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Test Code TGLBF Triglycerides, Body Fluid

Reporting Name

Triglycerides, BF

Useful For

Distinguishing between chylous and nonchylous effusions

 

Measurement of triglycerides in body fluids as a surrogate for chylomicrons

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Body Fluid


Ordering Guidance


For help distinguishing between chylous and nonchylous effusions, order BFLA1 / Lipid Analysis, Body Fluid. The body fluid will be tested for cholesterol and triglyceride concentrations and undergo lipoprotein electrophoresis.



Necessary Information


1. Date and time of collection is required.

2. Specimen source is required.



Specimen Required


Specimen Type: Body fluid

Preferred Source:

-Peritoneal fluid (peritoneal, abdominal, ascites, paracentesis)

-Pleural fluid (pleural, chest, thoracentesis)

-Drain fluid (drainage, Jackson Pratt [JP] drain)

-Pericardial Fluid

Acceptable Source: Write in source name with source location (if appropriate)

Collection Container/Tube: Sterile container

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Centrifuge to remove any cellular material and transfer into a plastic vial.

2. Indicate the specimen source and source location on label.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Body Fluid Frozen (preferred) 30 days
  Refrigerated  7 days
  Ambient  24 hours

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Sunday

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

84478

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TGLBF Triglycerides, BF 12228-3

 

Result ID Test Result Name Result LOINC Value
FLD25 Fluid Type: 14725-6
BFTGL Triglycerides (BF) 12228-3

Clinical Information

Triglyceride concentration in body fluids is correlated to the presence of chylomicrons and can be useful when diagnosing chylous effusion or differentiating from pseudochylous effusion.(1) Chylous effusions are characterized by the presence of chyle which contains chylomicrons circulating through the lymphatic system. Pseudochylous effusions do not have chylomicrons. These fluids have a milky appearance and can be confused with chylous effusions. While chylous effusions often have elevated triglyceride concentrations and decreased cholesterol concentrations, identification of chylomicrons is considered the gold standard for the diagnosis.

 

Pleural fluid:

Chylothorax is the name given to pleural effusions containing chylomicrons. They develop when chyle accumulates from disruption of the lymphatic system, often the thoracic duct, caused mainly by malignancy or trauma.(1) Lymph contains chylomicron rich chyle characterized by high concentrations of triglycerides. Pseudochylous effusions are the name given to milky appearing effusions that do not contain lymphatic contents but rather form gradually through the breakdown of cellular lipids in long-standing effusions such as rheumatoid pleuritis, tuberculosis, or myxedema and by definition the effluent contains high concentrations of cholesterol.(2) Differentiation of pseudochylothorax from chylothorax is important as their milky or opalescent appearance is similar, however therapeutic management strategies differ.

 

Peritoneal fluid:

Chylous ascites is the name given to peritoneal effusions containing chylomicrons. Obstruction of lymph flow causing leakage from dilated subserosal lymphatics, exudation through the walls of retroperitoneal megalymphatics, and direct leakage of chyle due to a lymphoperitoneal fistula have been proposed as possible mechanisms causing chylous ascites.(3) Elevated triglyceride concentrations have the best correlation with detection of chylomicrons, while cholesterol is not useful at predicting the presence or absence of chylomicrons.

Interpretation

Pleural fluid triglyceride concentrations over 110 mg/dL are consistent with a chylous effusion. Triglyceride concentrations below 50 mg/dL are usually not due to chylous effusions.(1)

 

Peritoneal fluid triglyceride concentrations over 187 mg/dL are most consistent with chylous effusion.(3)

Report Available

Same day/1 to 2 days

Specimen Retention Time

1 week

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus Reject
Anticoagulant or additive, amniotic fluid, breast milk, saliva, sputum, synovial fluid, bronchoalveolar lavage (BAL) or bronchial washings, colostomy, ostomy, feces, cerebrospinal fluid, gastric secretions, nasal secretions, urine, vitreous Reject

Method Name

Colorimetry