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Epic Code LAB3216 Riboflavin (Vitamin B2), Plasma

Important Note

Protect from light after collecting. Spin at 3500 for 5 minutes after 30 minute rest. Pour into brown pour-over tube. Transport and store refrigerated.

Fasting specimen required -overnight (12-14 hours)

  • infants-draw prior to next feeding

Additional Codes

Mayo Code: VITB2

Interface Order Alias: 11566

Epic Code: LAB 3216

Cerner: 8197

Reporting Name

Riboflavin (Vitamin B2), P

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Clinical Information

There are 3 principal vitamin B2-active flavins found in nature: riboflavin, riboflavin 5-phosphate (flavin mononucleotide: FMN), and riboflavin-5'-adenosyl-diphosphate (flavin adenosine dinucleotide: FAD). In biological tissues, FMN and FAD serve as prosthetic groups for a large variety of flavoproteins, which are hydrogen carriers in oxidation-reduction processes.

 

Dietary deficiency of riboflavin (ariboflavinosis) is characterized by sore throat, cheilosis (lesions on the lips), angular stomatitis (lesions on the angles of the mouth), glossitis (fissured and magenta-colored tongue), corneal vascularization, dyssebacia (red, scaly, greasy patches on the nose, eyelids, scrotum, and labia), and normocytic, normochromic anemia. Severe riboflavin deficiency may affect the conversion of vitamin B6 to its coenzyme, as well as conversion of tryptophan to niacin.

 

There is also evidence that more subtle riboflavin deficiency might have negative health consequences.

 

Finally, in addition to dietary deficiency, there are rare inborn errors of metabolism, primarily involving loss of function of riboflavin transporters, which result in functional vitamin B2 deficiency. Many of these latter cases present with neurodegenerative features.

Riboflavin has a low level of toxicity and no case of riboflavin toxicity in humans has been reported. The limited absorptivity of riboflavin and its ready excretion in the urine normally preclude a health problem due to increased intake of riboflavin.

Useful For

Evaluation of individuals who present the signs of ariboflavinosis

Specimen Type

Plasma Heparin


Shipping Instructions


Ship specimen in amber vial to protect from light.



Specimen Required


Patient Preparation: Fasting-overnight (12-14 hours) (infants-collect specimen prior to next feeding)

Supplies: Amber Frosted Tube, 5 mL (T192)

Collection Container/Tube:

Preferred: Green top (sodium or lithium heparin)

Acceptable: Light-green top (sodium or lithium heparin plasma gel)

Submission Container/Tube: Amber vial

Specimen Volume: 2 mL

Collection Instructions: Centrifuge within 2 hours of collection and aliquot plasma into amber vial.


Laboratory Test Directory Note:

Collection Container/Tube: Sodium Heparin Green Top (2 mL or 6 mL)

COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Heparin Refrigerated (preferred) 28 days LIGHT PROTECTED
  Frozen  28 days LIGHT PROTECTED
  Ambient  72 hours LIGHT PROTECTED

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Day(s) Performed

Monday, Wednesday, Friday

Reference Values

1-19 mcg/L

Interpretation

Low concentrations in the blood plasma are indicative of nutritional deficiency. Concentrations below 1 mcg/L are considered significantly diminished. Marginally low levels probably represent nutritional deficiency that should be corrected.

Cautions

Testing of nonfasting specimens or the use of dietary vitamin B2 supplementation can result in elevated plasma vitamin B2 concentrations.

Clinical Reference

1. McCormick DB: Riboflavin. In: Shils ME, Shike M, Ross AC, et al. Modern Nutrition in Health and Disease. 10th ed. Lippincott Williams and Wilkins; 2006:434-441

2. Hustad S, McKinley MC, McNulty H, et al: Riboflavin, flavin mononucleotide, and flavin adenine dinucleotide in human plasma and erythrocytes at baseline and after low-dose riboflavin supplementation. Clin Chem. 2002 Sept;48(9):1571-1577

3. Roberts NB. Taylor A. Sodi R: Vitamins and trace elements. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:639-718

4. Balasubramaniam S, Christodoulou J, Rahman S: Disorders of riboflavin metabolism. J Inherit Metab Dis. 2019 Jul;42(4):608–619. doi: 10.1002/jimd.12058

5. Suwannasom S, Kao I, PruB A, Georgieva R, Baumler H: Riboflavin: the health benefits of a forgotten natural vitamin. Int J Mol Sci. 2020 Jan 31;21(3):950. doi: 10.3390/ijms21030950

6. O'Callaghan B, Bosch AM, Houlden H: An update on the genetics, clinical presentation, and pathomechanisms of human riboflavin transporter deficiency. J Inherit Metab Dis. 2019 Jul;42(4):598-607. doi: 10.1002/jimd.12053

Method Name

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

Portions of this test are covered by patents held by Quest Diagnostics

Method Description

Riboflavin (Vitamin B2) is extracted from plasma heparin specimens with internal standard and then analyzed by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

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. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

84252

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VITB2 Riboflavin (Vitamin B2), P 2924-9

 

Result ID Test Result Name Result LOINC Value
61637 Riboflavin (Vitamin B2), P 2924-9