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Test Code DLAC D-Lactate, Plasma

Reporting Name

D-Lactate, P

Useful For

As an adjunct to urine D-lactate (preferred) for the diagnosis of D-lactate acidosis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Plasma NaFl-KOx


Ordering Guidance


Urine is the preferred specimen for D-lactate determination, order DLAU / D-Lactate, Urine.

 

For determination of L-lactate (lactic acid), order LACS1 / Lactate, Plasma



Specimen Required


Supplies: Sodium Fluoride/Potassium Oxalate Tube, 2 mL (T275)

Collection Container/Tube:

Preferred: Sodium fluoride/potassium oxalate tube

Acceptable: Green top (sodium heparin)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge, aliquot plasma into a plastic vial, and freeze immediately.

NOTE: If collecting in sodium heparin tubes, centrifugation must occur within one hour of collection.


Specimen Minimum Volume

0.15 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma NaFl-KOx Frozen (preferred) 91 days
  Ambient  91 days
  Refrigerated  91 days

Reference Values

0.0-0.25 mmol/L

Day(s) Performed

Monday, Thursday

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

83605

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DLAC D-Lactate, P 14045-9

 

Result ID Test Result Name Result LOINC Value
8878 D-Lactate, P 14045-9

Clinical Information

D-lactate is produced by bacteria residing in the colon when carbohydrates are not completely absorbed in the small intestine. When large amounts of D-lactate are present, individuals can experience metabolic acidosis, altered mental status (from drowsiness to coma), and a variety of other neurologic symptoms, in particular dysarthria and ataxia. Although a temporal relationship has been described between elevations of plasma and urine D-lactate and the accompanying encephalopathy, the mechanism of neurologic manifestations has not been elucidated.

 

D-lactic acidosis is typically observed in patients with a malabsorptive disorder, such as short-bowel syndrome, or following a jejunoileal bypass. In addition, healthy children presenting with gastroenteritis may also develop the clinical presentation of D-lactic acidosis.

 

Routine lactic acid determinations in blood will not reveal abnormalities because most lactic acid assays measure only L-lactate. Accordingly, D-lactate analysis must be specifically requested (eg, this test). However, as D-lactate is readily excreted in urine, it is the preferred specimen for D-lactate determinations; see DLAU / D-Lactate, Urine.

Interpretation

Increased levels are consistent with D-lactic acidosis. However, because D-lactate is readily excreted, urine determinations are preferred.

Cautions

The test performed is for D-lactate. This is a product of bacterial overgrowth in the gastrointestinal tract. It should not be confused with L-lactate, which accumulates in some metabolic acidosis.

Report Available

3 to 6 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method Name

Gas Chromatography Mass Spectrometry (GCMS) Stable Isotope Dilution Analysis