Sign in →

Test Code 23BPR 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, Random, Urine


Ordering Guidance


Although a random urine collection is acceptable, the preferred specimen for 2,3-dinor-11beta-prostaglandin F2 alpha analysis is a 24-hour urine collection; order 23BPT / 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine.

 

If ordering this test with NMHR / N-Methylhistamine, Random, Urine, both tests must be ordered under different order numbers. They cannot share an order number.



Specimen Required


Patient Preparation: Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha. If possible, discontinue for 2 weeks or 72 hours, respectively, prior to collecting a specimen.

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Container/Tube: Plastic, 5-mL tube

Specimen Volume: 5 mL

Collection Instructions: Collect a random urine specimen.


Useful For

Screening for mast cell activation disorders including systemic mastocytosis using random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
R23BP 2,3-dinor 11B-Prostaglandin F2a No Yes
CRETR Creatinine, Random, U No Yes

Method Name

R23BP: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

2,3-dinor 11B-Prostaglandin F2a,RU

Specimen Type

Urine

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  30 days
  Ambient  8 hours

Reject Due To

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

Clinical Information

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is the most abundant metabolic product of prostaglandins released by activated mast cells. Systemic mastocytosis (SM) is a disease in which clonally derived mast cells accumulate in peripheral tissues. Degranulation of these mast cells releases large amounts of histamines, prostaglandins, leukotrienes, and tryptase.

 

The World Health Organization diagnostic criteria for SM require the presence of elevated mast cell counts on a bone marrow biopsy and one of the following minor criteria:

-Abnormal mast cell morphology

-KIT Asp816Val variant

-CD25-positive mast cells

-Serum tryptase greater than 20 ng/mL

 

Alternatively, SM diagnosis can be made with the presence of 3 minor criteria in the absence of abnormal bone marrow studies.

 

Measurement of mast cell mediators in blood or urine is less invasive and is advised for the initial evaluation of suspected cases. Elevated levels of serum tryptase, urinary N-methylhistamine, 2,3 BPG, or leukotriene E4 are consistent with the diagnosis of systemic mast cell disease.

Reference Values

<1802 pg/mg creatinine

Interpretation

Elevated urinary 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG) concentrations greater than 1820 pg/mg creatinine are consistent with the diagnosis of systemic mast cell disease when combined with clinical signs and symptoms. Pharmacological treatment with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) has been shown to decrease production of 2,3 BPG.

 

Urinary 2,3 BPG has been shown to improve sensitivity in the screening of mastocytosis when used in conjunction with urinary leukotriene E4 and urinary N-methylhistamine. An internal study showed when all three urine markers are measured; sensitivity for systemic mastocytosis detection is 90%.

Cautions

Elevated levels of 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG) in urine are not specific for systemic mast cell disease and may be found in patients with angioedema, diffuse urticaria, or myeloproliferative diseases in the absence of diffuse mast cell proliferation.

 

Systemic mast cell disease is a heterogeneous disease, and some patients may not have elevated 2,3 BPG in urine.

 

Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha if dosage has not been discontinued for 2 weeks or 72 hours, respectively.

Method Description

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is quantified in urine by liquid chromatography tandem mass spectrometry (LC-MS/MS). Deuterium-labeled 2,3-dinor-11beta-prostaglandin F2 alpha (d9-2,3 BPG) and reagent are added to all controls and specimens, which are then liquid/liquid extracted. The extractant is evaporated and samples and controls  then reconstituted. Chromatographic separation is achieved with an analytical column. This eluent is transferred to an API 5000 MS/MS. The ratios of the integrated peak heights of 2,3 BPG and d9-2,3 BPG internal standard are used to calculate the concentration of the analyte. All 2,3 BPG concentrations are normalized to urine creatinine levels.(Unpublished Mayo method)

 

Creatinine:

All 2,3 BPG concentrations are normalized to urine creatinine levels measured using a Roche cobas enzymatic method. The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V15.0, 03/2019)

Day(s) Performed

Tuesday, Thursday

Report Available

3 to 8 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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.

CPT Code Information

84150

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
23BPR 2,3-dinor 11B-Prostaglandin F2a,RU 97658-9

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
603459 2,3-dinor 11B-Prostaglandin F2a 97658-9