth 16:0/18:1 (POPEth) by LC-MS/MS 97607-6
617482 PEth 16:0/18:2 (PLPEth) by LC-MS/MS 97606-8
617483 PEth Interpretation 59462-2

Report Available

2 to 5 days

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.

Clinical Reference

1. Helander A, Zheng Y. Molecular species of the alcohol biomarker phosphatidyethanol in human blood measured by LC-MS. Clin Chem. 2009:55:(7):1395-1405. doi: 10.1373/clinchem.2008.120923

2. Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute on Alcohol Abuse and Alcoholism. Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. HHS Publication No. (SMA) 15-4907. SAMHSA; 2015.

3. Ulwelling W, Smith K. The PEth blood test in the security environment: What it is; why it is important; and interpretative guidelines. J Forensic Sci. 2018;63(6):1634-1640. doi: 10.1111/1556-4029.13874

4. Hakim F, Wiart JF, Menard O, Allorge D, Gaulier JM. Dosage sanguin du phosphatidylethanol Phosphatidylethanol blood analysis. Ann Biol Clin (Paris). 2019;77(6):638-644. French. doi: 10.1684/abc.2019.1499

Laboratory Test Catalog | West Additional Information:

LAB1230725

1230725