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Alkali Denaturation Test (APT and Downey)
Test Code90584
CPT Codes
85460
Preferred Specimen
2 mL of a random, bloody stool submitted in a plastic leak-proof container
Minimum Volume
1 mL
Other Acceptable Specimens
2 mL bloody vomitus or bloody mucus, submitted in a plastic leak-proof container or bloody diaper submitted in a plastic leak-proof container
Instructions
Note: The specimen requirement for this test is a grossly bloody (red) non-tarry stool (or bloody vomitus, bloody mucus or blood-stained diaper from newborn within 1 day of birth). If the specimen submitted was not bloody and we were unable to elute any red color from it, the test cannot be performed and will be cancelled
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 7 days
Refrigerated: 7 days
Frozen: Unacceptable
Refrigerated: 7 days
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received frozen
Methodology
Colorimetric (C)
Setup Schedule
Set up: Daily; Report available: 1 day
Reference Range
Negative for fetal blood
Clinical Significance
The Alkali Denaturation Test (APT) is useful in distinguishing between newborn swallowing mother's blood and fetal gastrointestinal bleeding (Melena neonatorum).
The APT test is used to determine whether blood in the diaper, vomitus, or feces of a neonate contains predominantly the baby's or the mother's blood. It is a crude, qualitative method based on resistance of hemoglobin F to alkali denaturation.
The APT test is used to determine whether blood in the diaper, vomitus, or feces of a neonate contains predominantly the baby's or the mother's blood. It is a crude, qualitative method based on resistance of hemoglobin F to alkali denaturation.
