Sign in →

Mayo Test ID TPI1 Triosephosphate Isomerase Enzyme Activity, Blood


Specimen Required


Container/Tube:

Preferred: Yellow top (ACD solution B)

Acceptable: Lavender top (EDTA)

Specimen Volume: 6 mL

Collection Instructions: Send in original tube. Do not transfer blood to other containers.


Useful For

Evaluating individuals with chronic nonspherocytic hemolytic anemia

 

Evaluating individuals with early onset neurologic impairment

 

Genetic counseling for families with triosephosphate isomerase deficiency

Method Name

Kinetic Spectrophotometry (KS)

Reporting Name

Triosephosphate Isomerase, B

Specimen Type

Whole Blood ACD-B

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood ACD-B Refrigerated 20 days

Reject Due To

Gross hemolysis Reject

Clinical Information

Triosephosphate isomerase (TPI) converts dihydroxyacetone phosphate to glyceraldehyde 3-phosphate during glycolysis. Clinically significant TPI deficiency (OMIM #615512, autosomal recessive) is rare and classically manifests as a severe multisystem disorder with early hemolytic anemia and progressive neurologic impairment in infancy. Other clinical features include motor impairment, diaphragm paralysis, cardiomyopathy, and susceptibility to infections. Some cases have isolated hemolytic anemia.

Reference Values

≥12 months: 1033-1363 U/g Hb

Reference values have not been established for patients who are less than12 months of age.

Interpretation

Clinically significant hemolytic anemias due to triosephosphate isomerase deficiency are associated with activity levels below 30% of mean normal. Heterozygotes usually show approximately 50% of mean normal activity and are clinically unaffected.

Cautions

Recent transfusion may mask the enzyme activity of the patient and cause unreliable results.

Clinical Reference

1. Orosz F, Olah J, Ovadi J. Triosephosphate isomerase deficiency: facts and doubts. IUBMB Life. 2006;58(12):703-715

2. Fermo E, Bianchi P, Vercellati C, et al. Triose phosphate isomerase deficiency associated with two novel mutations in TPI gene. Eur J Haematol. 2010;85(2):170-173

3. Tanaka KR, Zerez CR. Red cell enzymopathies of the glycolytic pathway. Semin Hematol. 1990;27:165-185

4. Koralkova P, van Solinge WW, van Wijk R. Rare hereditary red blood cell enzymopathies associated with hemolytic anemia-pathophysiology, clinical aspects, and laboratory diagnosis. Int J Lab Hematol. 2014;36:388-397

Method Description

Triosephosphate isomerase interconverts glyceraldehyde 3-phosphate and dihydroxyacetone phosphate (DHAP). The rate of DHAP formation is measured by further converting it to alpha-glycerophosphate by alpha-glycerophosphate dehydrogenase which results in the oxidation of1,4-dihydronicotinamide adenine dinucleotide (NADH) to NAD(+). The oxidation of NADH is measured spectrophotometrically by the decrease in absorbance at 340 nm on an automated chemistry analyzer.(Beutler E: Red Cell Metabolism. A Manual of Biochemical Methods. 3rd ed. Grune and Stratton; 1984; van Solinge WW, van Wijk. Enzymes of the red blood cell. In: Rifai N, Horvath AR, Wittwer CT: eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 30)

Specimen Retention Time

7 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

82657

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TPI1 Triosephosphate Isomerase, B 44054-5

 

Result ID Test Result Name Result LOINC Value
TPICL Triosephosphate Isomerase, B 44054-5

Day(s) Performed

Tuesday, Thursday

Report Available

1 to 6 days