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HelpTest ID: DLAC D-Lactate, Plasma
Reporting Name
D-Lactate, PUseful For
An adjunct to urine D-lactate (preferred) for the diagnosis of D-lactate acidosis
Specimen Type
Plasma NaFl-KOxOrdering Guidance
Urine is the preferred specimen for D-lactate determination, order DLAU / D-Lactate, Urine.
For determination of L-lactate (lactic acid), order LACS1 / Lactate, Plasma
Specimen Required
Collection Container/Tube: Sodium Fluoride/Potassium Oxalate Tube, 2 mL (T275)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge, aliquot plasma into plastic vial, and freeze immediately.
Specimen Minimum Volume
0.55 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma NaFl-KOx | Frozen (preferred) | 365 days | |
| Ambient | 7 days | ||
| Refrigerated | 7 days |
Reference Values
0.0-0.25 mmol/L
Day(s) Performed
Wednesday, Friday
Test Classification
This test was developed, and its performance characteristics 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.CPT Code Information
83605
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DLAC | D-Lactate, P | 14045-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8878 | D-Lactate, P | 14045-9 |
Clinical Information
D-lactate is produced by bacteria residing in the colon when carbohydrates are not completely absorbed in the small intestine. When large amounts of D-lactate are present, individuals can experience metabolic acidosis, altered mental status (from drowsiness to coma), and a variety of other neurologic symptoms, in particular dysarthria and ataxia. Although a temporal relationship has been described between elevations of plasma and urine D-lactate and the accompanying encephalopathy, the mechanism of neurologic manifestations has not been elucidated.
D-lactic acidosis is typically observed in patients with a malabsorptive disorder, such as short-bowel syndrome, or following a jejunoileal bypass. In addition, healthy children presenting with gastroenteritis may also develop the clinical presentation of D-lactic acidosis.
Routine lactic acid determinations in blood will not reveal abnormalities because most lactic acid assays measure only L-lactate. Accordingly, D-lactate analysis must be specifically requested (eg, this test). However, as D-lactate is readily excreted in urine, it is the preferred specimen for D-lactate determinations; see DLAU / D-Lactate, Urine.
Interpretation
Increased levels are consistent with D-lactic acidosis. However, because D-lactate is readily excreted, urine determinations are preferred.
Clinical Reference
1. Petersen C: D-lactic acidosis. Nutr Clin Pract. 2005;20(6):634-645
2. Kowlgi NG, Chhabra L: D-Lactic acidosis: An underrecognized complication of short bowel syndrome. Gastroenterol Res Pract. 2015;2015:476215. doi: /10.1155/2015/476215
Report Available
4 to 8 daysMethod Name
Enzymatic
Special Instructions
mml-biochemical