Test Id : OLIGU
Oligosaccharide Screen, Random, Urine
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Screening for selected oligosaccharidosis
    
        Genetics Test Information
            
                
                
                    
                    Provides information that may help with selection of the correct genetic test or proper submission of the test request
                
            
    
    Oligosaccharidoses are characterized by the abnormal accumulation of incompletely degraded oligosaccharides in cells and tissues and the corresponding increase of related free oligosaccharides in the urine.
 
Clinical features of the oligosaccharidoses often overlap; therefore, urine screening is an important tool in the initial workup for these disorders.
 
Enzyme or molecular analysis is required to make a definitive diagnosis.
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    Oligosaccharide analysis may be considered in the workup of unexplained refractory epilepsy. For more information see:
-Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm
    
        Method Name
            
                
                
                    
                    A short description of the method used to perform the test
                
            
    
    Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)
    
        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
                
            
    
    
    
        Aliases
            
                
                
                    
                    Lists additional common names for a test, as an aid in searching
                
            
    
    Oligosaccharidosis
Oligosaccharidoses
OLIGO
Alpha-Mannosidosis
Alpha-Fucosidosis
Alpha-N-Acetylgalactosaminidase Deficiency
Aspartylglycosaminuria
Galactosialidosis
GM1 gangliosidosis
GM2 gangliosidosis
I-Cell Disease
Mucolipidosis II
Mucolipidosis III
Pompe Disease
Pseudo-Hurler Polydystrophy
Sandhoff Disease
Schindler Disease
Sialidosis
Beta-Mannosidosis
Mucopolysaccharidosis IVB
Urineoligos
Beta-galactosidase
MOGS-CDG
NGLY1-CDG
CDG IIb
Fucosidosis
Mannosidosis
Urine oligos
Urine oligosaccharides
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    Oligosaccharide analysis may be considered in the workup of unexplained refractory epilepsy. For more information see:
-Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm
    
        Specimen Type
            
                
                
                    
                    Describes the specimen type validated for testing
                
            
    
        Urine
    
        Ordering Guidance
    
    This is the recommended test when clinical features are suggestive of, or when molecular testing results suggest, an oligosaccharidosis disorder that can be identified by this test.
 
The recommended screening test for the initial workup of a suspected lysosomal storage disorder, particularly when clinical features are nonspecific, is LSDS / Lysosomal Storage Disorders Screen, Random, Urine.
    
        Necessary Information
    
    1. Patient's age is required.
2. Biochemical Genetics Patient Information (T602) is recommended. This information aids in providing a more thorough interpretation of results. Send information with specimen.
    
        Specimen Required
            
                
                
                    
                    Defines the optimal specimen required to perform the test and the preferred volume to complete testing
                
            
    
    Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 8 mL
Pediatric Volume: 2 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No added preservative.
3. Immediately freeze specimen.
    
        Special Instructions
            
                
                
                    
                    Library of PDFs including pertinent information and forms related to the test
                
            
    
    
    
        Forms
    
    1. Biochemical Genetics Patient Information (T602)
2. If not ordering electronically, complete, print, and send a Biochemical Genetics Test Request (T798) with the specimen.
    
        Specimen Minimum Volume
            
                
                
                    
                    Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
                
            
    
    2.5 mL
    
        Reject Due To
            
                
                
                    
                    Identifies specimen types and conditions that may cause the specimen to be rejected
                
            
    
    
    
        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 | 
|---|---|---|---|
| Urine | Frozen (preferred) | 365 days | |
| Ambient | 7 days | ||
| Refrigerated | 15 days | 
    
        Useful For
            
                
                
                    
                    Suggests clinical disorders or settings where the test may be helpful
                
            
    
    Screening for selected oligosaccharidosis
    
        Genetics Test Information
            
                
                
                    
                    Provides information that may help with selection of the correct genetic test or proper submission of the test request
                
            
    
    Oligosaccharidoses are characterized by the abnormal accumulation of incompletely degraded oligosaccharides in cells and tissues and the corresponding increase of related free oligosaccharides in the urine.
 
