Test Catalog

Test Id : 23BPR

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2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, Random, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Highlights

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is elevated in the urine of patients with systemic mastocytosis (SM).

 

This test should be used as a screening test for SM.

 

When 2,3 BPG is used in combination with urinary leukotriene E4 and N-methylhistamine, the sensitivity for SM detection increases to 90%.

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

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
A short description of the method used to perform the test

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

CRETR: Enzymatic Colorimetric Assay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

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

Aliases
Lists additional common names for a test, as an aid in searching

11 Beta-Prostaglandin F2 Alpha

11BPG

2,3 11 Beta-Prostaglandin F2 Alpha

23BPG

BPG2

Mastocytosis

Prostaglandin

Specimen Type
Describes the specimen type validated for testing

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
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

3 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

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

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<1802 pg/mg creatinine

Interpretation
Provides information to assist in interpretation of the test results

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%.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Elevated levels of 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG) in urine are not specific for systemic mast cell disease and may be found in patients with angioedema, diffuse urticaria, or myeloproliferative diseases in the absence of diffuse mast cell proliferation.

 

Systemic mast cell disease is a heterogeneous disease, and some patients may not have elevated 2,3 BPG in urine.

 

Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha if dosage has not been discontinued for 2 weeks or 72 hours, respectively.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Gotlib J, Pardanani A, Akin C, et al. International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) and European Competence Network on Mastocytosis (ECNM) consensus response criteria in advanced systemic mastocytosis. Blood. 2013 Mar 28;121(13):2393-2401. doi: 10.1182/blood-2012-09-458521

2. Butterfield JH. Increased leukotriene E4 excretion in systemic mastocytosis. Prostaglandins Other Lipid Mediat. 2010 Jun;92(1-4):73-76. doi: 10.1016/j.prostaglandins.2010.03.003

3. Roberts LJ 2nd, Sweetman BJ, Lewis RA, Austen KF, Oates JA. Increased production of prostaglandin D2 in patients with systemic mastocytosis. N Engl J Med. 1980;303(24):1400-1404. doi:10.1056/NEJM198012113032405

4. Metcalfe DD. Mastocytosis syndromes. In: Middleton E Jr, Reed CE, Ellis EF, et al. eds. Allergy Principles and Practice. Vol II. 4th ed. Mosby Yearbook Inc; 1993:1537-1551

5. Butterfield J, Weiler CR. The utility of measuring urinary metabolites of mast cell mediators in systemic mastocytosis and mast cell activation syndrome. J Allergy Clin Immunol Pract. 2020;8(8):2533-2541

Method Description
Describes how the test is performed and provides a method-specific reference

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is quantified in urine by liquid chromatography tandem mass spectrometry (LC-MS/MS). Deuterium-labeled 2,3-dinor-11beta-prostaglandin F2 alpha (d9-2,3 BPG) and reagent are added to all controls and specimens, which are then liquid/liquid extracted. The extractant is evaporated and samples and controls  then reconstituted. Chromatographic separation is achieved with an analytical column. This eluent is transferred to an API 5000 MS/MS. The ratios of the integrated peak heights of 2,3 BPG and d9-2,3 BPG internal standard are used to calculate the concentration of the analyte. All 2,3 BPG concentrations are normalized to urine creatinine levels.(Unpublished Mayo method)

 

Creatinine:

All 2,3 BPG concentrations are normalized to urine creatinine levels measured using a Roche cobas enzymatic method. The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V15.0, 03/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday, Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 8 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84150

82570

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

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
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CRETR Creatinine, Random, U 2161-8
603459 2,3-dinor 11B-Prostaglandin F2a 97658-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports