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Prostaglandins (D2, DM and F2-Alpha)

Container:

Prostaglandins (D2, DM and F2-Alpha)
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Reference Range:

Prostaglandin D2/Creatinine Ratio (0 - 825) ng/mmol
Prostaglandin DM/Creatinine Ratio ((0 - 2300) ng/mmol
Prostaglandin F2-Alpha/Creatinine Ratio (0 - 105) ng/mmol

Turnaround Time:

32 working days

Comments:

Internal Test Code:- PRGL

Description:

Indication: Investigation of Mast cell activation syndrome (MCAS) and anaphylaxis

Background:Prostaglandins are a group of lipid, hormone-like substances derived from arachidonic acid. They are involved in a wide range of functions such as the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, and modulation of inflammation.
Along with histamine and tryptase they are present in the preformed granules within mast cells. When mast cells are activated by antigen cross-linking IgE on the cell surface they degranulate and the contents are released into the circulation.
Prostaglandin D2 (PGD2) is a strong bronchoconstrictor which plays a role in allergic and asthmatic anaphylaxis, and in systemic mastocytosis. PGD2 is unstable and therefore has a short half-life (1-30 minutes). It is readily broken down into various metabolites, a major metabolite being 11beta-PGF2alpha. This metabolite shows greater stability.
PGD2 is readily broken down into various metabolites, including 11beta-PGF2alpha and tetranor-prostaglandin DM (PGDM). The concentration of PGDM is proportional to the concentration of the precursor PGD2 therefore the measurement of urine PGDM of may be useful in investigations into allergic and asthmatic anaphylaxis, and mast cell disease.

Method:Enzyme Linked Immunosorbant Assay (ELISA)

Repeat Frequency:For anaphylaxis a baseline sample should also be performed 24 hours post reaction.

Preparation:

A 24 hour urine sample is recommended when investigating mast cell activation syndrome (MCAS) as symptom flares and the short half-life of mast cell mediators can lead to a normal result in spot urine samples. Some patients with MCAS may not have raised mast cell mediator levels (tryptase, urine methylhistamine and prostaglandins) unless they are symptomatic. If there is good clinical history but negative results, it is recommended that the tests are repeated on a spot urine sample when the patient is symptomatic.

Vessels and Containers:

White topped universal/urine tube or 24 hour urine collection container (preservative free)

Sample Requirements:

For anaphylaxis - Spontaneous urine sample following allergic reaction followed by a baseline sample taken 24 hours post reaction.
For Mast Cell Activation Syndrome (MCAS) a 24 hour urine sample is required.
External requestors - If 24 hour sample provided, please mix samples from all containers together, volume (write this on request) and aliquot sample into a 25ml universal/urine container (not acidified) and freeze as soon as possible after receipt.

Interference:

Urinary tract infections may cause erroneous results. Collect sample when the patient does not have a UTI where possible.

How result is reported:

Numeric values

Important Information:

Entry Last Modified 24/05/2019

Reference Lab Description:

Protein Reference Unit, Northern General Hospital (Sheffield)

Transportation and Handling:

External Requestors - Freeze sample and transport frozen sample to Immunology laboratory on dry ice.
Laboratory - Freeze sample prior to dispatch and transport frozen sample at ambient temperature via Royal Mail or Courier (dry ice not required).

Special Precautions:

None

Time limits for requesting additional examinations:

This test cannot be added to samples already received.