Test Catalog

Test Id : TGLBF

Triglycerides, Body Fluid

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

Distinguishing between chylous and nonchylous effusions

 

Measurement of triglycerides in body fluids as a surrogate for chylomicrons

Method Name
A short description of the method used to perform the test

Colorimetry

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Triglycerides, BF

Aliases
Lists additional common names for a test, as an aid in searching

Chylothorax Analysis, Abnormal Body Fluid

Chylothorax Lipid Analysis, Abnormal Body Fluid

Fat, Body Fluids

Triglyceride, Body Fluids

TGLBF

Specimen Type
Describes the specimen type validated for testing

Body Fluid

Ordering Guidance

For help distinguishing between chylous and nonchylous effusions, order BFLA1 / Lipid Analysis, Body Fluid. The body fluid will be tested for cholesterol and triglyceride concentrations and undergo lipoprotein electrophoresis.

Necessary Information

1. Date and time of collection is required.

2. Specimen source is required.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Preferred Source:

-Peritoneal fluid (peritoneal, abdominal, ascites, paracentesis)

-Pleural fluid (pleural, chest, thoracentesis)

-Drain fluid (drainage, JP drain)

-Pericardial Fluid

Acceptable Source: Write in source name with source location (if appropriate)

Collection Container/Tube: Sterile container

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Centrifuge to remove any cellular material and transfer into a plastic vial.

2. Indicate the specimen source and source location on label.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia OK
Gross icterus Reject
Anticoagulant or additive, amniotic fluid, breast milk, saliva, sputum, synovial fluid, bronchoalveolar lavage (BAL) or bronchial washings, colostomy, ostomy, feces, cerebrospinal fluid, gastric secretions, nasal secretions, urine, vitreous Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Body Fluid Frozen (preferred) 30 days
Refrigerated 7 days
Ambient 24 hours

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

Distinguishing between chylous and nonchylous effusions

 

Measurement of triglycerides in body fluids as a surrogate for chylomicrons

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

Triglyceride concentration in body fluids is correlated to the presence of chylomicrons and can be useful when diagnosing chylous effusion or differentiating from pseudochylous effusion.(1) Chylous effusions are characterized by the presence of chyle which contains chylomicrons circulating through the lymphatic system. Pseudochylous effusions do not have chylomicrons. These fluids have a milky appearance and can be confused with chylous effusions. While chylous effusions often have elevated triglyceride concentrations and decreased cholesterol concentrations, identification of chylomicrons is considered the gold standard for the diagnosis.

               

Pleural fluid:

Chylothorax is the name given to pleural effusions containing chylomicrons. They develop when chyle accumulates from disruption of the lymphatic system, often the thoracic duct, caused mainly by malignancy or trauma.(1) Lymph contains chylomicron rich chyle characterized by high concentrations of triglycerides. Pseudochylous effusions are the name given to milky appearing effusions that do not contain lymphatic contents but rather form gradually through the breakdown of cellular lipids in long-standing effusions such as rheumatoid pleuritis, tuberculosis, or myxedema and by definition the effluent contains high concentrations of cholesterol.(2) Differentiation of pseudochylothorax from chylothorax is important as their milky or opalescent appearance is similar, however therapeutic management strategies differ.

 

Peritoneal fluid:

Chylous ascites is the name given to peritoneal effusions containing chylomicrons. Obstruction of lymph flow causing leakage from dilated subserosal lymphatics, exudation through the walls of retroperitoneal megalymphatics, and direct leakage of chyle due to a lymphoperitoneal fistula have been proposed as possible mechanisms causing chylous ascites.(3) Elevated triglyceride concentrations have the best correlation with detection of chylomicrons, while cholesterol is not useful at predicting the presence or absence of chylomicrons.

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.

An interpretive report will be provided

Interpretation
Provides information to assist in interpretation of the test results

Pleural fluid triglyceride concentrations over 110 mg/dL are consistent with a chylous effusion. Triglyceride concentrations below 50 mg/dL are usually not due to chylous effusions.(1)

 

Peritoneal fluid triglyceride concentrations over 187 mg/dL are most consistent with chylous effusion.(3)

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

Dicynone (Etamsylate) at therapeutic concentrations may lead to false-low results.

 

Acetaminophen intoxications are frequently treated with N-acetylcysteine.

 

N-acetylcysteine at a plasma concentration above 166 mg/L and the acetaminophen metabolite, N-acetyl-p-benzoquinone imine (NAPQI) may independently cause falsely low results.

 

In very rare cases, gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), may cause unreliable results.

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

1. Hooper C, Lee YC, Maskell N, BTS Pleural Guideline Group: Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl2):ii4-17. doi: 10.1136/thx.2010.136978

2. Staats BA, Ellefson RD, Budahn LL, et al: The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc. 1980;55(11):700-704

3. Thaler MA, Bietenbeck A, Schulz C, Luppa PB: Establishment of triglyceride cut-off values to detect chylous ascites and pleural effusions. Clin Biochem. 2017 Feb;50(3):134-138. doi: 10.1016/j.clinbiochem.2016.10.008

4. McGrath EE, Blades Z, Anderson PB:Chylothorax: aetiology, diagnosis, and therapeutic options. Respir Med. 2010 Jan;104(1):1-8. doi: 10.1016/j.rmed.2009.08.010

Method Description
Describes how the test is performed and provides a method-specific reference

Samples analyzed for triglycerides are measured by an automated enzymatic method. The chemistry includes hydrolysis of the triglycerides and phosphorylation of the resulting glycerol.(Package insert: Roche Triglycerides Reagent. Roche Diagnostics Corp; V12.0, 11/2017)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 week

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been modified from the manufacturer's instructions. Its performance characteristics were 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.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84478

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports