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Test Code C4U C4 Acylcarnitine, Quantitative, Random, Urine

Reporting Name

C4 Acylcarnitine, QN, U

Useful For

Evaluation of patients with abnormal newborn screens showing elevations of iso-/butyrylcarnitine to aid in the differential diagnosis of short-chain acyl-CoA dehydrogenase and isobutyryl-CoA dehydrogenase deficiencies

Method Name

Flow Injection Analysis-Tandem Mass Spectrometry (FIA-MS/MS)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


This second-tier test is used specifically to evaluate a newborn screening elevation of iso-/butyrylcarnitine and must not be ordered with either C5OHU / C5-OH Acylcarnitine, Quantitative, Random, Urine or C5DCU / C5-DC Acylcarnitine, Quantitative, Random, Urine.

 

For general screening for metabolic disorders, see OAU / Organic Acids Screen, Random, Urine; ACRN / Acylcarnitines, Quantitative, Plasma; and AAQP / Amino Acids, Quantitative, Plasma.



Necessary Information


Include patient's age, family history, clinical condition (asymptomatic or acute episode), diet, and drug therapy information.

Specimen Required


Patient Preparation: If clinically feasible, discontinue L-carnitine supplementation at least 72 hours before specimen collection.

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 10 mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Freeze specimen immediately.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Frozen (preferred) 7 days
  Refrigerated  24 hours

Reject Due To

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

Reference Values

<3.00 millimoles/mole creatinine

Day(s) Performed

Monday, Wednesday, Friday

CPT Code Information

82017

LOINC Code Information

Test ID Test Order Name Order LOINC Value
C4U C4 Acylcarnitine, QN, U 53111-1

 

Result ID Test Result Name Result LOINC Value
88829 C4 Acylcarnitine, QN, U 53111-1
28075 C4 Interpretation 59462-2
34468 Reviewed By 18771-6

Clinical Information

An isolated elevation of iso-/butyrylcarnitine (C4) in plasma or newborn screening blood spots is related to a diagnosis of either short chain acyl-CoA dehydrogenase (SCAD) deficiency or isobutyryl-CoA dehydrogenase (IBD) deficiency. Diagnostic testing by acylcarnitine analysis, including the evaluation of C4 excretion in urine, is necessary to differentiate the 2 clinical entities.(1) Patients with IBD deficiency excrete an abnormal amount of C4 acylcarnitine in urine, whereas patients with SCAD deficiency can have a normal excretion of this metabolite.

Specimen Retention Time

1 month

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.

Genetics Test Information

Elevated iso-/butyrylcarnitine (C4) in plasma or newborn screening blood spots is due to either short chain acyl-CoA dehydrogenase (SCAD) deficiency or isobutyryl-CoA dehydrogenase (IBD) deficiency.

 

Urine C4 results can distinguish between SCAD deficiency, which results in normal C4 in urine, and IBD deficiency, which results in elevated C4 in urine.

Report Available

2 to 5 days