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Test Code LAB873 Erythropoietin, Serum

Reporting Name

Erythropoietin (EPO), S

Useful For

An aid in distinguishing between primary and secondary polycythemia

 

Differentiating between appropriate secondary polycythemia (eg, high-altitude living, pulmonary disease, tobacco use) and inappropriate secondary polycythemia (eg, tumors)

 

Identifying candidates for erythropoietin (EPO) replacement therapy (eg, those with chronic renal failure)

 

Evaluating patients undergoing EPO replacement therapy who demonstrate an inadequate hematopoietic response

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.6 mL

Collection Instructions:

1. Morning collection, 7:30 a.m.-12 p.m. is preferred due to diurnal variation. For more information see Cautions.

2. Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  7 days

Reference Values

2.6-18.5 mIU/mL

Day(s) Performed

Monday through Friday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82668

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EPO Erythropoietin (EPO), S 15061-5

 

Result ID Test Result Name Result LOINC Value
EPO Erythropoietin (EPO), S 15061-5

Cautions

Erythropoietin (EPO) levels alone cannot reliably distinguish between primary and secondary polycythemia; EPO levels are within normal limits in some patients with primary polycythemia.

 

People living at high altitudes may have higher EPO levels than people living at lower altitudes.

 

This assay cannot distinguish between endogenous and exogenous EPO.

 

There are no specific assays for measuring recombinant EPO compounds. Drug levels can only be roughly estimated from the cross reactivity of the compounds in EPO assays. According to Mayo Clinic in-house studies, epoetin and darbepoetin show approximately 58% and 36% cross reactivity, respectively, in the EPO assay.

 

Because results obtained with one commercial EPO assay may differ significantly from those obtained with any other, it is recommended that any serial testing performed on the same patient over time should be performed with the same commercial EPO test.

 

Heterophile antibodies may interfere in this assay. Results markedly at variance with presentation should be questioned. Additional specimen workup to eliminate heterophile antibody interference can be performed; call 800-533-1710 for additional information.

 

Lower EPO levels than expected have been seen with anemias associated with the following conditions: rheumatoid arthritis, AIDS, cancer, ulcerative colitis, sickle cell disease, and in premature neonates.

 

After allogeneic bone marrow transplant, impaired EPO response may delay EPO recovery.

 

Patients with hypergammaglobulinemia associated with multiple myeloma or Waldenstrom disease have impaired production of EPO in relation to hemoglobin concentration. This has been linked to increased plasma viscosity.

 

There is some diurnal variation in EPO levels. For optimal results in serial patient monitoring, all specimens should be collected at the same time of day. The diurnal variation is minimal in normal individuals (<20%), but in hospitalized patients with a variety of illnesses, as well as ambulatory patients with chronic lung disease, serum EPO concentrations can be 20% to 60% higher at night than early in the morning. This phenomenon is most pronounced in patients with EPO levels within approximately 2-times the upper limit of the normal population reference interval.

Report Available

1 to 3 days

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross Icterus OK

NY State Approved

Yes

Method Name

Immunoenzymatic Assay

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Benign Hematology Test Request (T755)