Organic Acids, Comprehensive, Quantitative, Urine

Message
Order in Quanum - Non-Interfaced test code


Test Code
OAFULLQNTU


Quest Code
35819


CPT Codes
83918, 82570

Preferred Specimen
10 mL random urine collected in a sterile screw-cap container with no preservative


Minimum Volume
4 mL


Other Acceptable Specimens
24-hour urine • First void clean catch urine • Catheterized urine


Instructions
Sterile screw-cap container. Freeze immediately. Ship frozen. Do not thaw.
Patient age should be included.


Transport Temperature
Frozen


Specimen Stability
Room temperature: Unacceptable
Refrigerated: 72 hours
Frozen: 28 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received refrigerated • Samples with pH <2


Methodology
Gas Chromatography/Mass Spectrometry (GC/MS)

Setup Schedule
Sets up 6 days a week.


Report Available
Reports in 4 to 6 days.


Reference Range
See Laboratory Report


Clinical Significance
This test is intended for the diagnosis and monitoring of inherited disorders affecting multiple metabolic pathways.

Organic acidurias are inherited disorders resulting from a deficient enzyme or transport protein. Although most are autosomal recessive disorders, several are X-linked. The more than 60 described organic acidurias affect many metabolic pathways including amino acid metabolism, lipid metabolism, purine and pyrimidine metabolism, the urea cycle, the Krebs cycle and fatty acid oxidation. These disorders are characterized by a wide variety of symptoms such as lethargy, coma, hypotonia, seizures, ataxia, vomiting, failure to thrive, developmental delay, liver disease, neutropenia, thrombocytopenia, osteomalacia and osteoporosis. Severity of presentation is highly variable as is age of onset, and patients may not present with the most characteristic features. Laboratory results commonly indicate metabolic acidosis, increased anion gap, hyperammonemia, hypoglycemia, lactic acidemia, ketosis, or abnormal lipid patterns. Treatment may be based on dietary restrictions and/or supplementation with cofactors (e.g., riboflavin or cobalamin) or conjugating agents (e.g., carnitine or sodium benzoate); however, there is no effective therapy for some of the disorders.

Elevation of one or more organic acids is diagnostic for an organic aciduria; however, elevations should be interpreted in context with clinical findings and/or additional test results. See additional information for a table of selected organic acidurias and associated organic acid elevations. Since many organic acidurias are episodic, the diagnostic efficacy is maximized when the patient is expressing symptoms at the time of specimen collection.

The test will be capable of diagnosing over 30 inherited metabolic defects, and will also allow physicians to determine dietary compliance or the effectiveness of dietary/cofactor therapy for their patients. It can also be used, alone or in conjunction with other tests, to confirm the findings of a positive expanded newborn screen.


Performing Laboratory
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042



The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.