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Increased levels of neopterin are found during impaired renal function and viral infection in transplant patients. Elevated levels are also indicators for conditions related to impaired cellular immunity.
This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not be payable as a covered benefit for patients.
Neopterin, a pyrazolopyridine compound, is produced by macrophages after induction by interferon γ and serves as a marker of cellular immune system activation. Measurable levels of neopterin have been detected in both the serum and urine of patients suffering from various types of malignancies1 and viral infections. Changes in neopterin concentrations in serum or urine can predict complications such as graft rejection in organ transplant recipients. Elevated neopterin levels are found in autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus (SLE). Neopterin levels can be used as prognostic predictors for certain types of malignancies. Measurement of neopterin levels has particular value for monitoring patients infected with HIV. Neopterin is eliminated primarily in the urine, so evaluation of urinary neopterin levels may be useful in assessing activation of the cellular immunity system even in the absence of typical clinical symptoms, since a correlation has been observed with the course of diseases involving cellular immunity activation and urinary neopterin levels.
1. Werner ER, Bichler A, Daxenbichler G, et al. Determination of neopterin in serum and urine. Clin Chem. 1987 Jan; 33(1):62-66. PubMed 3802497
Fahey JL, Taylor JM, Detels R, et al. The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type I. N Engl J Med. 1990 Jan; 322(3):166-172. PubMed 1967191
Fuchs D, Hausen A, Reibnegger G, Werner ER, Dierich MP, Wachter H. Neopterin as a marker for activated cell-mediated immunity: Application in HIV infection. Immunol Today. 1988 May; 9(5):150-155. PubMed 3076770
Jacobson MA, Bacchetti P, Kolokathis A, et al. Surrogate markers for survival in patients with AIDS and AIDS related complex treated with zidovudine. BMJ. 1991 Jan 12; 302(6768):73-78. PubMed 1671651
Wachter H, Fuchs D, Hausen A, Reibnegger G, Werner ER. Neopterin as a marker for activation of cellular immunity: Immunologic basis and clinical application. Adv Clin Chem. 1989; 27:81-141. PubMed 2667296
