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HelpEpic Code LAB1230587 Lipase, Body Fluid
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Determining whether pancreatic inflammation or pancreatic fistula may be contributing to a pathological accumulation of fluid
Specimen Type
Body FluidNecessary Information
1. Date and time of collection are required.
2. Specimen source is required.
Specimen Required
Specimen Type: Body fluid
Preferred Sources:
-Peritoneal fluid (peritoneal, abdominal, ascites, paracentesis)
-Pleural fluid (pleural, chest, thoracentesis)
-Drain fluid (drainage, Jackson Pratt [JP] drain)
-Pericardial
Acceptable Source: Write in source name with source location (if appropriate)
Collection Container/Tube: Sterile container
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge to remove any cellular material and transfer into a plastic vial.
2. Indicate the specimen source and source location on label.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Body Fluid | Refrigerated (preferred) | 7 days | |
| Frozen | 30 days | ||
| Ambient | 24 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Cerebrospinal fluid, feces, breast milk, saliva, nasal secretions, gastric secretions, bronchoalveolar lavage (BAL) or bronchial washings, sputum, synovial, colostomy/ostomy, urine, or vitreous fluid | Reject |
Day(s) Performed
Monday through Sunday
Reference Values
An interpretive report will be provided.
Clinical Information
Lipases are enzymes that hydrolyze glycerol esters of long-chain fatty acids and produce fatty acids and 2-acylglycerol. The pancreas is the primary source of serum lipase. Pancreatic injury results in increased serum lipase levels. Serum lipase is measured to aid in the diagnosis of pancreatitis.
Peritoneal fluid:
The digestive enzymes amylase and lipase can be measured in the identification of pancreatic fluid in the peritoneal cavity. Concentrations are expected to be elevated and at least several-fold times higher in fluid of pancreatic origin compared to simultaneous concentrations in serum.(1,2)
Drain fluid:
Lipase is expected to be elevated in drain fluids formed due to chronic pancreatitis or formation of a fistula following surgery.(1,3,4) Comparison to serum concentrations is recommended with elevations several-fold higher than blood being suggestive of the presence of pancreatic fluid in the drained cavity.(5)
Cautions
In very rare cases of gammopathy, in particular type IgM (Waldenstrom macroglobulinemia) may cause unreliable results.
Calcium dobesilate causes artificially low lipase results.
Interpretation
Fluids (peritoneal, drain):
Lipase concentrations several-fold higher than serum lipase concentrations is suggestive of the presence of pancreatic fluid in the drained cavity.
All other fluids:
Body fluid lipase activity may become elevated due to the presence of pancreatic fluid in the drained cavity. Results should be interpreted in conjunction with serum lipase and other clinical findings.
Reporting Name
Lipase, BFMethod Name
Enzymatic Colorimetric Reaction
Method Description
The chromogenic lipase substrate 1,2-O-dilauryl-rac-glycero-3-glutaric acid-(6-methylresorufin) ester is cleaved by the catalytic action of alkaline lipase solution to form 1,2-O-dilauryl-rac-glycerol and an unstable intermediate, glutaric acid-(6-methylresorufin) ester.
This decomposes spontaneously in alkaline solution to form glutaric acid and methylresorufin. Addition of detergent and colipase increases the specificity of the assay for pancreatic lipase.(Package insert: Roche Lipase reagent. Roche Diagnostics; V 3.0, 03/2022)
CPT Code Information
83690
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| LPSBF | Lipase, BF | 15212-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| LPBF | Lipase, BF | 15212-4 |
| FLD7 | Fluid Type, Lipase | 14725-6 |
Report Available
Same day/1 to 2 daysTest Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were 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.Clinical Reference
1. Block DR, Florkowski CM. Body Fluids. In: Rifai N, Horvath AR, Wittwer CT. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier;2018:chap 43
2. Robert JH, Meyer P, Rohner A. Can serum and peritoneal amylase and lipase determinations help in the early prognosis of acute pancreatitis? Ann Surg. 1986;203(2):163-168. doi:10.1097/00000658-198602000-00009
3. Lipsett PA, Cameron JL. Internal pancreatic fistula. Am J Surg. 1992;163(2):216-220. doi:10.1016/0002-9610(92)90104-y
4. Kaman L, Behera A, Singh R, Katariya RN. Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management. ANZ J Surg. 200;71(4):221-225. doi:10.1046/j.1440-1622.2001.02077.x
5. Sileo AV, Chawla SK, LoPresti PA: Pancreatic ascites: Diagnostic importance of ascitic lipase. Am J Dig Dis. 1975 Dec;20(12):1110-1114. doi:10.1007/BF01070753
6. Nandakumar V, Dolan C, Baumann NA, et al. Effect of pH on the quantification of body fluid analytes for clinical diagnostic testing. Am J Clin Path. 2019; 152(1):S10-S11