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HelpTest 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.
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,RUSpecimen Type
UrineSpecimen 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 daysSpecimen Retention Time
14 daysPerforming 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 |