Iron, Liver
Test Mnemonic
LIVIRO
CPT Codes
- 83540 - QTY (1)
Performing Laboratory
ARUP
FDA Category
Laboratory Developed Test
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 1 cm long | Tissue, liver | See note | N/A | See note | Obtain a minimum of two liver cores, at least 1 cm in length per core, with an 18 gauge needle. Tissue can be fresh, dried, paraffin-embedded, or formalin-fixed (refer to stability for transport temperature). If formalin-fixed, the tissue should immediately be placed in the same container with formalin. Create a surgical pathology order for liver biopsy and include the comment "QUANTITATIVE IRON." Specimens other than paraffin-embedded should be stored and transported in a metal-free container (e.g., royal blue with no additive). |
Stability
| Environmental Condition | Description |
|---|---|
| Refrigerated | Paraffin block, preserved (formalin), or dried: Indefinitely; Fresh tissue: 1 week |
| Frozen | Paraffin block, preserved (formalin), or dried: Indefinitely; Fresh tissue: Indefinitely |
| Ambient | Paraffin block, preserved (formalin), or dried: Indefinitely; Fresh tissue: Unacceptable |
Days Performed
Fri
Turnaround Time
4 - 11 days
Methodology
| Name | Description |
|---|---|
| Inductively Coupled Plasma / Mass Spectrometry (ICP-MS) |
Reference Range
| Hep Fe Conc by Wt | |||||
|---|---|---|---|---|---|
| Sex | Age From | Age To | Type | Range | Range Unit |
| Male | Normal | 200-2000 | ug/g | Female | Normal | 200-1600 | ug/g |
| Hepatic Fe Index | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | Less than 1.0 |
Special Info
Specimens less than 0.25 mg (dry weight) are unacceptable. Existing routine paraffin blocks may be used. Specimens stored or shipped in saline will be rejected. Age is required on test request form in order to calculate iron index. This test is New York DOH approved.
Clinical Info
Useful in confirming hepatic iron overload, particularly in individuals with hemochromatosis and no common HFE mutations. A Hepatic Iron Index (HII) is not calculated for patients < 14 years of age. Note: HII < 1.0 is consistent with normal iron accumulation; HII 1.0 - 1.9 is consistent with mild iron accumulation such as in heterozygous hemochromatosis or alcoholic liver disease; HII > 1.9 is consistent with iron overload such as in homozygous hemochromatosis, porphyria cutanea tarda, and cirrhotic liver disease. The HII will decrease with chelation, chronic blood loss, or phlebotomy.