Pyruvate, Spinal Fluid

Casandra

Casandra Test Code MC65410Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID PYRCCPT Code 84210

Pyruvate, Spinal Fluid

Clinical Use

Use

The test is useful for investigating possible disorders of mitochondrial metabolism when used alongside cerebrospinal fluid lactate measurements to calculate the lactate-to-pyruvate ratio (L:P). It assists in evaluating patients with neurological dysfunction and normal blood L:P ratios. The ratio aids in the assessment of patients suspected to have mitochondrial metabolism disorders, especially when neurological symptoms are present despite normal blood L:P ratios.

Special Instructions

Pyruvic acid levels alone have little clinical utility; the test is most informative when combined with lactic acid measurements to calculate the L:P ratio. Collection of cerebrospinal fluid (CSF) and blood specimens should occur simultaneously for accurate L:P ratio comparison. Ensure specimen collection and handling are conducted correctly to yield reliable results. Abnormal pyruvic and lactate levels must be interpreted alongside the patient's clinical presentation and other laboratory findings.

Limitations

The test does not calculate the lactate-to-pyruvate ratio. Both tests PYRC (Pyruvic Acid, CSF) and LASF1 (Lactic Acid, Spinal Fluid) must be ordered together to derive this ratio. The L:P ratio is elevated in various mitochondrial respiratory chain disorders and can vary widely depending on the specific mitochondrial disorder, which often manifests with neurological symptoms, developmental delays, and, potentially, a range of multisystemic issues. A low L:P ratio is indicative of inherited disorders linked to pyruvate metabolism such as pyruvate dehydrogenase complex (PDHC) deficiency.

Test Details

New York Approved