Pernicious Anemia Cascade
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
If vitamin B12 is <150 ng/L, then intrinsic factor blocking antibody (IFBA) is performed. If IFBA is negative or indeterminate, then gastrin is performed.
If vitamin B12 is 150 to 400 ng/L, then methylmalonic acid (MMA) is performed. If MMA is >0.40 nmol/mL, then IFBA is performed.
See Vitamin B12 Deficiency Evaluation in Special Instructions.
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 4 mL
1. Fasting (8 hours)
2. Divide specimen into 3 plastic vials, 1 containing 1 mL, 1 containing 1.5 mL, and 1 containing 1.5 mL
3. Band specimens together.
Additional Information: This test should not be ordered on patients who have received vitamin B12 injection within the last 2 weeks.
Forms: If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
Neurology Test Request Form-General (T732) (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)
Benign Hematology Test Request Form (T755) (http://www.mayomedicallaboratories.com/it-mmfiles/benign-hematology-test-request-form.pdf)
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Mild OK; Gross reject
Mild OK; Gross OK
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.