Test Catalog

Test Id : A2M

Alpha-2-Macroglobulin, Serum

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

Evaluating patients with nephrotic syndrome and pancreatitis

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

Nephelometry

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

Alpha-2-Macroglobulin, S

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

AMG (Alpha-2-Macroglobulin)

Macroglobulin, Alpha-2

AMG, Macroglobulin

Specimen Type
Describes the specimen type validated for testing

Serum

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

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.

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 OK
Gross lipemia Reject
Gross icterus OK

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
Serum Refrigerated (preferred) 21 days
Frozen 28 days
Ambient 72 hours

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

Evaluating patients with nephrotic syndrome and pancreatitis

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

Alpha-2-macroglobulin is a protease inhibitor and is one of the largest plasma proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development of the lymphatic system, and inhibits components of the complement system and hemostasis system.

 

Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when lower molecular weight proteins are lost, but alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.

 

Patients with acute pancreatitis exhibit low serum concentrations, which correlate with the severity of the disease. In hyperfibrinolytic states, after major surgery, in septicemia, and severe hepatic insufficiency, the measured levels of alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the greater than a year survival time.

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 =18 years: 178-495 mg/dL

>18 years: 100-280 mg/dL

Interpretation
Provides information to assist in interpretation of the test results

Values are elevated in the nephrotic syndrome in proportion to the severity of protein loss (lower molecular weight).  

 

Values are low in proteolytic diseases such as pancreatitis.

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

Quantitation of specific proteins by nephelometric means may not be possible in lipemic sera due to the extreme light scattering properties of the specimen. Turbidity and particles in the specimen may result in extraneous light scattering signals, resulting in variable specimen analysis.

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

1. McMahon MJ, Bowen M, Mayer AD, Cooper EH: Relation of alpha-2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis. Am J Surg. 1984 Jan;147(1):164-170. doi: 10.1016/0002-9610(84)90052-7

2. Haines AP, Howarth D, North WR, et al: Haemostatic variables and the outcome of myocardial infarction. Thromb Haemost. 1983;50(4):800-803

3. Hofmann W, Schmidt D, Guder WG, Edel HH: Differentiation of hematuria by quantitative determination of urinary marker proteins. Klin Wochenschr. 1991 Jan 22;69(2):68-75. doi: 10.1007/BF01666819

4. Solerte SB, Adamo S, Viola C, et al: Acute-phase protein reactants pattern and alpha 2 macroglobulin in diabetes mellitus. Pathophysiological aspects in diabetic microangiopathy. RIC Clin Lab. 1984;14(3):575-579. doi: 10.1007/BF02904891

5. Silverman LM, Christenson RH, Grant GH: Basic chemistry of amino acids and proteins. In: Tietz, NW ed. Clinical Guide to Laboratory Tests. 2nd ed. WB Saunders Comp; 1990:380-381

6. Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018

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

In this method, the light scattered onto the antigen-antibody complexes is measured. The intensity of the measured scattered light is proportional to the amount of antigen-antibody complexes in the sample under certain conditions. If the antibody volume is kept constant, the signal behaves proportionally to the antigen volume.

 

A reference curve is generated by a standard with a known antigen content on which the scattered light signals of the samples can be evaluated and calculated as an antigen concentration. Antigen-antibody complexes are formed when a sample containing antigen and the corresponding antiserum are put into a cuvette. A light beam is generated with a light-emitting diode, which is transmitted through the cuvette. The light is scattered onto the immuno-complexes that are present. Antigen and antibody are mixed in the initial measurement, but no complex is formed yet. An antigen-antibody complex is formed in the final measurement.

 

The result is calculated by subtracting the value of the final measurement from the initial measurement. The distribution of intensity of the scattered light depends on the ratio of the particle size of the antigen-antibody complexes to the radiated wavelength.(Instruction manual: Siemens Nephelometer II. Siemens, Inc; Version 2.3, 2008; Addendum to the Instruction Manual 2.3. 08/2017)

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 Friday

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.

2 to 5 days

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

14 days

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 cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

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.

83883

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
A2M Alpha-2-Macroglobulin, S 1835-8
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.
A2M Alpha-2-Macroglobulin, S 1835-8

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