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Test Catalog

Test ID: 23BPR    
2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, Random, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Screening for mast cell activation disorders including systemic mastocytosis using random urine specimens

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

2,3-Dinor-11beta-prostaglandin F2 alpha (2,3 BPG) is the most abundant metabolic product of prostaglandins released by activated mast cells. Systemic mastocytosis (SM) is a disease in which clonally derived mast cells accumulate in peripheral tissues. Degranulation of these mast cells releases large amounts of histamines, prostaglandins, leukotrienes, and tryptase.

 

World Health Organization diagnostic criteria for SM require the presence of elevated mast cell counts on a bone marrow biopsy and 1 of the following minor criteria:

-Abnormal mast cell morphology

-KIT Asp816Val variant

-CD25-positive mast cells

-Serum tryptase greater than 20 ng/mL

 

Alternatively, SM diagnosis can be made with the presence of 3 minor criteria in the absence of abnormal bone marrow studies.

 

Measurement of mast cell mediators in blood or urine is less invasive and is advised for the initial evaluation of suspected cases. Elevated levels of serum tryptase, urinary N-methylhistamine, 2,3 BPG, or leukotriene E4 are consistent with the diagnosis of systemic mast cell disease.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<1802 pg/mg creatinine

Interpretation Provides information to assist in interpretation of the test results

Elevated urine 2,3-dinor-11beta-prostaglandin F2 alpha is consistent with systemic mastocytosis.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Elevated levels of 2,3-dinor-11beta-prostaglandin F2 alpha (2,3 BPG) in urine are not specific for systemic mast cell disease and may be found in patients with angioedema, diffuse urticaria, or myeloproliferative diseases in the absence of diffuse mast cell proliferation.

 

Systemic mast cell disease is a heterogeneous disease, and some patients may not have elevated 2,3 BPG in urine.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Gotlib J, Pardanani A, Akin C, et al: International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) and European Competence Network on Mastocytosis (ECNM) consensus response criteria in advanced systemic mastocytosis. Blood. 2013 Mar 28;121(13):2393-2401. doi: 10.1182/blood-2012-09-458521

2. Butterfield JH: Increased leukotriene E4 excretion in systemic mastocytosis. Prostaglandins Other Lipid Mediat. 2010 Jun;92(1-4):73-76. doi: 10.1016/j.prostaglandins.2010.03.003

3. Roberts LJ 2nd, Sweetman BJ, Lewis RA, Austen KF, Oates JA: Increased production of prostaglandin D2 in patients with systemic mastocytosis. N Engl J Med. 1980 Dec 11;303(24):1400-1404. doi: 10.1056/NEJM198012113032405

4. Metcalfe DD: Mastocytosis syndromes. In: Middleton E Jr, Reed CE, Ellis EF, et al. eds. Allergy Principles and Practice. Vol II. 4th ed. Mosby Yearbook Inc; 1993:1537-1551