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HelpEpic Code LAB1230896 Phosphatidylethanol Confirmation, Blood
Additional Codes
Mayo: PETH
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Verifying abstinence or use of ethanol, especially in liver transplant candidates/patients
Specimen Type
Whole Blood EDTASpecimen Required
Container/Tube: Lavender top (EDTA)
Specimen Volume: 1 mL
Collection Instructions:
1. Do not use alcohol to clean arm. Use alternatives such as Betadine or ChloraPrep to cleanse arm before collecting any specimen.
2. Do not centrifuge.
3. Send whole blood specimen in original tube. Do not aliquot.
Note: Collection Instructions 1. ChloraPrep is an approved alternative to alcohol wipes.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Frozen (preferred) | 28 days | |
| Refrigerated | 14 days |
Reject Due To
| Gross lipemia | OK |
| Gross icterus | OK |
Day(s) Performed
Monday through Sunday
Reference Values
Negative (<10 ng/mL)
PEth 16:0/18:1 (POPEth): Lower limit of quantification =10 ng/mL
PEth 16:0/18:2 (PLPEth): Lower limit of quantification =10 ng/mL
Clinical Information
Phosphatidylethanol (PEth) is a direct biomarker for alcohol (ethanol) intake. In presence of ethanol, phosphatidylcholine is converted to PEth on the red blood cell membrane by the phospholipase D enzyme. PEth homologues (16:0/18:1 [POPEth: 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol] and 16:0/18:2 [PLPEth: 1-palmitoyl-2-linoleoyl-sn-glycero-3-phosphoethanol]) levels correlate with the amount of alcohol consumed within the previous 2 weeks and may be detected in the blood up to 2 to 4 weeks after excessive alcohol consumption. POPEth and PLPEth comprise approximately 60% of all observed PEth homologues in the blood.(1)
Cautions
No significant cautionary statements
Interpretation
POPEth (1-Palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanol):
A result of 20 ng/mL to 200 ng/mL is considered evidence of moderate ethanol consumption, while results over 200 ng/mL indicate heavy ethanol consumption. However, the Center for Substance Abuse Treatment advises caution in interpretation and use of biomarkers alone to assess alcohol use. Results should be interpreted in the context of all available clinical and behavioral information.(2)
PLPEth (1-Palmitoyl-2-linoleoyl-sn-glycero-3-phosphoethanol):
There are no current clinical reference limits for this phosphatidylethanol (PEth) homologue.
PEth 16:0/18:1 (POPEth)
Less than 10 ng/mL: Not detected
10-19 ng/mL: Abstinence or light alcohol consumption (<2 drinks per day for several days a week)
20-200 ng/mL: Moderate alcohol consumption (up to 4 drinks per day for several days a week)
Greater than 200 ng/mL: Heavy alcohol consumption or chronic alcohol use (at least 4 drinks per day several days a week)
PEth 16:0/18:2 (PLPEth): Reference ranges are not well established.
Reporting Name
Phosphatidylethanol Confirmation, BMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Method Description
The received whole blood sample is diluted and mixed with internal standard and clinical laboratory reagent water, extracted using supported liquid extraction, and analyzed by an in-house developed liquid chromatography tandem mass spectrometry method.(Unpublished Mayo method)
CPT Code Information
80321
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PETH | Phosphatidylethanol Confirmation, B | 101506-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 617481 | PEth 16:0/18:1 (POPEth) by LC-MS/MS | 97607-6 |
| 617482 | PEth 16:0/18:2 (PLPEth) by LC-MS/MS | 97606-8 |
| 617483 | PEth Interpretation | 69050-3 |
Report Available
2 to 5 daysTest Classification
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.Clinical Reference
1. Helander A, Zheng Y. Molecular species of the alcohol biomarker phosphatidyethanol in human blood measured by LC-MS. Clin Chem. 2009:55:(7):1395-1405. doi:10.1373/clinchem.2008.120923
2. Substance Abuse and Mental Health Services Administration (SAMHSA) and National Institute on Alcohol Abuse and Alcoholism. Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. HHS Publication No. (SMA) 15-4907. SAMHSA; 2015.
3. Ulwelling W, Smith K. The PEth blood test in the security environment: What it is; why it is important; and interpretative guidelines. J Forensic Sci. 2018;63(6):1634-1640. doi:10.1111/1556-4029.13874
4. Hakim F, Wiart JF, Menard O, Allorge D, Gaulier JM. Dosage sanguin du phosphatidylethanol Phosphatidylethanol blood analysis. Ann Biol Clin (Paris). 2019;77(6):638-644. French. doi:10.1684/abc.2019.1499
5. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Forms
If not ordering electronically, complete, print, and send 1 of the following with the specimen:
-Therapeutics Test Request (T831)
-General Test Request (T239)
-Renal Diagnostics Test Request (T830)
LAB1230725
1230725