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Test Code LAB23BPG 2,3-Dinor-11Beta-Prostaglandin F2 Alpha, Urine

Additional Codes

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
2,3-DINOR-11BETA-PROSTAGLANDIN F2 ALPHA, URINE LAB23BPG 23BPG 23BPG

 

Useful For

Screening for mast cell activation disorders including systemic mastocytosis

Additional Tests

Test ID Reporting Name Available Separately Always Performed
AACT Creatinine, U No Yes

Testing Algorithm

When this test is performed, urine creatinine will always be performed at no additional charge.

Method Name

23BPG: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

AACT: Enzymatic Colorimetric Assay

Reporting Name

2,3-dinor 11B-Prostaglandin F2a, U

Specimen Type

Urine


Advisory Information


 



Specimen Required


Submit only 1 of the following specimens:

 

Preferred: 24-hour urine collection

Supplies: Plastic, 5-mL tube (T465)

Specimen Volume: 4 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. No preservative preferred.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.

 

Acceptable: Random collection

Supplies: Plastic, 5-mL tube (T465)

Specimen Volume: 4 mL

Collection Instructions:

1. Collect a random urine specimen. 

2. No preservative preferred.


Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 14 days
  Frozen  30 days
  Ambient  8 hours

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Clinical Information

2,3-Dinor-11beta-prostaglandin F2 alpha is the most abundant metabolic product of prostaglandins released by activated mast cells. Systemic mastocytosis (SM) is a disease in which clonally derived mast cells accumulate in peripheral tissues. Degranulation of these mast cells releases large amounts of histamines, prostaglandins, leukotrienes, and tryptase.

 

World Health Organization diagnostic criteria for SM require the presence of elevated mast cell counts on a bone marrow biopsy and 1 of the following minor criteria: abnormal mast cell morphology, KIT Asp816Val mutation, CD25-positive mast cells, or serum tryptase greater than 20 ng/mL. Alternatively, SM diagnosis can be made with the presence of 3 minor criteria in the absence of abnormal bone marrow studies.

 

Measurement of mast cell mediators in blood or urine is less invasive and is advised for the initial evaluation of suspected cases. Elevated levels of serum tryptase, urinary N-methylhistamine (NMH), 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG), or leukotriene E4 (LTE4) are consistent with the diagnosis of systemic mast cell disease.

Reference Values

<5,205 pg/mg creatinine

Interpretation

Elevated urine 2,3-dinor-11beta-prostaglandin F2 alpha is consistent with systemic mastocytosis.

Cautions

Elevated levels of 2,3-dinor-11beta-prostaglandin F2 alpha in urine are not specific for systemic mast cell disease and may be found in patients with angioedema, diffuse urticaria, or myeloproliferative diseases in the absence of diffuse mast cell proliferation. 

 

Systemic mast cell disease is a heterogeneous disease, and some patients may not have elevated 2,3-dinor-11beta-prostaglandin F2 alpha in urine.

 

Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha if dosage has not been discontinued for 2 weeks or 72 hours, respectively.

Supportive Data

An internal study of 203 patients presenting with symptoms consistent with systemic mastocytosis found a receiver operating characteristic (ROC) area under the curve (AUC) of 0.62 for 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BGP) concentration discrimination for detection of systemic mastocytosis (SM)

Method Description

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is quantified in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS). All 2,3 BPG concentrations are normalized to urine creatinine levels measured using a Roche Cobas enzymatic method.(Package insert: Roche Diagnostics, Indianapolis IN, 2004)

Day(s) and Time(s) Performed

Monday, Thursday; 11 a.m.

Analytic Time

2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

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 U.S. Food and Drug Administration.

CPT Code Information

84150

LOINC Code Information

Test ID Test Order Name Order LOINC Value
23BPG 2,3-dinor 11B-Prostaglandin F2a, U In Process

 

Result ID Test Result Name Result LOINC Value
37931 2,3-dinor 11B-Prostaglandin F2a, U In Process

Urine Preservative Collection Options

Ambient

No

Refrigerated

Preferred

Frozen

Yes

6N HCl

No

50% acetic acid

Yes

Na2CO3

Yes

Toluene

Yes

6N HNO3

No

Boric acid

Yes

Thymol

No