Lab Test

Pyruvic Acid

Pyruvate

Test Codes

Blood: ARUP: 80310, EPIC: LAB6763, SOFT: XPABL, CSF: ARUP: 80312, EPIC: LAB6764, SOFT: XPACS

Instructions

  • Because of the importance of sample processing it is required that blood be drawn only on inpatients or patients sent to the Beaumont Outpatient Lab at the Grosse Pointe, Royal Oak, or Troy Hospitals.
  • NOTE – SPECIAL HANDLING: A tube containing the appropriate volume of 8% Perchloric Acid MUST be obtained from Phlebotomy before blood is obtained from the patient.

Specimen Collection Criteria

Collect (preferred specimen): Whole blood in a syringe. (Minimum: 1.0 mL)
Also acceptable: Slightly more than 1.0 mL CSF in a sterile container.

  • Venous samples should be collected without (or with minimal use of) a tourniquet.
  • NOTE: Personal protective equipment, including goggles, is mandatory when handling. The Perchloric Acid (8%) tube should be chilled prior to specimen collection. Once collected, IMMEDIATELY transfer 1.0 mL of whole blood to the chill Perchloric Acid (8%) tube. Replace cap, mix vigorously and place ON ICE. Send tube(s), ON ICE, to the lab for processing.

Rejection Criteria

Specimens not collected and processed as indicated.

In-Lab Processing

  • Measure the exact volume of CSF indicated into the Perchloric Acid (8%) tubes.
    • For 2.0 mL Perchloric Acid, add EXACTLY 1.0 mL CSF.
  • Recap tube, shake vigorously for about 30 seconds then place on ice for 10 minutes.
  • Send specimen to the Laboratory, ON ICE, for processing.
    • NOTE: CSF needs to be added to the Perchloric Acid (8%) tube within 4 hours of collection. If unable to do so, contact the Send Outs Laboratory at (248) 551-9045.

In- Lab Preparation of Protein-Free Filtrate:

  1. Centrifuge 10 minutes. 
  2. Transfer 2.0 mL supernatant to an aliquot tube and freeze.
    • NOTE: Sample can be spun a second time if the supernatant is not colorless.

Transport: 2.0 mL supernatant, frozen (-20°C/-4°F or below). (Minimum: 1.0 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 2 days
Frozen (-20°C/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP Laboratories, Salt Lake City, UT.

Performed

Sunday – Saturday.
Results available in 2-5 days.

Reference Range

Blood: 0.030-0.107 mmol/L.
CSF: 0.060-0.190 mmol/L.

Test Methodology

Quantitative Enzymatic.

Interpretation

  • Increased blood pyruvic acid levels occur in liver disease, congestive heart failure, uremia, diabetic ketosis, diabetes mellitus, muscular dystrophy, malignant hyperthermia, thiamine deficiency and neoplastic conditions.
  • The pyruvate level will be significantly decreased if the blood is not added to the perchloric acid immediately after collection.

Clinical Utility

  • Pyruvic and lactic acid levels are widely used as measures of "oxygen-debt." These measurements are helpful in that they provide an index of the severity of circulatory failure.
  • Pyruvic acid is also helpful in evaluating patients with inborn errors of metabolism leading to increased serum lactate levels. A lactate to pyruvate ratio less than 25 suggests defective gluconeogenesis, whereas a ratio 35 or greater is consistent with hypoxia. An elevated CSF pyruvate has been reported in patients with Alzheimer's disease.

CPT Codes

84210

Contacts

Last Updated

4/1/2020

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This directory currently reflects information only for specimens collected and/or processed at the
Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.