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22228 Aminolevulinic Acid Dehydratase (ALAD)

Aminolevulinic Acid Dehydratase (ALAD)
Test Code: MISC
Synonyms/Keywords
​Ref Lab Code: 88924, ALA (Aminolevulinic Acid) Dehydratase, Doss Porphyria, PBG (Porphobilinogen) Synthase, Plumboporphyria, Porphobilinogen (PBG) Synthase, ALAD (Aminolevulinic Acid Dehydratase) Deficiency Porphyria (ADP)
Useful For
​Confirmation of a diagnosis of aminolevulinic acid dehydratase deficiency porphyria
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole blood​ Sodium-heparin Green Top Tube (GTT)​ EDTA Lavender Top Tube (LTT) or Lithium-heparin Green Top Tube (GTT)​ Full tube ​ 3 mL​ ​
Collection Processing Instructions
​All porphyrin tests on whole blood can be performed on 1 draw tube.
 
Specimen must arrive within 96 hours of draw.
1. Patient should abstain from alcohol for 24 hours.
2. Immediately place specimen on wet ice.
Additional Information: Include a list of medications the patient is currently taking.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood Refrigerated​ 4 days​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​ Monday through Friday​
2 days (not reported on Saturday or Sunday)​
Enzymatic End point/Spectrofluorometric​
Reference Lab
Mayo Clinic Laboratories
Reference Range Information
Aminolevulinic Dehydratase:
>=4.0 nmol/L/sec
3.5 - 3.9 nmol/L/sec (Indeterminate)
<3.5 nmol/L/sec (Diminished)
Interpretation
​In patients with deficiency porphyria (ADP), erythrocyte aminolevulinic acid (ALA) dehydratase (ALAD) activity is typically reduced by 80%, or more, from normal levels.
 
ALAD activity can be inhibited in other situations including hereditary tyrosinemia type 1, lead intoxication, and exposure to styrene, trichloroethylene, and bromobenzene. These causes should be ruled out when considering a diagnosis of ADP.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82657 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 88924, ALA (Aminolevulinic Acid) Dehydratase, Doss Porphyria, PBG (Porphobilinogen) Synthase, Plumboporphyria, Porphobilinogen (PBG) Synthase, ALAD (Aminolevulinic Acid Dehydratase) Deficiency Porphyria (ADP)
Ordering Applications
Ordering Application Description
​COM ​Misc Test
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole blood​ Sodium-heparin Green Top Tube (GTT)​ EDTA Lavender Top Tube (LTT) or Lithium-heparin Green Top Tube (GTT)​ Full tube ​ 3 mL​ ​
Collection Processing
​All porphyrin tests on whole blood can be performed on 1 draw tube.
 
Specimen must arrive within 96 hours of draw.
1. Patient should abstain from alcohol for 24 hours.
2. Immediately place specimen on wet ice.
Additional Information: Include a list of medications the patient is currently taking.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood Refrigerated​ 4 days​
Useful For
​Confirmation of a diagnosis of aminolevulinic acid dehydratase deficiency porphyria
Reference Range Information
Aminolevulinic Dehydratase:
>=4.0 nmol/L/sec
3.5 - 3.9 nmol/L/sec (Indeterminate)
<3.5 nmol/L/sec (Diminished)
Interpretation
​In patients with deficiency porphyria (ADP), erythrocyte aminolevulinic acid (ALA) dehydratase (ALAD) activity is typically reduced by 80%, or more, from normal levels.
 
ALAD activity can be inhibited in other situations including hereditary tyrosinemia type 1, lead intoxication, and exposure to styrene, trichloroethylene, and bromobenzene. These causes should be ruled out when considering a diagnosis of ADP.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​ Monday through Friday​
2 days (not reported on Saturday or Sunday)​
Enzymatic End point/Spectrofluorometric​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82657 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.