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Test Code CUS1 Copper, Serum


Specimen Required


Patient Preparation: High concentrations of gadolinium, iodine, and barium are known to interfere with most metal tests. If gadolinium-, iodine, or barium-containing contrast media has been administered, the specimen should not be collected for at least 96 hours.

Supplies:

-Metal Free Specimen Vial (T173)

-Metal Free B-D Tube (No Additive), 6 mL (T184)

Collection Container/Tube: 6-mL Plain, royal blue-top Vacutainer plastic trace element blood collection tube

Submission Container/Tube: 7-mL Metal-free, screw-capped, polypropylene vial

Specimen Volume: 0.8 mL

Collection Instructions:

1. Allow the specimen to clot for 30 minutes; then centrifuge the specimen to separate serum from the cellular fraction.

2. Remove the stopper. Carefully pour specimen into metal-free, polypropylene vial, avoiding transfer of the cellular components of blood. Do not insert a pipet into the serum to accomplish transfer, and do not ream the specimen with a wooden stick to assist with serum transfer.

3. See Metals Analysis Specimen Collection and Transport for complete instructions.


Useful For

Diagnosis of:

-Wilson disease

-Primary biliary cholangitis

-Primary sclerosing cholangitis

Method Name

Dynamic Reaction Cell-Inductively Coupled Plasma-Mass Spectrometry (DRC-ICP-MS)

Reporting Name

Copper, S

Specimen Type

Serum

Specimen Minimum Volume

0.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days METAL FREE
  Ambient  28 days METAL FREE
  Frozen  28 days METAL FREE

Reference Values

0-2 months: 40-140 mcg/dL

3-6 months: 40-160 mcg/dL

7-9 months: 40-170 mcg/dL

10-12 months: 80-170 mcg/dL

13 months-10 years: 80-180 mcg/dL

11-17 years: 75-145 mcg/dL

Males:

≥18 years: 73-129 mcg/dL

Females:

≥18 years: 77-206 mcg/dL

Interpretation

Serum copper below the normal range is associated with Wilson disease, as well as a variety of other clinical situations (see Clinical Information). Excess use of denture cream containing zinc can cause hypocupremia.

 

Serum concentrations above the normal range are seen in primary biliary cirrhosis, primary sclerosing cholangitis, and a variety of other clinical situations (see Clinical Information).

Clinical Reference

1. McCullough AJ, Fleming CR, Thistle JL, et al. Diagnosis of Wilson's disease presenting as fulminant hepatic failure. Gastroenterology. 1983;84:161-167

2. Wiesner RH, LaRusso NF, Ludwig J, Dickson ER. Comparison of the clinicopathologic features of primary sclerosing cholangitis and primary biliary cirrhosis. Gastroenterology. 1985;88:108-114

3. Spain RI, Leist TP, De Sousa EA. When metals compete: a case of copper-deficiency myeloneuropathy and anemia. Nat Clin Pract Neurol. 2009;5(2):106-111

4. Kale SG, Holmes CS, Goldstein DS, et al. Neonatal diagnosis and treatment of Menkes disease. N Engl J Med. 2008;358(6):605-614

5. Nations SP, Boyer PJ, Love LA, et al. Denture cream: An unusual source of excess zinc, leading to hypocupremia and neurologic disease. Neurology. 2008;71;639-643

6. Strathmann FG, Blum LM: Toxic elements. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 7th ed. Elsevier; 2023:chap 44

Day(s) Performed

Monday through Saturday

Report Available

1 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

CPT Code Information

82525

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CUS1 Copper, S 5631-7

 

Result ID Test Result Name Result LOINC Value
616155 Copper, S 5631-7

Forms

If not ordering electronically, complete, print, and send 1 of the following with the specimen:

-General Test Request (T239)

-Gastroenterology and Hepatology Test Request (T728)

-Biochemical Genetics Test Request (T798