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Test Code 23BPR 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, Random, Urine


Ordering Guidance


Although a random urine collection is acceptable, the preferred specimen for 2,3-dinor-11beta-prostaglandin F2 alpha analysis is a 24-hour urine collection; order 23BPT / 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine.

 

If ordering this test with NMHR / N-Methylhistamine, Random, Urine, both tests must be ordered under different order numbers. They cannot share an order number.



Specimen Required


Patient Preparation: Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha. If possible, discontinue for 2 weeks or 72 hours, respectively, prior to collecting a specimen.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 5 mL

Collection Instructions: Collect a random urine specimen.


Secondary ID

606356

Useful For

Screening for mast cell activation disorders including systemic mastocytosis using random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
R23BP 2,3-dinor 11B-Prostaglandin F2a No Yes
CRETR Creatinine, Random, U No Yes

Method Name

R23BP: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

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

Specimen Type

Urine

Specimen Minimum Volume

3 mL

Specimen Stability Information

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

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) 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.

 

The World Health Organization diagnostic criteria for SM require the presence of elevated mast cell counts on a bone marrow biopsy and one of the following minor criteria:

-Abnormal mast cell morphology

-KIT Asp816Val variant

-CD25-positive mast cells

-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, 2,3 BPG, or leukotriene E4 are consistent with the diagnosis of systemic mast cell disease.

Reference Values

<1802 pg/mg creatinine

Interpretation

Elevated urinary 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG) concentrations greater than 1820 pg/mg creatinine are consistent with the diagnosis of systemic mast cell disease when combined with clinical signs and symptoms. Pharmacological treatment with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) has been shown to decrease production of 2,3 BPG.

 

Urinary 2,3 BPG has been shown to improve sensitivity in the screening of mastocytosis when used in conjunction with urinary leukotriene E4 and urinary N-methylhistamine. An internal study showed when all three urine markers are measured; sensitivity for systemic mastocytosis detection is 90%.

Day(s) Performed

Tuesday, Thursday

Report Available

3 to 8 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test 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

84150

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
23BPR 2,3-dinor 11B-Prostaglandin F2a,RU 97658-9

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
603459 2,3-dinor 11B-Prostaglandin F2a 97658-9