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HelpTest ID ACASM Pernicious Anemia Cascade, Serum
Useful For
Diagnosis of pernicious anemia
Diagnosis of vitamin B12 deficiency-associated neuropathy
Special Instructions
Method Name
Immunoenzymatic Assay
Reporting Name
Pernicious Anemia CascadeSpecimen Type
SerumOrdering Guidance
Ask patients if they have received a vitamin B12 injection or radiolabeled vitamin B12 injection within the last 2 weeks. Patient results will not reflect deficiency or malabsorption after recent B12 injection. If patient has received such an injection within the past 2 weeks, this test should not be ordered.
Specimen Required
Patient Preparation:
1. This test should not be performed on patients who have received a vitamin B12 injection or radiolabeled vitamin B12 injection within the previous 2 weeks.
2. Patient should be fasting for 8 hours.
3. If medically feasible, proton pump inhibitor (omeprazole, lansoprazole, dexlansoprazole, esomeprazole, pantoprazole, and rabeprazole) therapy should be discontinued 1 week before measurement of serum gastrin levels.
4. Drugs that interfere with gastrointestinal motility (eg, opioids) should be discontinued for at least 2 weeks before serum gastrin testing.
Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 4 mL
Collection Instructions:
1. Divide specimen into 3 plastic vials, 1 containing 1 mL (label as PAGAS), 1 containing 1.5 mL (label as PAMMA), and 1 containing 1.5 mL (label as B12PA).
2. Band specimens together.
Specimen Minimum Volume
2.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 30 days | |
| Refrigerated | 24 hours |
Reference Values
180-914 ng/L
Day(s) Performed
Monday through Saturday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
82607-Vitamin B12 assay
82941-Gastrin (if appropriate)
83921-MMA (if appropriate)
86340-IFBA (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ACASM | Pernicious Anemia Cascade | 2132-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| B12PA | Vitamin B12 Assay, S | 2132-9 |
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| IFBPA | Intrinsic Factor Blocking Ab, S | Yes, (order IFBA) | No |
| MMAPA | Methylmalonic Acid, QN, S | Yes, (order MMAS) | No |
| GASTR | Gastrin, S | Yes, (order GAST) | No |
Testing Algorithm
If the vitamin B12 concentration is less than 150 ng/L, then the intrinsic factor blocking antibody (IFBA) test is performed at an additional charge.
If IFBA result is negative or indeterminate, then the gastrin test is performed at an additional charge.
If the vitamin B12 concentration is 150 to 400 ng/L, then the methylmalonic acid (MMA) test is performed at an additional charge.
If the MMA result is greater than 0.40 nmol/mL, then the IFBA test is performed at an additional charge.
For more information, see Vitamin B12 Deficiency Evaluation.
Report Available
Same day/1 to 4 daysNY State Approved
YesForms
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.