Ordering Recommendation

Preferred initial molecular test to confirm a diagnosis or identify carriers of medium chain acyl-CoA dehydrogenase (MCAD) deficiency for individuals with suggestive clinical and/or biochemical findings. To diagnose or rule out MCAD deficiency, refer to Acylcarnitine Quantitative Profile, Plasma (0040033), Acylglycine, Quantitative, Urine (0081170), and Organic Acids, Urine (0098389).

Mnemonic
MCADPCR
Methodology

Polymerase Chain Reaction/Fluorescence Monitoring

Performed

DNA isolation: Sun-Sat; Assay: Sun-Sat

Reported

3-5 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).

Specimen Preparation

Transport 3 mL whole blood. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions
Remarks
Stability

Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable

Reference Interval

Negative: The patient is negative for the ACADM 985A>G and 199T>C mutations. Persons affected with MCAD deficiency may have rare mutations in ACADM or other genes not detected by this assay.

Interpretive Data

Interpretive Data:
Background Information for Medium Chain Acyl-CoA Dehydrogenase (ACADM) 2 Mutations:
Characteristics:
Limited mitochondrial fatty acid beta-oxidation leading to hypoglycemia, lethargy, seizures, hypoketotic aciduria, vomiting, hepatomegaly, hepatic failure, encephalopathy, and sudden death. Manifestations often triggered by prolonged fasting or other metabolic stressors.
Incidence:
1 in 15,000.
Inheritance:
Autosomal recessive.
Cause:
Deleterious ACADM gene mutations.
Clinical Sensitivity:
75 percent for MCAD deficiency.
Mutations Tested:
ACADM mutations c.985A>G (p.K329E, also known as K304E) and c.199T>C (p.Y67H, also known as Y42H).
Methodology:
Polymerase chain reaction and fluorescence monitoring.
Analytical Sensitivity and Specificity:
99 percent.
Limitations:
Diagnostic errors can occur due to rare sequence variations. ACADM mutations other than c.985A>G and c.199T>C will not be detected.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

81401

Components
Component Test Code* Component Chart Name LOINC
0051209 MCAD Mutation A985G 50397-9
0051217 MCAD Mutation T199C
0051242 Medium Chain Acyl-CoA Interpretation 43242-7
2001328 MCADPCR Specimen
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • ACADM
  • MCAD Deficienc
  • MCAD gene mutation assay
Medium Chain Acyl-CoA Dehydrogenase (ACADM) 2 Mutations