Test Code LAB2199 Carnitine, Plasma
Additional Codes
CARN
Useful For
Evaluation of patients with a clinical suspicion of a wide range of conditions including organic acidemias, fatty acid oxidation disorders, and primary carnitine deficiency using plasma specimens
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
PlasmaNecessary Information
Patient's age is required.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Green top (sodium heparin)
Acceptable: Lavender top (EDTA), green top (lithium heparin)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot plasma into a plastic vial
Specimen Minimum Volume
0.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma | Frozen (preferred) | 60 days | |
Refrigerated | 21 days | ||
Ambient | 7 days |
Reference Values
|
Total carnitine (TC) |
Free carnitine (FC) |
Acylcarnitine (AC) |
AC/FC Ratio |
Age Group |
Range* |
Range* |
Range* |
Range |
≤1 day |
23-68 |
12-36 |
7-37 |
0.4-1.7 |
2-7 days |
17-41 |
10-21 |
3-24 |
0.2-1.4 |
8-31 days |
19-59 |
12-46 |
4-15 |
0.1-0.7 |
32 days-12 months |
38-68 |
27-49 |
7-19 |
0.2-0.5 |
13 months-6 years |
35-84 |
24-63 |
4-28 |
0.1-0.8 |
7-10 years |
28-83 |
22-66 |
3-32 |
0.1-0.9 |
11-17 years |
34-77 |
22-65 |
4-29 |
0.1-0.9 |
≥18 years |
34-78 |
25-54 |
5-30 |
0.1-0.8 |
*Values expressed as nmol/mL
Schmidt-Sommerfeld E, Werner E, Penn D: Carnitine plasma concentrations in 353 metabolically healthy children. Eur J Pediatr. 1988;147:356-360
Used with permission of European Journal of Pediatrics.
Day(s) Performed
Monday through Friday
CPT Code Information
82379
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
CARN | Carnitine, P | 97182-0 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
32050 | Total | 14288-5 |
32051 | Free (FC) | 14286-9 |
32052 | Acylcarnitine (AC) | 14282-8 |
21032 | AC/FC Ratio | 30193-7 |
21549 | Interpretation | 59462-2 |
Interpretation
When abnormal results are detected, a detailed interpretation is given, including an overview of the results and of their significance, a correlation to available clinical information, elements of differential diagnosis, recommendations for additional biochemical testing, and a phone number to reach one of the laboratory directors in case the referring physician has additional questions.
Method Description
Free and total carnitines are measured by tandem mass spectrometry (MS/MS) stable isotope dilution analysis. Hydrolysis enables measurement of total carnitine, and esterified carnitine (acylcarnitine) is calculated as the difference between the total and free carnitine. Quantification is enabled using deuterium-labeled carnitine (d3-carnitine) added as internal standard. A selected reaction monitoring experiment is performed by MS/MS. The first mass spectrometer detects carnitine and d3-carnitine precursors and transmits them to a collision cell within the mass spectrometer where they are fragmented. Specific fragments derived from the carnitine and internal standard are monitored in the second mass spectrometer.(Stevens RD, Hillman SL, Worthy S, Sanders D, Millington DS. Assay for free and total carnitine in human plasma using tandem mass spectrometry. Clin Chem. 2000;46(5):727-729; Miller MJ, Cusmano-Ozog K, Oglesbee D, Young S. ACMG Laboratory Quality Assurance Committee. Laboratory analysis of acylcarnitines, 2020 update: a technical standard of the American College of Medical Genetics and Genomics [ACMG]. Genet Med. 2021;23[2]:249-258)
Report Available
3 to 5 daysSpecimen Retention Time
1 monthReject Due To
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Method Name
Flow Injection Analysis-Tandem Mass Spectrometry (FIA-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.