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Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

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TRYPU<br />

83823<br />

from 0 to 5 years of age. In addition to other indices of malnutrition, the measurement of plasma<br />

concentration of tryptophan is used as an indicator of appropriate dietary therapy. Determination of<br />

tryptophan by conventional amino acid profiling methods (ninhydrin-based, HPLC) is hampered by<br />

coelution with other compounds. This liquid chromatography-tandem mass spectrometry (LC-MS/MS)<br />

method quantifies tryptophan and is interference free.<br />

Useful For: Investigating inadequate tryptophan intake and monitoring dietary treatment<br />

Interpretation: If the result is within the respective age-matched reference range, no interpretation is<br />

provided. When an abnormal result is reported, an interpretation may be added including a correlation to<br />

available clinical information, elements of differential diagnosis, and recommendations for additional<br />

biochemical testing, if applicable.<br />

Reference Values:<br />

< or =23 months: 17-75 nmol/mL<br />

2 years-17 years: 23-80 nmol/mL<br />

> or =18 years: 29-77 nmol/mL<br />

Clinical References: 1. Bremer HJ, Duran M, Kamerling JP, et al: In Disturbances of amino acid<br />

metabolism: Clinical Chemistry and Diagnosis. Edited by HJ Bremer, M Duran, JP Kamerling, et al.<br />

Baltimore-Munich, Urban and Schwarzenberg, 1981, pp 171-173 2. Hoffmann GF, Schulze A: Organic<br />

acidurias. In Pediatric Endocrinology and Inborn Errors of Metabolism. Edited by K Sarafoglou, GF<br />

Hoffmann, KS Roth, New York, McGraw-Hill <strong>Medical</strong> Division, 2009, pp 108-112<br />

Tryptophan, Urine<br />

Clinical Information: Amino acids are the basic units that make up proteins and are crucial to<br />

virtually all metabolic processes in the body. Tryptophan is an essential amino acid necessary for the<br />

synthesis of serotonin, melatonin, and niacin. Hartnup disease is a rare, usually benign, autosomal<br />

recessive disorder of renal and intestinal neutral amino acid transport. The clinical features associated<br />

with Hartnup disease include an erythematous skin rash on exposed surfaces that is identical to the rash<br />

seen in pellagra (niacin deficiency) and cerebral ataxia. Biochemically, it is characterized by increased<br />

renal excretion of tryptophan and other neutral amino acids. Newborn screening studies reveal that most<br />

affected individuals remain asymptomatic, suggesting that clinical expression of symptoms is dependent<br />

on additional genetic or environmental factors (ie, multifactorial disease). Determination of tryptophan by<br />

conventional amino acid profiling methods (ninhydrin-based, HPLC) is hampered by co-elution with<br />

other compounds. This liquid chromatography-tandem mass spectrometry method quantifies tryptophan<br />

and is interference free.<br />

Useful For: An aid in the screening and monitoring of Hartnup disease<br />

Interpretation: Increased urinary excretion of tryptophan is suggestive of Hartnup disease. If the result<br />

is within the respective age-matched reference range, no interpretation is provided. When an abnormal<br />

result is reported, an interpretation may be added, including a correlation to available clinical information<br />

and recommendations for additional biochemical testing, if applicable.<br />

Reference Values:<br />

< or =35 months: 14-315 nmol/mg creatinine<br />

3-8 years: 10-303 nmol/mg creatinine<br />

9-17 years: 15-229 nmol/mg creatinine<br />

> or =18 years: 18-114 nmol/mg creatinine<br />

Clinical References: 1. Roth KS: Disorders of membrane transport. In Pediatric Endocrinology and<br />

Inborn Errors of Metabolism. Edited by K Sarafoglou, GF Hoffmann, KS Roth. New York, McGraw-Hill<br />

<strong>Medical</strong> Division, 2009, pp 108-112 2. Bremer HJ, Duran M, Kamerling JP, et al: Disturbances of Amino<br />

Acid Metabolism: Clinical Chemistry and Diagnosis. Edited by Urban and Schwarzenberg.<br />

Baltimore-Munich, 1981, pp 171-173<br />

Current as of January 3, 2013 2:22 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong>Laboratories.com Page 1810

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