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Test Code:
090-51-0001

Order Name:
Iron, Liver Tissue **

 
Useful For:

Diagnosis of hemochromatosis using liver tissue specimens

 
Methodology:
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
 
 
 
Test Code:
090-51-0001

Order Name:
Iron, Liver Tissue **

 
Patient Preparation:
Gadolinium is known to interfere with most metals tests. If gadolinium-containing contrast media has been administered a specimen should not be collected for 96 hours.
 
Collection Specimen Or Container:
Liver Tissue, Mayo metal-free specimen vial (blue label)

Collection Instructions:
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.




 
 
Specimen Testing Type:
Liver Tissue, Mayo metal-free specimen vial (blue label)
Minimum volume:
2 cm (22-gauge needle)
1 cm (18-gauge needle)
2 mm x 2 mm (punch) 0.3 mg by dry weight
 
Sub Mission Container:
Mayo metal-free specimen vial (blue label) (Ship frozen)
 
Rejection Criteria:
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

 
 
Specimen Stabillity:

 
 
 
 
Test Code:
090-51-0001

Order Name:
Iron, Liver Tissue **

 
Method detail:
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
 
Schedule:
N/A **Sent out to MAYO, USA
 
Turnaround Time:
Received specimen to reported within 14 days
 
 
Performing Location:
MAYO Laboratory
Referral Lab Services, Laboratory Department 14160-2
 
 
 
Test Code:
090-51-0001

Order Name:
Iron, Liver Tissue **

 
 
Clinical Information:

Hemosiderosis is the condition of excessive iron accumulation in tissues. Liver is the first organ affected in iron-overload diseases. Transient increases in iron first appear in Kupffer cells. This finding is commonly related to sideroblastic anemia, excessive iron consumption, or chronic alcohol ingestion. Persistent hemosiderosis, as seen in hemochromatosis, causes iron accumulation in hepatocytes, and is usually concentrated in biliary cells.

 
Reference Value:
IRON
Males: 200-2,400 mcg/g dry weight
Females: 400-1,600 mcg/g dry weight

IRON INDEX
Reference values have not been established for patients that are <13 years of age.
<1.0 mcmol/g/year (> or =13 years)
 
Interpretation:
A hepatic iron concentration above 10,000 mcg/g dry weight is diagnostic for hemochromatosis.

Hepatic iron concentrations above 3,000 mcg/g are seen when there is iron overload without cellular injury and cirrhosis. Hepatic iron concentrations greater than the reference range are associated with hemosiderosis, thalassemia, and sideroblastic anemia. Some patients with hepatitis or cirrhosis without significant fibrosis will have hepatic iron concentrations at the top end of normal or just slightly above the normal range.

Iron accumulates in the liver normally with aging. The hepatic iron index (HII) normalizes hepatic iron concentration for age. The HII is calculated from the hepatic iron concentration by converting the concentration from mcg/g to mcmol/g dry weight and dividing by years of age. The normal range for HII is less than 1.0.
-Patients with homozygous hemochromatosis have an HII above 1.9.
-Patients with heterozygous hemochromatosis often have an HII ranging from 1.0 to 1.9.
-Patients with hepatitis and alcoholic cirrhosis usually have an HII below 1.0, although a small percentage of patients with alcoholic cirrhosis have an HII in the range of 1.0 to 1.9.
-Patients with hemochromatosis who have been successfully treated with phlebotomy will have an HII below 1.0.

Liver specimens collected from patients with cirrhosis containing a high degree of fibrosis have results near the low end of the reference range, even though they will show significant iron staining in hepatocytes. While it is true that iron accumulates in hepatocytes in advanced alcoholic cirrhosis with fibrosis, there are relatively few hepatocytes compared to other inert (fibrotic) tissue, so the quantitative iron determination, which is expressed as mcg of iron per gram of dry weight tissues, yields a low result. Histologic examination of all tissue specimens should be performed to facilitate correct interpretation. When structural heterogeneity is apparent histologically, variation in measured iron should be anticipated. We have observed, in approximately 2% of cases, a high degree of hepatic heterogeneity that makes quantitation highly variable.
 
Clinical Reference:
www.mayomedicallaboratories.com (Retrieved: 27 Jun 2020)