Fatty Acid Profile, Peroxisomal

Last Modified: 12/28/2023 8:13:57 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation: 12 to 14 hour Fasting  For babies/infants, specimen should be collected before the next feeding

Patient must not consume any alcohol for 24 hours before the specimen is drawn.
Specimen Requirements: 1.0 mL Serum in a SST Gold Top Tube
Collection Instructions: Order must include the patient’s age all information regarding treatment, family history, and tentative diagnosis.Patient Information for order  

If not ordering electronically, complete, print, and send this form also Biochemical Genetics Test Request 
Minimum Volume: 0.15 mL Serum
Transport & Storage: Temperature/Stability: 15 days Refrigerated
92 days Frozen (preferred)
Rejection Criteria: Gross lipemia
Reference Range:
C22:0   < or = 96.3 umol/L
C24:0   < or = 91.4 umol/L
C26:0   < or = 1.30 umol/L
C24:0/C22:0 ratio   < or = 1.39
C26:0/C22:0 ratio   < or = 0.023
 
Pristanic Acid                                                                                                               
0-4 mo: < or = 0.60 umol/L
5-8 mo: < or = 0.84 umol/L
9-12 mo: < or = 0.77 umol/L
13-23 mo: < or = 1.47 umol/L
> or = 24 mo: < or = 2.98 umol/L
 
Phytanic Acid                                                                                                                
0-4 mo: < or = 5.28 umol/L
5-8 mo: < or = 5.70 umol/L
9-12 mo: < or = 4.40 umol/L
13-23 mo: < or = 8.62 umol/L
> or = 24 mo: < or = 9.88 umol/L
 
Pristanic/Phytanic Acid Ratio
0-4 mo: < or = 0.35
5-8 mo: < or = 0.28
9-12 mo: < or = 0.23
13-23 mo: < or = 0.24
> or = 24 mo: < or = 0.39       
Critical Ranges:  
Test Comments:  
Methodology: GC/MS Stable Isotope Dilution Analysis
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 3 to 5 days
Days Performed: Monday, Tuesday, Wednesday, Thursday, Friday
Sites Performed: Mayo Laboratory
PHL Test Code: FAPR
EPIC Test Code: LAB988
Send Out Test Code: POX
Alternate Test Names: C22-26; Long-Chain Fatty Acids; Peroxisomal Screen; Peroxisomal, Faty Acid Profile; Phytanic Acid; Pristanic Acid; Very Long Chain Fatty Acids; VLCFA
Included Tests:  
CPT Coding: 82726

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