Test Catalog

Test Id : PFK1

Phosphofructokinase Enzyme Activity, Blood

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

Evaluation of individuals with Coombs-negative nonspherocytic hemolytic anemia


Evaluation of individuals with exercise intolerance or myopathy


Genetic studies in families with phosphofructokinase deficiency

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

Kinetic Spectrophotometry

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


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

Phosphofructokinase, B

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

Erythrocyte Phosphofructokinase




Specimen Type
Describes the specimen type validated for testing

Whole Blood ACD-B

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

Collection Container/Tube:

Preferred: Yellow top (ACD solution B)

Acceptable: Lavender top (EDTA)

Specimen Volume: 6 mL

Collection Instructions: Send specimen in original tube. Do not transfer blood to other containers.


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

1 mL

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

Gross hemolysis Reject
Fully clotted 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
Whole Blood ACD-B Refrigerated 11 days

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

Evaluation of individuals with Coombs-negative nonspherocytic hemolytic anemia


Evaluation of individuals with exercise intolerance or myopathy


Genetic studies in families with phosphofructokinase deficiency

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

Phosphofructokinase (PFK) is the third enzyme in glycolysis. It converts fructose-6-phosphate to fructose 1,6-diphosphate. PFK deficiency, also called glycogen storage disease, type VII or Tarui disease (OMIM 232800), is a rare hereditary autosomal recessive disorder that is typically noticed in childhood. Different clinical subtypes (classical, late-onset, infantile and hemolytic) have been described. Manifestations can vary, including exercise intolerance, exertional myopathy, nausea, stiffness, and myoglobinuria. Although not classically described, a second-wind effect is noticed by some patients.(1) A subset of individuals have compensated (high normal hemoglobin values) or mild hemolytic anemia, episodic jaundice, hyperuricemia, or gout-like symptoms. No distinctive morphologic abnormalities are seen on the peripheral blood smear. Red blood cell PFK activity is typically partially decreased (30-50% mean normal) and muscle biopsy PFK activity is markedly decreased.

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.

> or =12 months of age: 5.8-10.9 U/g Hb

Reference values have not been established for patients who are <12 months of age.

Provides information to assist in interpretation of the test results

Clinically significant disorders due to phosphofructokinase deficiency are associated with red blood cell activity levels less than 50% of mean normal. Unaffected heterozygotes have been reported with levels of 63% of normal. Therefore, genetic correlation will often be important in ambiguous cases.

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

Recent transfusion may mask the patient's intrinsic erythrocyte (RBC) enzyme activity and cause unreliable results.


Some enzyme deficiency disorders can be masked by reticulocytosis and comparison of activities of other RBC enzyme activities in this panel can be useful.


Some enzyme deficiency disorders can be slightly decreased in normal neonates or conversely masked in the neonatal period. Repeat testing after 1 year of age can be useful if features of myopathy are present.

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

1. Sherman JB, Raben N, Nicastri C, et al: Common mutations in the phosphofructokinase-M gene in Ashkenazi Jewish patients with glycogenesis VII--and their population frequency. Am J Hum Genet. 1994 Aug;55(2):305-313

2. Tarui S, Okuno G, Ikura Y, Tanaka T, Suda M, Nishikawa M: Phosphofructokinase deficiency in a skeletal muscle. A new type of glycogenosis. Biochem Biophys Res Commun. 1965 May 3;19:517-23. doi: 10.1016/0006-291x(65)90156-7

3. Musumeci O, Bruno C, Mongini T, et al: Clinical features and new molecular findings in muscle phosphofructokinase deficiency (GSD type VII). Neuromuscul Disord. 2012 Apr;22(4):325-330

4. Nakajima H, Raben N, Hamaguchi T, Yamasaki T: Phosphofructokinase deficiency; past, present and future. Curr Mol Med. 2002 Mar;2(2):197-212. doi: 10.2174/1566524024605734

5. Auranen M, Palmio J, Ylikallio E, et al: PFKM gene defect and glycogen storage disease GSDVII with misleading enzyme histochemistry. Neurol Genet. 2015 Jun 4;1(1). doi: 10.1212/NXG.0000000000000007

6. Raben N, Sherman JB: Mutations in muscle phosphofructokinase gene. Hum Mutat. 1995;6(1):1-6. doi: 10.1002/humu.1380060102

7. Koralkova P, van Solinge WW, van Wijk R: Rare hereditary red blood cell enzymopathies associated with hemolytic anemia-pathophysiology, clinical aspects and laboratory diagnosis. Int J Lab Hematol. 2014 Jun;36:388-397. doi: 10.1111/ijlh.12223

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

Phosphofructokinase (PFK) catalyzes the phosphorylation of fructose-6-phosphate (F6P) by adenosine triphosphate (ATP) to fructose-1,6-diphosphate (F1,6-diP). F1,6-diP is then converted to dihydroxyacetone phosphate (DHAP) through subsequent aldolase and triosephosphate isomerase (TPI) catalyzed reactions. The rate of formation of DHAP is measured by linking its reduction to alpha-glycerophosphate by alpha-glycerophosphate dehydrogenase which results in the oxidation of reduced nicotinamide adenine dinucleotide (NADH) to NAD(+). The decrease in absorbance at 340 nm is measured spectrophotometrically as the NADH is oxidized on an automated chemistry analyzer.(Beutler E: Red cell metabolism. A Manual of Biochemical Methods. 3rd ed. Grune and Stratton; 1984: 68-71; van Solinge WW, van Wijk: Enzymes of the red blood cell. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 30)

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


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.

Tuesday, Thursday

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.

1 to 6 days

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

7 days

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


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 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.

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.


LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
PFK1 Phosphofructokinase, B 72664-6
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
PFKCL Phosphofructokinase, B 72664-6

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