The University of Iowa (UIHC)
Department of Pathology
LABORATORY SERVICES HANDBOOK


Alpha-1-Antitrypsin Clearance
Order Code: A1AC
Order Form: A-1a Miscellaneous Request or IPR Req
  Commercial "Mail-out" Laboratory
6240 RCP
356-3527
Specimen
Serum and Feces
Collection Medium:
and
Red top tube Sterile container
Minimum:
24 hr fecal collection and 1.0 ml serum
Rejection Criteria:
Specimens other than stool plus serum, hemolysis or lipemia are 
unacceptable.
Delivery Instructions:
Submit specimen to laboratory as soon as possible after
collection period is completed.
Analytic Time:
1 week
Reference Range:
Clearance: < or = 27 mL/24 hr
Fecal alpha-1-antitrypsin concentration: < or = 54 mg/dL
Serum alpha-1-antitrypsin concentration: 100 - 190 mg/dL
Interpretive Data:
Elevated A1A clearance suggests excessive gastrointestinal protein 
lloss. (The positive predictive value of the test has been found to be
97.7% and the negative predictive value is 75%.)

Patients with protein-losing enteropathies generally have A1A clearance
values >50 mL/24 hours and A1A stool concentrations >100 mg/mL.

Borderline elevations above the normal range are equivocal for protein-
losing enteropathies.
Comments:
Fecal specimen must be collected in special containers available from 
Specimen Control, 6240 RCP.  Draw serum sample during stool collection 
period. If no fecal specimen obtained in 24 hours, extend collection to 
48-72 hours and note time frame on requisition.
Methodology:
Nephelometry
CPT Code:
82103(x2)

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Updated: 07/11/2008

Note: The information contained in this handbook is for use by personnel of University of Iowa Health Care. No other use is implied or intended.