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Epic Code LAB8110 Amino Acids, Quantitative, Plasma

Important Note

Patient's age is required.

Patient Preparation: Fasting (overnight preferred, 4 hours minimum). Infants should be drawn just before next feeding (2-3 hours without total parenteral nutrition, if possible).

Additional Codes

Mayo Code: AAQP

Epic Code: LAB8110

Interface Order Alias: 10304

Cerner code: 4144

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Evaluating patients with possible inborn errors of metabolism using plasma specimens

 

May aid in evaluation of endocrine disorders, liver diseases, muscle diseases, neoplastic diseases, neurological disorders, nutritional disturbances, kidney failure, and burns

Specimen Type

Plasma


Additional Testing Requirements


Not all patients with homocystinuria/homocystinemia will be detected by this assay. If there is a concern for homocystinemia, order HCYSP / Homocysteine, Total, Plasma in conjunction with this amino acids profile.



Shipping Instructions


Send plasma frozen.



Necessary Information


1. Patient's age is required.

2. Include family history, clinical condition (asymptomatic or acute episode), diet, and drug therapy information.



Specimen Required


Patient Preparation: Fasting (overnight preferred, 4 hours minimum). Infants should be drawn just before next feeding (2-3 hours without total parenteral nutrition, if possible).

Collection Container/Tube:

Preferred: Green top (sodium heparin)

Acceptable: Lavender top (EDTA), plasma gel tube, green top (lithium heparin)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Collect specimen and place on wet ice. Note: Thrombin-activated tubes should not be used for collection.

2. Centrifuge immediately or within 4 hours of collection if the specimen is kept at refrigerated temperature.

3. Being careful to ensure that no buffy coat is transferred, aliquot plasma into a plastic vial and freeze.


Laboratory Test Directory Note:

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

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Frozen 14 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Day(s) Performed

Monday through Friday

Reference Values

Amino acids

Age groups

<24 months

2-17 years

≥18 years

Phosphoserine (PSer)

<109

<95

<18

Phosphoethanolamine (PEtN)

<6

<5

<12

Taurine (Tau)

37-177

38-153

42-156

Asparagine (Asn)

25-91

29-87

37-92

Serine (Ser)

69-271

71-208

63-187

Hydroxyproline (Hyp)

8-61

7-35

4-29

Glycine (Gly)

111-426

149-417

126-490

Glutamine (Gln)

316-1,020

329-976

371-957

Aspartic Acid (Asp)

2-20

<11

<7

Ethanolamine (EtN)

<70

<64

<67

Histidine (His)

10-116

12-132

39-123

Threonine (Thr)

47-237

58-195

85-231

Citrulline (Cit)

9-38

11-45

17-46

Sarcosine (Sar)

<5

<5

<5

b-Alanine (bAla)

<28

<27

<29

Alanine (Ala)

139-474

144-557

200-579

Glutamic Acid (Glu)

31-202

22-131

13-113

1-Methylhistidine (1MHis)

<11

<20

<28

3-Methylhistidine (3MHis)

<1

<1

2-9

Argininosuccinic Acid (Asa)

<2

<2

<2

Carnosine (Car)

<13

<1

<1

Anserine (Ans)

<1

<1

<1

Homocitruline (Hcit)

<5

 <2

<2

Arginine (Arg)

29-134

31-132

32-120

a-Aminoadipic Acid (Aad)

<4

<3

<3

g-Amino-n-butyric Acid (GABA)

<4

<3

<2

b-Aminoisobutyric Acid (bAib)

<9

<5

<5

a-Amino-n-butyric Acid (Abu)

7-28

7-31

9-37

Hydroxylysine (Hyl)

<4

<3

<2

Proline (Pro)

85-303

80-357

97-368

Ornithine (Orn)

20-130

22-97

38-130

Cystathionine (Cth)

<2

<2

<5

Cystine (Cys)

2-32

2-36

3-95

Lysine (Lys)

49-204

59-240

103-255

Methionine (Met)

11-35

11-37

4-44

Valine (Val)

83-300

106-320

136-309

Tyrosine (Tyr)

26-115

31-106

31-90

Isoleucine (IIe)

31-105

30-111

36-107

Leucine (Leu)

48-175

51-196

68-183

Phenylalanine (Phe)

28-80

30-95

35-80

Tryptophan (Trp)

17-75

23-80

29-77

Alloisoleucine (Allolle)

<2

<3

<5

 

All results reported in nmol/mL

Clinical Information

Amino acids are the basic structural units that comprise proteins and are found throughout the body. Many inborn errors of amino acid metabolism, such as phenylketonuria and tyrosinemia, have been identified. Amino acid disorders can manifest at any age, but most become evident in infancy or early childhood. These disorders result in the accumulation or the deficiency of 1 or more amino acids in biological fluids, which leads to the clinical signs and symptoms of the specific amino acid disorder.

