Order Code PIPU Pipecolic Acid, Random, Urine
Reporting Name
Pipecolic Acid, UUseful For
Differentiating between disorders of peroxisomal biogenesis (eg, Zellweger syndrome) and disorders with loss of a single peroxisomal function
Detecting abnormal elevations of pipecolic acid in urine
Performing Laboratory

Specimen Type
UrineNecessary Information
Patient's age is required.
Specimen Required
Supplies: Urine tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Specimen Minimum Volume
2 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Urine | Frozen (preferred) | 94 days |
Refrigerated | 14 days |
Special Instructions
Reference Values
≤31 days: ≤223.8 nmol/mg creatinine
32 days-5 months: ≤123.1 nmol/mg creatinine
6 months-11 months: ≤45.0 nmol/mg creatinine
≥1 year: ≤5.7 nmol/mg creatinine
Day(s) Performed
Tuesday
CPT Code Information
82542
Genetics Test Information
Pipecolic acid is not detected by conventional organic acid analysis of urine.
In the newborn period, pipecolic acid levels are more likely to be abnormal in urine than in plasma or serum. Abnormal levels of pipecolic acid should be interpreted together with the results of other biochemical markers of peroxisomal disorders, such as plasma C22-C26 very long-chain fatty acids, phytanic acid, pristanic acid, red blood cell plasmalogens, and bile acid intermediates.
Method Description
Pipecolic acid is quantitated by a stable isotope dilution method; electron capture negative chemical ionization gas chromatography mass spectrophotometry of pentafluorobenzyl esters.(Kok RM, Kaster L, de Jong AP, et al. Stable isotope dilution analysis of pipecolic acid in cerebrospinal fluid, plasma, urine and amniotic fluid using electron capture negative ion mass fragmentography. Clin Chim Acta. 1987;168:143-152, Kuhara t, Akiyama T, Ohse M, et al. Identification of new biomarkers of pyridoxine-dependent epilepsy by GC/MS-based urine metabolomics. Anal Biochem. 2020;604:113739. doi:10.1016/j.ab.2020.113739)
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Method Name
Gas Chromatography Mass Spectrometry (GC-MS)
Testing Algorithm
For more information see Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm.
Forms
If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.