Clinical features of the oligosaccharidoses often overlap; therefore, urine screening is an important tool in the initial workup for these disorders.
 
Enzyme or molecular analysis is required to make a definitive diagnosis.
    
        Testing Algorithm
            
                
                
                    
                    Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
                
            
    
    Oligosaccharide analysis may be considered in the workup of unexplained refractory epilepsy. For more information see:
-Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm
    
        Clinical Information
            
                
                
                    
                    Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
                
            
    
    The oligosaccharidoses (glycoproteinoses) are a subset of lysosomal disorders (LD) caused by the deficiency of any one of the lysosomal enzymes involved in the degradation of complex oligosaccharide chains. They are characterized by the abnormal accumulation of incompletely degraded oligosaccharides in cells and tissues and the corresponding increase of related free oligosaccharides in the urine. Clinical diagnosis can be difficult due to the similarity of clinical features across disorders and their variable severity. Clinical features can include bone abnormalities, coarse facial features, corneal cloudiness, organomegaly, muscle weakness, hypotonia, developmental delay, and ataxia. Age of onset ranges from early infancy to adulthood and can also present prenatally.
 
The oligosaccharidoses and other storage disorders detected by this assay include alpha-mannosidosis, beta-mannosidosis, aspartylglucosaminuria, fucosidosis, Schindler disease, GM1 gangliosidosis, Sandhoff disease, sialidosis, galactosialidosis, mucolipidoses types II and III, mucopolysaccharidosis IVA (Morquio A), mucopolysaccharidosis IVB (Morquio B), and Pompe disease (see Table). Additional conditions that may be picked up by this test include other mucopolysaccharidoses, Gaucher disease, and some congenital disorders of glycosylation (PMM2, NGLY1, MOGS, ALG1).
 
