Test ID PMSBB Postmortem Screening, Bile and Blood Spot
Useful For
Postmortem evaluation of individuals at any age who died suddenly or unexpectedly; testing is particularly recommended under the following circumstances (risk factors):
-Family history of sudden infant death syndrome or other sudden unexpected deaths at any age
-Family history of Reye syndrome
-Maternal complications of pregnancy (acute fatty liver pregnancy, HELLP syndrome [hemolysis, elevated liver enzymes, and low platelet count])
-Lethargy, vomiting, fasting in the 48 hours prior to death
-Allegation of child abuse (excluding obvious cases of trauma, physical harm)
Macroscopic findings at autopsy:
-Fatty infiltration of the liver
-Dilated or hypertrophic cardiomyopathy
-Autopsy evidence of infection that routinely would not represent a life-threatening event
Genetics Test Information
Acylcarnitine analysis in blood and bile specimens to evaluate cases of sudden or unexpected death. Confirmatory enzymatic and molecular studies of cultured fibroblasts may be recommended.
Highlights
Analysis of acylcarnitines in blood and bile spots represents the first level of evaluation of a complete postmortem investigation of a sudden or unexpected death of an individual at any age.
Analysis facilitates the diagnosis of over 20 inborn errors of metabolism including fatty acid oxidation disorders and organic acidurias.
Abnormal results are not always sufficient to conclusively establish a diagnosis of a particular disease. When abnormal results are obtained, additional confirmatory testing is recommended.
Detailed reports for abnormal acylcarnitine profiles are provided that include an overview of the results and recommendations for follow-up.
Special Instructions
Method Name
Flow Injection Analysis-Tandem Mass Spectrometry (FIA-MS/MS)
Reporting Name
Postmortem ScreeningSpecimen Type
Whole bloodNecessary Information
Request the original newborn screening card from the state laboratory where the decedent was born. See Request for Original Newborn Screening Card. Provide patient name, date and time of birth and death, suspected cause of death, circumstances of death, relevant family history, and date and time of sample collection.
Biochemical Genetics Patient Information (T602) is recommended, but not required, to be filled out and sent with the specimen to aid in the interpretation of test results.
Specimen Required
Both bile and blood spots are required.
Supplies: Card-Postmortem Screening (Filter Paper) (T525)
Container/Tube:
Preferred: Card-Postmortem Screening Card (Filter Paper)
Acceptable: Whatman Protein Saver 903 paper or local newborn screening card
Specimen Volume: Properly completed screening card
Collection Instructions:
1. Collect blood in a heparin-containing tube and drop 25 mcL of blood onto the 2 circles labeled Blood.
2. Collect bile by direct puncture of the gallbladder and drop 25 mcL of bile onto the 2 circles labeled Bile.
3. Allow to dry at ambient temperature in a horizontal position for a minimum of 3 hours.
4. Fill out information on page 2 of collection card.
5. Do not expose specimen to heat or direct sunlight.
6. Do not stack wet specimens.
7. Keep specimen dry.
Specimen Minimum Volume
Bile spot: 1; Blood spot: 1
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Ambient (preferred) | FILTER PAPER | |
Frozen | FILTER PAPER | ||
Refrigerated | FILTER PAPER |
Reference Values
Quantitative results are compared to a constantly updated range which corresponds to the 5 to 95 percentile interval of all postmortem cases analyzed in our laboratory.
Day(s) Performed
Wednesday
Performing Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
83789
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PMSBB | Postmortem Screening | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
22675 | Specimen | 31208-2 |
22676 | Specimen ID | 57723-9 |
22677 | Source | 31208-2 |
22678 | Order Date | 82785-7 |
22679 | Reason For Referral | 42349-1 |
22680 | Method | 85069-3 |
22684 | Results | In Process |
81931 | Interpretation | 59462-2 |
22681 | Amendment | 48767-8 |
22682 | Reviewed By | 18771-6 |
22683 | Release Date | 82772-5 |
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.Testing Algorithm
For more information see Postmortem Screening Algorithm for Fatty Acid Oxidation Disorders and Organic Acidurias.
Report Available
7 to 16 daysNY State Approved
YesForms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.