Newcastle Laboratories

Copper, Cu

Clinical Background:

Copper is a vital component of a number of metalloenzymes that are essential for human health. Ingested copper is mainly stored in the liver and removed via biliary excretion. Thus, cholestatic liv...

Copper is a vital component of a number of metalloenzymes that are essential for human health. Ingested copper is mainly stored in the liver and removed via biliary excretion. Thus, cholestatic liver disease, e.g. primary biliary cirrhosis or primary sclerosing cholangitis, can cause an increase in serum copper levels. Copper circulates predominantly bound to caeruloplasmin, which is a positive acute phase reactant, i.e. copper levels increase during the systemic inflammatory (acute phase) response. Wilson's disease is an inherited cause of copper excess where the liver fails to synthesise caeruloplasmin resulting in accumulation of copper in the liver and other tissues. Acquired copper deficiency is most commonly caused by intestinal disorders, inadequate TPN, and zinc over-supplementation. Menke's disease is an inherited cause of copper deficiency. Increased urinary excretion of copper of up to 100 mg/24hour can be found in patients with Wilson’s disease and Menkes disease.

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Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    Serum 

    Navy blue top 'trace element' tube with red-striped label

    Available on request from Blood Sciences reception at both Freeman and RVI site

    Urine

    24-hour urine in acid-washed bottle

    Serum 

    Navy blue top 'trace element' tube with red-striped label

    Available on request from Blood Sciences reception at both Freeman and RVI site

    Urine

    24-hour urine in acid-washed bottle

  • Specimen Container Paediatric:

    Serum

    Navy blue top 'trace element' tube with red-striped label - preferred sample if sufficient blood volume can be collected

    White top plain tube (glass)

    Urine

    24-hour urine in acid-washed bottle...

    Serum

    Navy blue top 'trace element' tube with red-striped label - preferred sample if sufficient blood volume can be collected

    White top plain tube (glass)

    Urine

    24-hour urine in acid-washed bottle

     

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  • Minimum Volume Adult:

    Serum: 1 mL blood

    Urine: 1 mL urine

    Serum: 1 mL blood

    Urine: 1 mL urine

  • Minimum Volume Paediatric:

    Serum: 1 mL blood

    Urine: 1 mL urine

    Serum: 1 mL blood

    Urine: 1 mL urine

  • Special Requirement:

    Avoid contamination by dust.

    Avoid contamination by dust.

  • Sample Stability:

    Serum and urine samples are stable at 2-4°C for up to 6 weeks or at -20°C indefinitely.

    Serum and urine samples are stable at 2-4°C for up to 6 weeks or at -20°C indefinitely.

  • Transport Requirements:

    Ambient temperature.

    Ambient temperature.

  • Freq Analysis:

    Assay performed weekly.

    Assay performed weekly.

  • Quality Assurance:

    Trace Element Quality Assurance Scheme (TEQAS) for Trace Elements

    Trace Element Quality Assurance Scheme (TEQAS) for Trace Elements

  • Interpretation:

    Low serum copper

    Wilson's disease (copper toxicity)
    Excess zinc or iron ingestion
    Long-term total parenteral nutrition in adults and children
    Malnourished children; premature infants
    Menke's ...

    Low serum copper

    Wilson's disease (copper toxicity)
    Excess zinc or iron ingestion
    Long-term total parenteral nutrition in adults and children
    Malnourished children; premature infants
    Menke's disease (copper deficiency)

     

     

    High serum copper

    Primary biliary cirrhosis
    Primary sclerosing cholangitis
    Haemochromatosis
    Malignant diseases (including leukaemia)
    Thyrotoxicosis
    Acute phase response

     

     

    Low urine copper

    Malnutrition/malabsorption
    Hypoproteinemias and nephrotic syndrome

     

     

    High urine copper

    Wilson's disease (copper toxicity)
    Menke's disease (copper deficiency)
    Primary biliary cirrhosis
    Haemochromatosis
    Thyrotoxicosis
    Various infections and acute, chronic and malignant   diseases (including leukaemia)
    Women taking OCP/oestrogen during pregnancy

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  • Reference Ranges:

    Serum

        Age

    Copper (µmol/L)

        0 to 6 months

    3 – 11

        7 months to 15 years

    10 – 30

        Adults (Male, >16 years)

    10.4 – 19.8

        Adults (Female, >16 years)

    11.6 – ...

    Serum

        Age

    Copper (µmol/L)

        0 to 6 months

    3 – 11

        7 months to 15 years

    10 – 30

        Adults (Male, >16 years)

    10.4 – 19.8

        Adults (Female, >16 years)

    11.6 – 22.9

     

    Urine

        Age

    Copper (µmol/24h)

        Paediatric

    <0.7

        Adult

    <0.1

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  • Factors Affecting Result:

    Failure to adhere to correct specimen collection procedures can cause abnormal results due to specimen (dust) contamination, which can lead to misinterpretation and misdiagnosis.

    Heparin may conta...

    Failure to adhere to correct specimen collection procedures can cause abnormal results due to specimen (dust) contamination, which can lead to misinterpretation and misdiagnosis.

    Heparin may contain copper.

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  • Other Info:

    Assay performed by ICP-MS in collision mode.

    Assay performed by ICP-MS in collision mode.

  • Routine Contact Name:

    Duty Biochemist

  • Routine Telephone:

    Freeman

    0191 244 8889

    RVI

    0191 282 9719

    Freeman

    0191 244 8889

    RVI

    0191 282 9719

  • Routine Email:

    For external users

    TNU-Tr.duty.biochemist@nhs.net

    For Trust users

    DutyBiochemist@nuth.nhs.uk

  • Specialist Test:

    Yes

    Yes

Availability:

Available during full access hours. Assayed as service demands
Site of analysis: Freeman

Turn Around:

Within 2 weeks

Send To:

Department of Blood Sciences

Freeman Hospital
Freeman Road
Newcastle upon Tyne
NE7 7DN

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