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HelpOrder Code LABGOR, MALP Malabsorption Evaluation Panel, Feces
Additional Codes
Mayo Test Code: MALP
Specimen Required
Supplies: Malabsorption Panel (T920)
Container/Tube: Malabsorption kit or 2 small stool containers
Specimen Volume: 18 g split between 2 containers, each containing half of the specimen
Collection Instructions:
1. Collect a fresh, random fecal specimen, no preservative.
2. Split specimen between 2 small containers, each containing half of the specimen.
3. Label one small container with the A1AF and UREDF sample collection labels. Label the other small container with the CALPR, ELASF sample collection label.
4. Freeze immediately
Additional Information:
1. Specimen must be split prior to transport.
2. Testing cannot be added to a previously collected specimen.
3. Specimen cannot be collected from a diaper.
Useful For
Evaluation of patients with suspected malabsorption, as suggested by chronic diarrhea, unexplained weight loss, or nutritional deficiencies
Differentiation between causes of malabsorption, specifically inflammatory conditions, pancreatic insufficiency, and osmotic diarrhea
Detection of protein-losing enteropathy that may be associated with an underlying malabsorption
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| A1AF | Alpha-1-Antitrypsin, Random, F | Yes | Yes |
| CALPR | Calprotectin, F | Yes | Yes |
| ELASF | Pancreatic Elastase, F | Yes | Yes |
| UREDF | Reducing Substance, F | Yes | Yes |
Method Name
A1AF: Nephelometry
CALPR, ELASF: Enzyme-Linked Immunosorbent Assay (ELISA)
UREDF: Benedict’s Copper Reduction Reaction
Reporting Name
Malabsorption Evaluation Panel, FSpecimen Type
FecalSpecimen Minimum Volume
5 g
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Fecal | Frozen | 7 days |
Reject Due To
| Urine and feces mixed Specimens collected from diapers Feces collected in any preservative or fixative |
Reject |
Reference Values
ALPHA-1-ANTITRYPSIN, RANDOM:
≤54 mg/dL
CALPROTECTIN:
<50.0 mcg/g (Normal)
50.0-120 mcg/g (Borderline)
>120 mcg/g (Abnormal)
Reference values apply to all ages.
PANCREATIC ELASTASE:
<100 mcg/g (Severe pancreatic insufficiency)
100-200 mcg/g (Moderate pancreatic insufficiency)
>200 mcg/g (Normal)
Reference values apply to all ages.
REDUCING SUBSTANCE:
Negative or trace
Method Description
Alpha-1-Antitrypsin:
Immunonephelometry quantitates the alpha-1-antitrypsin (AAT) contained in a fecal specimen. In the absence of a timed fecal collection, an AAT fecal concentration will be reported.(Instruction manual: Siemens Nephelometer II Operations. Siemens, Inc; Version 2.3, 2008; Addendum to the Instruction Manual 2.3. 08/2017)
Calprotectin:
The QUANTA Lite Calprotectin Extended Range assay is an enzyme-linked immunosorbent assay (ELISA). Briefly, polyclonal capture antibodies specific for human calprotectin are immobilized on a 96-well plate. Calibrators, controls, and diluted patient samples are added to the wells of the plate. If present, calprotectin will bind to the capture antibodies on the plate. After a wash step, a solution containing an enzyme-labelled antibody is added. After another wash step, a substrate solution is added, which will change color in the presence of the enzyme. The absorbance of the color produced is proportional to the amount of calprotectin in the patient sample. Lastly, the control and patient results are calculated based on a curve generated from the kit calibrators.(Packet insert: QUANTA Lite Calprotectin Extended Range ELISA kit. INOVA Diagnostics; 04/2019)
Pancreatic Elastase:
The Immundiagnostik Pancreatic Elastase assay is an ELISA. Calibrators, controls, and diluted patient samples are added to a 96-well plate pre-coated with monoclonal antibodies to pancreatic elastase. If present, pancreatic elastase will bind to the antibodies on the surface of the microtiter wells. After a wash step, a peroxidase-labeled conjugate (mouse anti-pancreatic elastase) is added. After another washing step, substrate tetramethylbenzidine is added, which reacts with the peroxidase. An acidic stop solution is added, causing the color to change from blue to yellow. The intensity of the yellow color is directly proportional to the concentration of pancreatic elastase. A dose response curve of absorbance unit (optical density at 450 nm) vs. concentration is generated using the values obtained from the standards. Pancreatic elastase present in the patient samples is determined directly from this curve.(Package insert: IDK Pancreatic Elastase ELISA kit. Immundiagnostik AG; 2019)
Reducing Substances:
Copper sulfate in the tablet reacts with reducing substances converting cupric sulfate to cuprous oxide.(Package insert: AimTab Reducing Substances Tablets. Germaine Laboratories, Inc; 12/2015)
Day(s) Performed
Monday through Friday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
0430U
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen.