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HelpTest Code LAB1232368 Pernicious Anemia Cascade, Serum
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Reporting Name
Pernicious Anemia CascadeSpecimen Type
SerumOrdering Guidance
Ask patients if they have received a vitamin B12 injection or radiolabeled vitamin B12 injection within the last 2 weeks. Patient results will not reflect deficiency or malabsorption after recent B12 injection. If patient has received such an injection within the past 2 weeks, this test should not be ordered.
Specimen Required
Patient Preparation:
1. Patient should fast for 8 hours.
2. For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
3. For 1 week before specimen collection, if medically feasible, patient should not take proton pump inhibitors (omeprazole, lansoprazole, dexlansoprazole, esomeprazole, pantoprazole, and rabeprazole).
4. For at least 2 weeks before specimen collection, patient should not take or receive drugs that interfere with gastrointestinal motility (eg, opioids).
Collection Container/Tube:
Preferred:Â Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions:
1. Centrifuge, divide specimen into 3 plastic vials:
Vial 1 (B12PA): 1 mL of serum
Vial 2 (PAMMA): 1.5 mL of serum
Vial 3 (PAGAS): 0.5 mL of serum
2. Band specimens together and send frozen.
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | Reject |
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 30 days | |
| Refrigerated | 24 hours |
Specimen Minimum Volume
1.6 mL
Special Instructions
Day(s) Performed
Monday through Saturday
Specimen Retention Time
2 weeksReport Available
Same day/1 to 4 daysReference Values
180-914 ng/L
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IFBPA | Intrinsic Factor Blocking Ab, S | Yes, (order IFBA) | No |
| MMAPA | Methylmalonic Acid, QN, S | Yes, (order MMAS) | No |
| GASTR | Gastrin, S | Yes, (order GAST) | No |
Useful For
Diagnosis of pernicious anemia
Diagnosis of vitamin B12 deficiency-associated neuropathy
Testing Algorithm
If the vitamin B12 concentration is less than 150 ng/L, then the intrinsic factor blocking antibody (IFBA) test is performed at an additional charge.
If IFBA result is negative or indeterminate, then the gastrin test is performed at an additional charge.
If the vitamin B12 concentration is 150 to 400 ng/L, then the methylmalonic acid (MMA) test is performed at an additional charge.
If the MMA result is greater than 0.40 nmol/mL, then the IFBA test is performed at an additional charge.
If the IFBA test is negative or indeterminate, then the gastrin test is performed at an additional charge.
For more information see Vitamin B12 Deficiency Evaluation.
CPT Code Information
82607
82941-(if appropriate)
83921-(if appropriate)
86340-(if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ACASM | Pernicious Anemia Cascade | 2132-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| B12PA | Vitamin B12 Assay, S | 2132-9 |
Forms
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.