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Test Code Copper L Copper, Liver Tissue

Reporting Name

Copper, Liver Ts

Useful For

Diagnosing Wilson disease and primary biliary cirrhosis


Advisory Information


This test is for liver tissue only. If tissue is other than liver tissue, see MSCM / Miscellaneous Metals Testing.



Specimen Required


Supplies: Metal Free Specimen Vial (T173)

Container/Tube:

Preferred: Mayo metal-free specimen vial (blue label) (T173)

Acceptable: Paraffin block if no more than 1 or 2 cuts have been made to it for slides

Specimen Volume: 2 mg

Collection Instructions:

1. Two mg of liver tissue is required. This is typically a piece of tissue from a 22-gauge needle biopsy at least 2 cm long. If an 18-gauge needle is used, the tissue must be at least 1 cm in length.

2. Any specimen vial other than a Mayo metal-free vial used should be plastic, leached with 10% nitric acid for 2 days, rinsed with redistilled water, and dried in clean air.

Additional Information: Paraffin blocks will be returned 3 days after analysis.


Specimen Type

Liver Tissue

Specimen Minimum Volume

2 cm (22-gauge needle), 1 cm (18-gauge needle), or 2 mm x 2 mm (punch)
0.3 mg by dry weight

Specimen Stability Information

Specimen Type Temperature Time
Liver Tissue Refrigerated (preferred)
  Ambient 
  Frozen 

Day(s) and Time(s) Performed

Monday, Wednesday, Friday; 11 a.m.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Method Description

After digestion of the liver tissue with nitric acid and hydrogen peroxide, the digest is diluted and tissue copper concentration is analyzed by ICP-MS using gallium (Ga) as an internal standard and an aqueous acidic calibration.(Unpublished Mayo method)

Reference Values

10-35 mcg/g dry weight

 

>1,000 mcg/g dry weight: VERY HIGH

This finding is strongly suggestive of Wilson disease. If this finding is without supporting histology and other biochemical test results, contamination during collection, handling, or processing should be considered. Fresh tissue would be appropriate for copper measurement. Genetic test for Wilson disease (WDZ / Wilson Disease, Full Gene Analysis) is also available at Mayo Clinic. Please call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700 if you need further assistance.

 

250-1,000 mcg/g dry weight: HIGH

This finding is suggestive of possible Wilson disease. If this finding is without supporting histology and other biochemical test results, contamination during collection, handling, or processing should be considered. Fresh tissue would be appropriate for copper measurement. Genetic test for Wilson disease (WDZ / Wilson Disease, Full Gene Analysis) is also available at Mayo Clinic. Please call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700 if you need further assistance.

 

35-250 mcg/g dry weight: HIGH

Excessive copper at this level can be associated with cholestatic liver disease, such as primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis, and familial cholestatic syndrome. Heterozygous carriers for Wilson disease occasionally have modestly elevated values, but rarely higher than 125 mcg/g of dry weight. In general, the liver copper content is higher than 250 mcg/g dried tissue in patients with Wilson disease. If this finding is without supporting histology and other biochemical test results, contamination during collection, handling, or processing should be considered. Fresh tissue would be appropriate for copper measurement. Genetic test for Wilson disease (WDZ / Wilson Disease, Full Gene Analysis) is also available at Mayo Clinic. Please call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700 if you need further assistance.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

82525

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CUT Copper, Liver Ts 8198-4

 

Result ID Test Result Name Result LOINC Value
8687 Copper, Liver Ts 8198-4

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

 

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request Form (T728) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/gastroenterology-and-hepatology-test-request.pdf)