Table. Conditions Identifiable by Test
| Disease | Gene | Enzyme deficiency | 
| Alpha- mannosidosis | MAN2B1 | Alpha-mannosidase | 
| Phenotype: Considerably variable.   Three clinical types have been suggested in untreated individuals. Type I   Clinically recognized after age ten years, with myopathy, slow progression,   and absence of skeletal abnormalities. Type 2 - Clinically recognized before   age ten years, with myopathy, slow progression, and presence of skeletal   abnormalities. Type 3 – Severe progression leading to early death from   primary central nervous system involvement or infection. Enzyme replacement   therapy is available for all forms. | ||
| Beta-mannosidosis | MANBA | Beta-mannosidase | 
| Phenotype: Disease severity and   progression is highly variable with onset from infancy to adulthood. Clinical   features may include intellectual disability, respiratory infections, hearing   loss, hypotonia, peripheral neuropathy, seizures, and behavioral problems. | ||
| Aspartylglucosaminuria | AGA | Aspartylglucosaminidase | 
|  | Phenotype: Clinical features   include developmental delay, intellectual disability, behavioral problems,   recurrent infections, musculoskeletal features, and characteristic facial   features. Clinical features worsen with age, and adults have progressive psychomotor   decline. | |
| Fucosidosis | FUCA1 | Alpha-L-fucosidase | 
| Phenotype: Continuum within a   wide spectrum of severity; clinical features include neurodegeneration,   coarse facial features, growth delay, recurrent infections, dysostosis   multiplex, angiokeratoma, and elevated sweat chloride. | ||
| Schindler disease | NAGA | Alpha-N-acetyl-galactosaminidase | 
| Phenotype: There are three types   of Schindler diseases that differ in disease severity and age of onset. Type   I is characterized by rapidly progressive neurodegeneration, typically by age   2 years. Type II is typically diagnosed in adulthood and characterized by   angiokeratomas, mild cognitive impairment, and hearing loss.  Type III is an intermediate form that   presents as a variety of symptoms that may include intellectual disability,   seizures, and autism spectrum disorder. | ||
| GM1 gangliosidosis | GLB1 | Beta-galactosidase | 
| Phenotype: Continuum of clinical   features ranging from severe and rapidly progressive disease to a milder and   more slowly progressive course; infantile onset (type I) is characterized by   early developmental delay/arrest followed by progressive neurodegeneration,   skeletal dysplasia, facial coarseness, hepatosplenomegaly, and macular cherry   red spot. Later onset forms (types II and III) are milder and observed as   progressive neurologic disease and vertebral dysplasia. Adult onset presents   mainly with dystonia. | ||
| Sandhoff disease GM2 gangliosidosis, type II | HEXB | Beta-hexosaminidase A and B | 
| Phenotype: Infantile onset is   characterized by rapidly progressive neurodegeneration, exaggerated startle   reflex, "cherry red spot". Juvenile and late-onset forms of the   disease can present with developmental regression and/or neurological impairment,   such as ataxia, dystonia, spinocerebellar degeneration, and behavior changes. | ||
| Sialidosis (ML I) | NEU1 | Alpha-neuraminidase | 
| Phenotype: Continuum of clinical   features ranging from severe disease (type II) to a milder and more slowly   progressive course (type I). Clinical features range from early developmental   delay, coarse facial features, short stature, dysostosis multiplex, and   hepatosplenomegaly to late onset cherry-red spot myoclonus syndrome.   Seizures, hyperreflexia, and ataxia have been reported in more than 50% of   later-onset patients. A congenital form of the disease has been reported in   which patients present with fetal hydrops or neonatal ascites. | ||
| Galactosialidosis | CTSA | Cathepsin A causing secondary   deficiencies in Beta-galactosidase and Alpha-neuraminidase | 
| Phenotype: Continuum of clinical   features ranging from severe and rapidly progressive disease to a milder and   more slowly progressive course; clinical features of the early infantile type   include fetal hydrops, edema, ascites, visceromegaly, dysostosis multiplex,   coarse facies, and cherry red spot. Most patients have milder presentations,   which include ataxia, myoclonus, angiokeratoma, cognitive and neurologic   decline. | ||
| Mucolipidosis II/III alpha/beta (ML II/III a/ß) Mucolipidosis III gamma (ML   III?) | GNPTAB(alpha/beta) GNPTG (gamma) | N-acetylglucosaminyl-1-phosphotransferase   deficiency causing secondary intracellular deficiency of multiple enzyme   activities | 
| Phenotype: ML II is slowly   progressive with features evident at birth. Common symptoms include skeletal   abnormalities such as clubfeet, kyphosis, thoracic deformity, and deformed   long bones, coarse facial features, gingival hyperplasia, and cardiovascular   disease. ML III a/ß is slowly progressive with onset in early   childhood presenting as slowed growth, short stature, and joint pain and   stiffness. ML III? presents similarly to ML III a/ß but milder. | ||
| Mucopolysaccharidosis IVB   (Morquio B) | GLB1 | Beta-galactosidase | 
| Phenotype: Progressive skeletal   dysplasia with findings such as dysostosis multiplex, short stature,   kyphoscoliosis, and genu/coxa valga. Corneal clouding is present in some   individuals. Central nervous system dysfunction, course facial features, and   organ enlargement are not typical. | ||
| Pompe disease (glycogen   storage disease type II) | GAA | Alpha-glucosidase | 
| Phenotype: Infantile onset is   characterized by prominent cardiomegaly, hypotonia, respiratory distress, and   weakness with onset before age 12 months. Later onset disease includes   individuals with onset before age 12 months without cardiomyopathy and all individuals   with onset after age 12 months and is characterized by proximal muscle   weakness and respiratory insufficiency. Clinically significant cardiac   involvement is uncommon with late onset. | ||
    
        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
                
            
    
    This is a screening test; not all oligosaccharidoses are detected. The resulting excretion profile may be characteristic of a specific disorder; however, abnormal results require confirmation by enzyme assay or molecular genetic testing.
When abnormal results are detected with characteristic patterns, a detailed interpretation is given, including an overview of results and significance, a correlation to available clinical information, elements of differential diagnosis, recommendations for additional confirmatory studies (enzyme assay, molecular genetic analysis).
    
