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HelpTest Code A2M Alpha-2-Macroglobulin, Serum
Reporting Name
Alpha-2-Macroglobulin, SUseful For
Evaluating patients with nephrotic syndrome and pancreatitis
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
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
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 21 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reference Values
≤18 years: 178-495 mg/dL
>18 years: 100-280 mg/dL
Day(s) Performed
Monday through Friday
Test Classification
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
83883
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| A2M | Alpha-2-Macroglobulin, S | 1835-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| A2M | Alpha-2-Macroglobulin, S | 1835-8 |
Clinical Information
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.
Interpretation
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
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
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
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)
Report Available
1 to 3 daysSpecimen Retention Time
14 daysReject Due To
| Gross hemolysis | OK |
| Gross lipemia | Reject |
| Gross icterus | OK |
Method Name
Nephelometry
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.