NeuroSURE® Metabolites: Alpha Aminoadipic Semialdehyde, Cerebrospinal Fluid (CSF)

CPT: 84275

Special Instructions

This assay is not currently available in New York state.


Expected Turnaround Time

10 - 14 days


Specimen Requirements


Specimen

Cerebrospinal fluid (CSF)


Volume

1.0 mL


Minimum Volume

0.5 mL


Container

Sterile screw capped vial


Collection

Collect entire sample into a single sterile tube.


Storage Instructions

Freeze as soon as possible after collection.


Stability Requirements

Temperature

Period

Room temperature

Unstable (stability provided by manufacturer or literature reference)

Refrigerated

24 hours (stability provided by manufacturer or literature reference)

Frozen

-20°C = 72 hours; -80°C = Indefinite (stability provided by manufacturer or literature reference)

Freeze/thaw cycles

None (stability provided by manufacturer or literature reference)


Causes for Rejection

Bloody CSF; received thawed


Test Details


Use

CSF Alpha aminoadipic semialdehyde is useful for diagnosing pyridoxine-dependent seizures (PDS) and folinic acid-responsive seizures (FRS). This testing may also be used for assessment of Variants of Uncertain Significance (VUS) identified during genetic testing (e.g. Next Generation Sequencing or Capillary Sequencing testing). Pyridoxine dependent seizures is a genetic disorder characterized by seizures in neonates or infants up to 3 years of age, which in general, respond to a pharmacologic dose of pyridoxine (vitamin B6). Alpha - aminoadipic semialdehyde dehydrogenase (antiquin) deficiency is the underlying defect. Piperideine-6- Carboxylate (P6C) is the cyclic isomer of alpha aminoadipic semialdehyde (AASA) and the equilibrium between P6C and Alpha aminoadipic semialdehyde is pH dependent. Folinic responsive seizures and PDS are allelic, and caused by mutations in the ALDH7A1 gene. Biochemical testing should be done prior to gene sequencing, and can be done regardless of pyridoxine therapy.


Limitations

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.


Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)


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