Order Code ALAD Aminolevulinic Acid Dehydratase, Whole Blood
Reporting Name
ALA Dehydratase, WBUseful For
Preferred confirmation test for the diagnosis of aminolevulinic acid dehydratase deficiency porphyria
This test is not useful for detecting lead intoxication.
Testing Algorithm
The following algorithms are available:
-Porphyria (Acute) Testing Algorithm
Performing Laboratory

Specimen Type
Whole bloodOrdering Guidance
This assay is not useful in assessment of lead intoxication as it reactivates aminolevulinic acid dehydratase that has been inhibited by lead. The preferred test for lead toxicity is PBDV / Lead, Venous, with Demographics, Blood.
Necessary Information
1. Patient’s age is required
2. Include a list of medications the patient is currently taking.
Specimen Required
Patient Preparation: Patient must not consume any alcohol for 24 hours before specimen collection. This is essential as ethanol suppresses aminolevulinic acid dehydratase activity, leading to false-positive results.
Container/Tube:
Preferred: Green top (sodium heparin)
Acceptable: Lavender top (EDTA) or green top (lithium heparin)
Specimen Volume: Full tube 4 mL
Collection Instructions: Refrigerate specimen as soon as possible.
Specimen Minimum Volume
3 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Whole blood | Refrigerated (preferred) | 7 days |
Ambient | 4 days |
Special Instructions
Reference Values
Reference ranges have not been established for patients who are younger than 16 years of age.
≥4.0 nmol/L/sec
3.5-3.9 nmol/L/sec (indeterminate)
<3.5 nmol/L/sec (diminished)
Day(s) Performed
Tuesday
CPT Code Information
82657
Genetics Test Information
Aminolevulinic acid dehydratase (ALAD) activity can be inhibited in situations including hereditary tyrosinemia type 1, lead intoxication, and exposure to styrene, trichloroethylene, or bromobenzene. These causes should be ruled out when considering a diagnosis of ALAD deficiency porphyria (ADP). This method will not detect a decreased ALAD enzyme activity due to lead intoxication.
This test will not detect lead intoxication.
Method Description
Measurement of aminolevulinic acid (ALA) dehydratase activity is based on the rate of synthesis of uroporphyrin from ALA in incubated, lysed erythrocytes. Low yield of uroporphyrin from ALA indicates a deficiency of ALAD.(Unpublished Mayo method)
Reject Due To
Gross hemolysis | Reject |
Method Name
Enzymatic End point/Spectrofluorometric
Forms
New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available: