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Test Code MEVP Methemoglobinemia Evaluation

Reporting Name

Methemoglobinemia Evaluation

Useful For

Diagnosis of methemoglobinemia and sulfhemoglobinemia and possible hereditary (congenital) causes

 

Differentiation of methemoglobinemia and sulfhemoglobinemia from other causes of cyanosis (eg, congenital heart disease)

Profile Information

Test ID Reporting Name Available Separately Always Performed
MEV Methemoglobinemia Interpretation No Yes
A2F Hemoglobin A2 and F No Yes
HBEL Hemoglobin Electrophoresis, B No Yes
METH Methemoglobin, B Yes, (Order MET) Yes
SULF Sulfhemoglobin, B Yes, (Order MET) Yes
METR Methemoglobin Reductase, B Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
SDEX Hemoglobin S, Scrn, B Yes No
IEF IEF Confirms No No
MASS Hb Variant by Mass Spec, B No No
UNHB Unstable Hemoglobin, B No No
HPFH Hemoglobin F, Red Cell Distrib, B No No
ATHAL Alpha-Globin Gene Analysis Yes No
WASQR Alpha Globin Gene Sequencing, B Yes, (Order WASEQ) No
WBSQR Beta Globin Gene Sequencing, B Yes, (Order WBSEQ) No
WBDDR Beta Globin Cluster Locus Del/Dup,B Yes, (Order WBDD) No
MEVA Methemoglobin Summary Interp No No
WGSQR Gamma Globin Full Gene Sequencing No No

Testing Algorithm

This is a consultative evaluation in which the case will be evaluated at Mayo Clinic Laboratories, the appropriate tests performed at an additional charge, and the results interpreted. This is an evaluation for methemoglobin and sulfhemoglobin levels and possible hereditary causes. Methemoglobin, sulfhemoglobin levels, methemoglobin reductase (cytochrome-b5 reductase) activity and protein analysis screening for hemoglobin variants (cation exchange HPLC and capillary electrophoresis) will always be performed. If additional hemoglobin variant confirmatory testing is required, appropriate reflex testing will be performed. This will vary from additional protein analysis methods to molecular testing, as needed.

 

MEVA / Methemoglobin Summary Interpretation, an additional consultative interpretation that summarizes all testing, will be provided after additional testing is completed if any of the following molecular tests are reflexed on the MEVP / Methemoglobinemia Evaluation:

-ATHAL / Alpha-Globin Gene Analysis

-WASQR / Alpha-Globin Gene Sequencing, Blood

-WBSQR / Beta-Globin Gene Sequencing, Blood

-WBDDR / Beta-Globin Cluster Locus Deletion/Duplication, Blood

-WGSQR / Gamma-Globin Full Gene Sequencing

 

See Benign Hematology Evaluation Comparison in Special Instructions.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole Blood ACD-B
Whole Blood EDTA


Shipping Instructions


Specimen must arrive within 3 days (72 hours) of draw.



Necessary Information


Include recent transfusion information.

 

Include most recent CBC results.



Specimen Required


Both ACD-B and EDTA blood are required.

 

Container/Tube: Lavender top (EDTA) and yellow top (ACD [Solution B])

Specimen Volume:

EDTA: Two 4-mL tubes

ACD: One 6-mL tube

Collection Instructions: Send specimens in original tube. Do not aliquot.


Specimen Minimum Volume

EDTA Blood: 3 mL; ACD Blood: 2.7 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood ACD-B Refrigerated 72 hours
Whole Blood EDTA Refrigerated 72 hours

Reference Values

Definitive results and an interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Saturday

CPT Code Information

Methemoglobinemia Evaluation

82657-Methemoglobin reductase

83020-Hemoglobin electrophoresis

83021-Hemoglobin A2 and F

83050-Methemoglobin, quantitative

83060-Sulfhemoglobin, quantitative

 

IEF Confirms

82664-Isoelectric focusing (if appropriate)

 

Hemoglobin, Unstable, Blood

83068 (if appropriate)

 

Hemoglobin Variant by Mass Spectrometry (MS), Blood

83789 (if appropriate)

 

Hemoglobin F, Red Cell Distribution, Blood

88184 (if appropriate)

 

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MEVP Methemoglobinemia Evaluation In Process

 

Result ID Test Result Name Result LOINC Value
8268 Methemoglobin, B 2614-6
9322 Methemoglobin Reductase, B 32703-1
8272 Sulfhemoglobin, B 4685-4
2381 Hemoglobin A2 42245-1
2380 Hemoglobin A 20572-4
586 Methemoglobinemia Interpretation 59465-5
2383 Variant 32017-6
2382 Hemoglobin F 42246-9
29224 Variant 2 32017-6
29225 Variant 3 32017-6
2101 Interpretation 78748-1

Method Name

MEV: Consultative Interpretation

A2F: Cation Exchange/High-Performance Liquid Chromatography (HPLC)

HBEL: Capillary Electrophoresis

METH, SULF: Spectrophotometry (SP)

METR: Kinetic Spectrophotometry (KS)

MASS: Mass Spectrometry (MS)

IEF: Electrophoresis

HPFH: Flow Cytometry

UNHB: Isopropanol and Heat Stability

MEVA: Consultative Interpretation

Test Classification

See Individual Test IDs

Forms

1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available in Special Instructions:

-Informed Consent for Genetic Testing (T576)

-Informed Consent for Genetic Testing-Spanish (T826)

2. Metabolic Hematology Patient Information (T810) is available in Special Instructions

3. If not ordering electronically, complete, print, and send a Benign Hematology Test Request (T755) with the specimen.