Test ID: TP
Protein, Total, Serum
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
Total protein measurements are used in the diagnosis and treatment of a variety of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders.
Method Name A short description of the method used to perform the test
Colorimetric, Biuret
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
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:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.5 mL
Additional Information: Patient's age and sex are required.
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 | Mild OK; Gross reject |
| 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 |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 180 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Plasma proteins are synthesized predominantly in the liver; immunoglobulins are synthesized by mononuclear cells of lymph nodes, spleen and bone marrow. The 2 general causes of alterations of serum total protein are a change in the volume of plasma water and a change in the concentration of one or more of the specific proteins in the plasma. Of the individual serum proteins, albumin is present in such high concentrations that low levels of this protein alone may cause hypoproteinemia.
Hemoconcentration (decrease in the volume of plasma water) results in relative hyperproteinemia; hemodilution results in relative hypoproteinemia. In both situations, concentrations of all the individual plasma proteins are affected to the same degree.
Hyperproteinemia may be seen in dehydration due to inadequate water intake or to excessive water loss (eg, severe vomiting, diarrhea, Addison's disease and diabetic acidosis) or as a result of increased production of proteins. Increased polyclonal protein production is seen in reactive, inflammatory processes; increased monoclonal protein production is seen in some hematopoeitic neoplasms (eg, multiple myeloma, Waldenstrom's macroglobulinemia, monoclonal gammopathy of undetermined significance).
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.
> or =1 year: 6.3-7.9 g/dL
Reference values have not been established for patients that are less than 12 months of age.
Interpretation Provides information to assist in interpretation of the test results
Mild hyperproteinemia may be caused by an increase in the concentration of specific proteins normally present in relatively low concentration, eg, increases in acute phase reactants and polyclonalimmunoglobulins produced in inflammatory states, late-stage liver disease, and infections. Moderate-to-marked hyperproteinemia may also be due to multiple myeloma and other malignant paraproteinemias, although normal total protein levels do not rule out these disorders. A serum protein electrophoresis should be performed to evaluate the cause of the elevated serum total protein.
Hypoproteinemia may be due to decreased production (eg, hypogammaglobulinemia) or increased protein loss (eg, nephrotic syndrome, protein-losing enteropathy). A serum protein electrophoresis should be performed to evaluate the cause of the decreased serum total protein. If a nephrotic pattern is identified, urine protein electrophoresis should also be performed.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
The total protein concentration is 0.4 to 0.8 mg/dL lower when the sample is collected from a patient in the recumbent position.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Tietz Textbook of Clinical Chemistry. Edited by CABurtis, ER Ashwood. Philadelphia, WB Saunders Company, 1994
2. Killingsworth LM: Plasma proteins in health and disease. Crit Rev Clin Lab Sci 1979;11:1-30
Method Description Describes how the test is performed and provides a method-specific reference
Divalent copper reacts in alkaline solution with protein peptide bonds to form the characteristic purple-colored biuret complex. Sodium potassium tartrate prevents the precipitation of copper hydroxide and potassium iodide prevents autoreduction of copper. The color intensity is directly proportional to the protein concentration which can be determined photometrically. (Package insert, Roche Protein reagent, Roche Diagnostic Corp., Indianapolis, IN 1999)
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 through Sunday continuously
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.
84155
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 |
|---|---|---|
| TP | Protein, Total, S | 2885-2 |
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