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Succinyladenosine (CSF)

CPT: 82542
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Special Instructions

This assay is available in New York State

Specimen Requirements


Cerebrospinal Fluid (CSF)


1.0 mL

Minimum Volume

0.5 mL


Sterile screw capped vial


Collect entire sample into a single sterile tube

Storage Instructions

Freeze as soon as possible after collection

Stability Requirements

Room Temperature: Not stable; Refrigerated: 24 hours; Frozen: 72 hours @ -20C, Indefinitely @ -80C; Freeze/Thaw: None

Causes for Rejection

Bloody CSF; Received thawed

Test Details


CSF Succinyladenosine is useful for diagnosing Adenylosuccinate Lyase Deficiency. This testing may also be used for assessment of Variants of Uncertain Significance (VUS) identified during genetic testing (e.g. Next Generation Sequencing or Capillary Sequencing Testing).

CLINICAL: Succinyladenosine is elevated in adenylosuccinate lyase (ADSL) deficiency and results in succinylpurinemic autism, intellectual disability, and, in some cases, growth delays associated with muscle wasting and epilepsy. Adenylosuccinate lyase is involved in both de novo synthesis of purines and formation of adenosine monophosphate from inosine monophosphate by catalyzing two reactions in AMP biosynthesis: the removal of a fumarate from succinylaminoimidazole carboxamide (SAICA) ribotide to give aminoimidazole carboxamide ribotide (AICA) and removal of fumarate from adenylosuccinate to give AMP. In normal individuals, succinyladenosine is either not detected or at very low levels in the CSF. Small elevations of succinyladenosine in spinal fluid have been reported in AICA-Ribosiduria (deficiency of AICAR transformylase) a devastating condition involving profound intellectual disability, epilepsy, dysmorphic features and congenital blindness. Small elevations are also seen secondary to fumarase deficiency. In adenylosuccinate lyase deficiency levels of succinyladenosine in CSF are highly elevated.


HPLC/UV Detection

Recommended MNG Kits

CSF Collection Tubes (set of 5 tubes per kit)


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
620035 Succinyladenosine (CSF) 42682-5 620051 ASLCSF Results 42682-5
620035 Succinyladenosine (CSF) 42682-5 620052 ASLCSF Interpretation N/A
620035 Succinyladenosine (CSF) 42682-5 630821 PDF 80563-0