Sign in →

Epic Test Code LAB558 Alpha-1-Antitrypsin, Random, Feces

Additional Codes

MML:A1AF

Reporting Name

Alpha-1-Antitrypsin, Random, F

Useful For

Diagnosing protein-losing enteropathies, especially when used in conjunction with serum alpha-1-antitrypsin (AAT) levels as a part of AAT clearance studies

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Fecal


Ordering Guidance


The preferred test for diagnosing protein-losing enteropathies is A1AFS / Alpha-1-Antitrypsin Clearance, Feces and Serum.



Specimen Required


Supplies:

-Stool container, Small (Random), 4 oz (T288)

-Stool Collection Kit, Random (T635)

Container/Tube: Stool container

Specimen Volume: 5 g

Collection Instructions: Collect a random fecal specimen.


Specimen Minimum Volume

Homogenized Stool: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Fecal Frozen (preferred) 14 days
  Ambient  14 days
  Refrigerated  14 days

Reference Values

≤54 mg/dL

Day(s) Performed

Monday through Friday

CPT Code Information

82103

Clinical Information

Alpha-1-antitrypsin (AAT) is a 54kDa glycoprotein that is resistant to degradation by digestive enzymes and is, therefore, used as an endogenous marker for the presence of blood proteins in the intestinal tract. AAT clearance is reliable for measuring protein loss distal to the pylorus. A serum sample is required to interpret results as a serum deficiency of AAT) would make the AAT fecal excretion lower and could invalidate the test utility.

 

Gastrointestinal protein enteropathy has been associated with regional enteritis, sprue, Whipple intestinal lipodystrophy, gastric carcinoma, allergic gastroenteropathy, intestinal lymphangiectasia, constrictive pericarditis, congenital hypogammaglobulinemia, and iron deficiency anemia associated with intolerance to cow's milk. Increased fecal excretion of AAT can be found in small and large intestine disease and is applicable to adults and children.

Interpretation

Patients with protein-losing enteropathies generally have alpha-1-antitrypsin fecal concentrations over 100 mg/dL.

 

Borderline elevations above the normal range are equivocal for protein-losing enteropathies.

Cautions

The clearance studies using 24-hour fecal specimens and serum determinations are preferred as it normalizes the large range of serum alpha-1-antitrypsin (AAT) concentrations and the variability in random fecal AAT concentrations. In the absence of either a 24-hour fecal collection or a contemporary serum specimen, the fecal concentration of AAT can be used as a surrogate marker.

 

When gastric loss of AAT is suspected (eg, Menetrier disease), AAT clearance is not a reliable indicator of protein loss as AAT is sensitive to pH <3 and is rapidly destroyed. When gastric protein loss is suspected and the AAT clearance is normal, the recommendation is to repeat testing after starting an acid suppressive medication regime.

Report Available

1 to 3 days

Specimen Retention Time

14 days; supernatant aliquot only, the feces are discarded after processing

Reject Due To

Feces collected in any preservative or fixative Reject

NY State Approved

Yes

Method Name

Nephelometry