Test ID: BPG2
11 Beta-Prostaglandin F2 Alpha, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Measurement of 11 beta-prostaglandin F2 alpha in urine is useful in the evaluation of patients suspected of having systemic mast-cell disease
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Enzyme Immunoassay (EIA)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
PGD2 (prostaglandin)
Prostaglandin
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.
Container/Tube: Plastic, 10-mL urine tube (Supply T068)
Specimen Volume: 10 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Refrigerate specimen during collection.
Additional Information:
1. 24-Hour volume is required.
2. See Urine Preservatives in Special Instructions for multiple collections.
Urine Preservative Collection Options
| Ambient | No |
| Refrigerated | Yes |
| Frozen | Yes |
| 6N HCl | Yes |
| 50% Acetic Acid | Preferred |
| Na2CO3 | No |
| Toluene | Yes |
| 6N HNO3 | Yes |
| Boric Acid | Yes |
| Thymol | Yes |
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.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Frozen (preferred) | 14 days |
| Refrigerated | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Prostaglandin D(2) (PGD[2]) is generated by human mast cells after they are activated via the IgE receptor or by calcium ionophore. In addition to mast cells, activated alveolar macrophages and platelets also produce and secrete PGD(2). There are a large number of metabolic products of PGD(2), the most abundant is 11 beta-prostaglandin F2 alpha.(1)
While the most definitive test for systemic mast-cell disease is bone marrow examination, 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 tryptase, N-methylhistamine or 11 beta-prostaglandin F2 alpha are consistent with the diagnosis of systemic mast cell disease.(2)
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
>1,000 ng/24 hours is considered elevated.
Interpretation Provides information to assist in interpretation of the test results
Levels of 11 beta-prostaglandin F2 alpha >1,000 ng/24 hours are consistent with the diagnosis of systemic mast-cell disease.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Elevated levels of 11 beta-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 levels of 11 beta-prostaglandin F2 alpha in urine.
Supportive Data
In studies performed at Mayo Clinic, elevated levels of 11 beta-prostaglandin F2 alpha in urine were found in 16 of 17 patients with systemic mast cell disease.
Misoprostol (Cytotec) does not cross-react in this assay.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Roberts LJ, Sweetman BJ, Lewis RA, et al: Increased production of prostaglandin D2 in patients with systemic mastocytosis. N Engl J Med 1980;303:1400-1404
2. Metcalfe DD: Mastocytosis syndromes. In Allergy Principles and Practice. Vol. II. 4th Edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, Mosby Yearbook, Inc. 1993, pp 1537-1551
Method Description Describes how the test is performed and provides a method-specific reference
11 Beta-prostaglandin F2 alpha, linked to an Acetylcholinesterase tracer, and endogenous 11 beta-prostaglandin F2 alpha compete for a limited number of rabbit antibody binding sites. The antibody-bound antigen binds to an anti-rabbit IgG attached to the well. The unbound antigen is then washed away, and Ellman's reagent is added to each well. The enzyme reaction between the bound acetylcholinesterase and the Ellman's reagent produces a yellow color that absorbs at 412 nm. The absorbance is inversely proportional to the amount of free 11 beta-prostaglandin F2 alpha. (Package insert: 11 Beta-prostaglandin F(2) Alpha Enzyme Immunoassay Kit, Cayman Chemical Company, Ann Arbor, MI)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday, Thursday; 10:00 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84150
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 21035 | BPG2 concentration | In Process |
| TM72 | Collection Duration | 13362-9 |
| VL62 | Urine Volume | 3167-4 |
| 81425 | 11 Beta-Prostaglandin F2 Alpha, U | 14007-9 |
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