About the Peroxisomal Diseases Laboratory:

The Peroxisomal Diseases Section of the Genetics Laboratories assays blood, urine, fibroblasts and cultured CVS/amniocytes for fatty acid abnormalities associated with diseases such as:

  • Adrenoleukodystrophy
  • Adult Refsum Disease
  • Zellweger Spectrum Disorders
  • Rhizomelic Chondrodysplasia Punctata Type 1

We also assay plasma and red blood cells for nutritional total lipid fatty acid content, including the essential fatty acids.

Indications for Peroxisomal Disease Screening:

The criteria for testing for a peroxisomal disease is very broad and is evolving. The following are offered as some characteristic features seen at particular ages.

Neonates

  • unusual facial features
  • hypotonia
  • shortened limbs
  • stippled epiphyses
  • enlarged liver
  • cataracts
  • seizures
  • failure to thrive

Children

  • intellectual disability
  • loss of previously attained function
  • leukodystrophy
  • adrenal hypo/hyperplasia
  • visual defect/retinal dysplasia
  • spasticity
  • attention deficit onset
  • behavioral changes

Adults

  • peripheral neuropathy
  • Retinitis pigmentosa
  • Sensorineural hearing loss
  • Prenatal diagnosis available for families with previous positive diagnoses

*Note: Prenatal diagnosis available for families with previous positive diagnoses.

Peroxisomal Disease Tests:

Very Long Chain Fatty Acids

Plasma from EDTA-treated whole blood is treated to extract fatty acids from circulating complex lipids and free fatty acids. The very long chain fatty acids (C20:0 to C26:0) as well as the branched chain fatty acids (phytanic and pristanic) are identified by gas chromatography/mass spectrometry and the values (ug/ml) compared to our normal and disease control values.

Plasma Fatty Acid Profile

Plasma from EDTA-treated whole blood is treated to extract fatty acids from circulating complex lipids and free fatty acids. The sample is analyzed by gas chromatography/mass spectrometry. A total of 57 fatty acids from C10:0 through C30:0 as well as useful ratios and group summaries (e.g. total omega-6 and omega-3 fatty acids including the essential fatty acids) are reported and compared to our normal control values.

Red Blood Cell Fatty Acid Profile

Red blood cells from EDTA-treated whole blood are washed free of plasma and treated to extract fatty acids from membrane complex lipids and free fatty acids. The sample is analyzed by gas chromatography/mass spectrometry. A total of 52 fatty acids from C10:0 through C30:0 as well as useful ratios and group summaries (e.g. total omega-6 and omega-3 fatty acids including the essential fatty acids) are reported and compared to our normal control values.

Plasmalogens

Red blood cells from EDTA-treated whole blood are washed free of plasma and treated to extract fatty acids from complex membrane lipids. Plasmalogens in the form of dimethylacetals (DMAs) are identified by gas chromatography and the DMA/fatty acid ratios (C16:0DMA/C16:0 and C18:0DMA/C18:0) are compared to our normal and disease control values.

Pipecolic Acid

Plasma from EDTA-treated whole blood and/or urine are treated to extract fatty acids from circulating complex lipids and free fatty acids. Pipecolic acid is identified by gas chromatography/mass spectrometry and the values (umol/L) compared to our normal and disease control values.

C26:0-Lysophosphatidylcholine (lysoPC)

Plasma from EDTA-treated whole blood or whole blood spotted on a Whatman DBS card to extract lipid biomolecules. C26:0 lysoPC is identified by liquid chromatography-mass spectrometry (LC-MS/MS) and the value compared to normal and disease control ranges.

Fibroblast Fatty Acid Analysis

Cells are cultured in our own media and treated to extract fatty acids from complex membrane lipids. The very long chain fatty acids (C22:0 to C26:0) are identified by gas chromatography and the values (ug/ml /mg protein) compared to our normal and disease control values.

Prenatal Testing for Peroxisomal Disorders

We can test cultured chorionic villus cells (CVS) or cultured amniocytes for the presence of peroxisomal disorders such as X-linked Adrenoleukodystrophy, Zellweger Spectrum Disorders and Rhizomelic Chondrodysplasia Punctata Type 1 in families with a history of these disorders. The assays include very long chain fatty acids and/or plasmalogen synthesis enzymes and are performed in the same manner as in cultured fibroblasts. Results are compared to our normal and disease control values for prenatal cells

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