Test Code TPIC Triosephosphate Isomerase Enzyme Activity, Blood
Specimen Required
Only available as part of a profile. For more information see:
-HAEV1 / Hemolytic Anemia Evaluation, Blood
-EEEV1 / Red Blood Cell (RBC) Enzyme Evaluation, Blood
Useful For
Evaluating individuals with chronic nonspherocytic hemolytic anemia
Evaluating individuals with early onset neurologic impairment
Genetic counseling for families with triosephosphate isomerase deficiency
Method Name
Only available as part of a profile. For more information see:
-HAEV1 / Hemolytic Anemia Evaluation, Blood
-EEEV1 / Red Blood Cell (RBC) Enzyme Evaluation, Blood
Kinetic Spectrophotometry
Reporting Name
Triosephosphate Isomerase, BSpecimen Type
Whole Blood ACD-BSpecimen Minimum Volume
1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole Blood ACD-B | Refrigerated | 20 days |
Reject Due To
Gross hemolysis | Reject |
Clinical Information
Triosephosphate isomerase (TPI) converts dihydroxyacetone phosphate to glyceraldehyde 3-phosphate during glycolysis. Clinically significant TPI deficiency (OMIM #615512, autosomal recessive) is rare and classically manifests as a severe multisystem disorder with early hemolytic anemia and progressive neurologic impairment in infancy. Other clinical features include motor impairment, diaphragm paralysis, cardiomyopathy and susceptibility to infections. Some cases have isolated hemolytic anemia.
Reference Values
Only available as part of a profile. For more information see:
-HAEV1 / Hemolytic Anemia Evaluation, Blood
-EEEV1 / Red Blood Cell (RBC) Enzyme Evaluation, Blood
≥12 months of age: 1033-1363 U/g Hb
Reference values have not been established for patients who are younger than 12 months of age.
Interpretation
Clinically significant hemolytic anemias due to triosephosphate isomerase deficiency are associated with activity levels less than 30% of mean normal. Heterozygotes usually show approximately 50% of mean normal activity and are clinically unaffected.
Cautions
Recent transfusion may mask the enzyme activity of the patient and cause unreliable results.
Method Description
Triosephosphate isomerase interconverts glyceraldehyde 3-phosphate and dihydroxyacetone phosphate (DHAP). The rate of DHAP formation is measured by further converting it to alpha-glycerophosphate by alpha-glycerophosphate dehydrogenase which results in the oxidation of 1,4-dihydronicotinamide adenine dinucleotide (NADH) to NAD(+). The oxidation of NADH is measured spectrophotometrically by the decrease in absorbance at 340 nm on an automated chemistry analyzer. (Beutler E. Red Cell Metabolism. A Manual of Biochemical Methods. Grune and Stratton; 1984; van Solinge WW, van Wijk. Enzymes of the red blood cell. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 30)
Specimen Retention Time
7 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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.CPT Code Information
82657
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
TPIC | Triosephosphate Isomerase, B | 44054-5 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
TPICL | Triosephosphate Isomerase, B | 44054-5 |
Day(s) Performed
Weekly, Varies