 

The clinical presentation is dependent upon the specific amino acid disorder. In general, affected patients may experience failure to thrive, neurologic symptoms, digestive problems, dermatologic findings, and physical and cognitive delays. If not diagnosed and treated promptly, amino acid disorders can result in intellectual disabilities and, possibly, death.

 

Treatment for amino acid disorders includes very specific dietary modifications. Nonessential amino acids are synthesized by the body, while essential amino acids are not and must be obtained through an individual's diet. Therapeutic diets are coordinated and closely monitored by a dietician or physician. They are structured to provide the necessary balance of amino acids with particular attention to essential amino acids and those that accumulate in a particular disorder. Patients must pay close attention to the protein content in their diet and generally need to supplement with medical formulas and foods. Dietary compliance is monitored by periodic analysis of plasma amino acids.

 

In addition, plasma amino acid analysis may have clinical importance in the evaluation of several acquired conditions, including endocrine disorders, liver diseases, muscle diseases, neoplastic diseases, neurological disorders, nutritional disturbances, kidney failure, and burns.

Cautions

Reference values are for fasting patients.

Interpretation

When no significant abnormalities are detected, a simple descriptive interpretation is provided. When abnormal results are detected, a detailed interpretation is given, including an overview of the results and their significance, a correlation to available clinical information, elements of differential diagnosis, recommendations for additional biochemical testing, and in vitro confirmatory studies (enzyme assay, molecular analysis), name and phone number of key contacts who may provide these studies, and a phone number to reach one of the laboratory directors in case the referring physician has additional questions.

Reporting Name

Amino Acids, QN, P

Method Name

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

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

Method Description

Quantitative analysis of amino acids is performed by liquid chromatography tandem mass spectrometry (LC-MS/MS) by labeling amino acids present in plasma, urine, and spinal fluid with aTRAQ Reagent 121. Samples are dried and reconstituted with aTRAQ Reagent 113-labeled Standard Mix. Amino acids are separated and detected by LC-MSMS. The concentrations of amino acids are established by comparison of their ion intensity (121-labeled amino acids) to that of their respective internal standards (113-labeled amino acids).(Unpublished Mayo method)

CPT Code Information

82139

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AAQP Amino Acids, QN, P 35083-5

 

Result ID Test Result Name Result LOINC Value
34449 Phosphoserine 20654-0
34457 Phosphoethanolamine 26612-2
3512 Taurine 20657-3
3517 Asparagine 20638-3
3516 Serine 20656-5
34458 Hydroxyproline 20647-4
3522 Glycine 20644-1
3518 Glutamine 20643-3
34459 Aspartic Acid 20639-1
34460 Ethanolamine 26608-0
3535 Histidine 20645-8
3515 Threonine 20658-1
3521 Citrulline 20640-9
34461 Sarcosine 26613-0
3532 Beta-Alanine 26604-9
3523 Alanine 20636-7
3520 Glutamic Acid 20642-5
34453 1-Methylhistidine 20633-4
34454 3-Methylhistidine 20635-9
32341 Argininosuccinic Acid 32227-1
34455 Carnosine 26606-4
34462 Anserine 26599-1
34456 Homocitrulline 55876-7
3536 Arginine 20637-5
34450 Alpha-aminoadipic Acid 26600-7
34463 Gamma-amino-n-butyric Acid 26609-8
34452 Beta-aminoisobutyric Acid 26605-6
3524 Alpha-amino-n-butyric Acid 20634-2
34464 Hydroxylysine 26610-6
3519 Proline 20655-7
3533 Ornithine 20652-4
34451 Cystathionine 26607-2
3526 Cystine 22672-0
3534 Lysine 20650-8
3527 Methionine 20651-6
3525 Valine 20661-5
3530 Tyrosine 20660-7
3528 Isoleucine 20648-2
3529 Leucine 20649-0
3531 Phenylalanine 14875-9
34465 Tryptophan 20659-9
32347 Allo-isoleucine 22670-4
3570 Interpretation (AAQP) 49247-0

Report Available

3 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. Part 8: Amino Acids. 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 Sep 9, 2022 Available at https://ommbid.mhmedical.com/book.aspx?bookID=2709#225069340

2. Duran M: Amino acids. In: Blau N, Duran M, Gibson KM, eds. Laboratory Guide to the Methods in Biochemical Genetics. Springer-Verlag; 2008:53-89