--- Query Results ---

Program:Genetics and Genomics
Test Name:Pyruvic Acid (G&G South ACH)
Test Code:PYR-W, PYR-C
Performing Site: Alberta Children's Hospital
Performing Dept:Biochemical Genetics
Availability:ARRANGED - prior arrangement is required before ordering - see additional test information.
TAT:3 days
Preferred Tube/Container:Sodium fluoride (grey)
Alternate:Sterile plastic screw-cap vial for Cerebrospinal Fluid
Specimen Requirements:For Blood Sample:
1. Patient must be fasting for 4 hours (including discontinuation of IV dextrose) and must be at
    rest for 30 minutes prior to collection.
2. Blood must be drawn WITHOUT a tourniquet.
3. Collect 1 x 2 mL sodium fluoride tube.

For CSF Sample
Preference is to use second CSF collection vial with no visible blood contamination.
Min. Sample Required:0.5 mL whole blood, 0.5 mL CSF
Specimen Processing:A staff member of the Alberta Children’s Hospital Biochemical Genetics Lab must be present at the time of collection to process the specimen.
Additional Information:This test must be booked at the ACH Biochemical Genetics Lab (403-955-7379) at least 24 hours prior to collection, and coordinated with CLS collection staff (403-955-7244).

Off-site collections will not be performed.
Requisition/Form:Submit request using Biochemical Genetics Laboratory Requisition.
Please ensure all required information, including patient's clinical history/indication, is provided on the requisition.
Order Restrictions:This test is considered specialty testing; this test will be cancelled if sufficient clinical justification is not provided.

This test must be ordered in conjunction with Lactate - Blood or Lactate - CSF.
Both tests (Pyruvic Acid and Lactate) will be performed on the same specimen.

Test will NOT be performed if patient has NOT had previous evidence of elevated blood or CSF lactate level.
Indications:Measurement of blood or CSF pyruvate, within the context of persistently elevated lactate, is used to distinguish between pyruvate dehydrogenase deficiency and other causes of congenital lactic acidosis. This test has no clinical utility outside of the context of elevated lactate. Furthermore, pediatric patients in acute liver failure have also been shown to have elevated lactate and elevated Lactate:Pyruvate (L:P) ratio irrespective of cause (i.e., values did not distinguish between mitochondrial and other causes).
Method:Pyruvate is detected spectrophotometrically using a commercially-available kit.
Method Details:When blood lactate is > 5 mmol/L, patient classification based on the L:P ratio shows improved diagnostic accuracy: the sensitivity has been reported to be 96% (95% CI, 77%–99%) with a specificity of 100% (95% CI, 59%–100%).
Reference Interval:
Blood Pyruvic Acid          0.03-0.15  mmol/l
Plasma Lactate**            0.5-2.2  mmol/l
Lactate:Pyruvic Acid Ratio              <25  ratio
** test performed by Calgary Laboratory Services (ACH)
CSF Pyruvic Acid          0.03-0.15   mmol/l
CSF Lactate**             1.0-2.1  mmol/l
Lactate:Pyruvic Acid Ratio               <25  ratio
** test performed by Calgary Laboratory Services (ACH)
Last Updated On:Wednesday, May 22, 2019
Date of Last Review:Jan 2 2018 12:00AM