        Cautions
            
                
                
                    
                    Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
                
            
    
    This test may give false-negative results, especially in older patients with mild clinical presentations.
 
This test may give false-positive results for Pompe disease, especially in pediatric patients on infant formula.
    
        Clinical Reference
            
                
                
                    
                    Recommendations for in-depth reading of a clinical nature
                
            
    
    1. Neufeld EF, Muenzer J. The mucopolysaccharidoses. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA. eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw Hill; 2019. Accessed June 9, 2025. Available at https://ommbid.mhmedical.com/content.aspx?bookId=2709§ionId=225544161
2. Thomas GH. Disorders of glycoprotein degradation: Alpha-mannosidosis, beta-mannosidosis, fucosidosis, and sialidosis. In: Valle DL, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA. eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw Hill; 2019. Accessed June 9, 2025. Available at https://ommbid.mhmedical.com/content.aspx?bookid=2709§ionid=225545029
3. Leslie N, Bailey L. Pompe Disease. In: Adam MP, Feldman J, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 1993-2025. Updated November 21, 2019. Accessed June 9, 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK1261/
4. Raas-Rothschild A, Spiegel R. Mucolipidosis III Gamma. In: Adam MP, Feldman J, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 1993-2025. Updated November 21,2019. Accessed June 9, 2025. Available at: www.ncbi.nlm.nih.gov/books/NBK24701/
5. Leroy JG, Cathey SS, Friez MJ. GNPTAB-Related Disorders.]. In: Adam MP, Feldman J, Mirzaa GM, et al, eds. GeneReviews [Internet]. University of Washington, Seattle; 1993-2025. Updated August 29, 2019.Accessed June 9, 2025. Available at: www.ncbi.nlm.nih.gov/books/NBK1828/
    
        Method Description
            
                
                
                    
                    Describes how the test is performed and provides a method-specific reference
                
            
    
    Urine samples are extracted using Oasis HLB and carbograph columns and lyophilized overnight. Oligosaccharides are permethylated, replacing all hydroxy groups (-OH) with methoxy groups (-OCH3) and esterifies carboxyl groups (-COOH to -COOCH3). After permethylation, the tubes are centrifuged, and the supernatant removed from the sodium hydroxide pellet. The supernatant is quenched, neutralized, extracted onto an Oasis HLB column, eluted, and lyophilized again overnight. Specimens are resuspended, mixed with a matrix solution containing 2,5-dihydroxybenzoic acid, spotted onto a MALDI plate, and allowed to air dry. The plate is then analyzed using a matrix-assisted laser desorption/ionization tandem time-of-flight (MALDI TOF/TOF) 5800 Analyzer.(Xia B, Asif G, Arthur L, et al. Oligosaccharide analysis in urine by MALDI-TOF mass spectrometry for the diagnosis of lysosomal storage diseases. Clin Chem. 2013;59[9]:1357-1368, Hall PL, Lam C, Alexander JJ. Urine oligosaccharide screening by MALDI-TOF for the identification of NGLY1 deficiency. Mol Genet Metab. 2018;124[1]:82-86)
    
        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.
                
            
    
    Monday
    
        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.
                
            
    
    
    
        Specimen Retention Time
            
                
                
                    
                    Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
                
            
    
    
    
        Performing Laboratory Location
            
                
                
                    
                    Indicates the location of the laboratory that performs the test
                
            
    
    
    
        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.
                
            
    
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        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. It 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.
                
            
    
    CPT codes are provided by the performing laboratory.
84377
    
        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 | 
|---|---|---|
| OLIGU | Oligosaccharide Screen, U | 49284-3 | 
| 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.
                                     | 
|---|---|---|
| 64889 | Oligosaccharide Screen, U | 49284-3 |