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HelpTest Code MOLPS Molybdenum, Serum
Reporting Name
Molybdenum, SUseful For
Monitoring of parenteral nutrition
Monitoring metallic prosthetic implant wear
As an indicator of molybdenum cofactor deficiency
Method Name
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies:
-Metal Free B-D Tube (No Additive), 6 mL (T184)
-Metal Free Specimen Vial (T173)
Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube
Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, polypropylene vial
Specimen Volume: 1.6 mL
Collection Instructions:
1. Allow 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 a Mayo 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.
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | METAL FREE |
| Ambient | 14 days | METAL FREE | |
| Frozen | 14 days | METAL FREE |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Special Instructions
Reference Values
0.3-2.0 ng/mL
Day(s) Performed
Wednesday
CPT Code Information
83018
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MOLPS | Molybdenum, S | 5698-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 89270 | Molybdenum, S | 5698-6 |
Clinical Information
Molybdenum is an essential trace element found in the daily diet. It is a cofactor for some enzymes important in nitrogen metabolism (aldehyde dehydrogenase, xanthine oxidase, nicotinamide adenine dinucleotide dehydrogenase). Due to the wide distribution of molybdenum in the environment and particularly in plant materials, molybdenum deficiency is rare in adults with normal, diverse diets. Typical molybdenum intake in most geographic locations is between 45 and 90 mcg/day. Urine is the primary source of excretion, though excesses are sometimes excreted by the biliary route.
Molybdenum deficiency associated with parenteral nutrition is indicated by symptoms such as stunted growth, reduced appetite, tachycardia, tachypnea, blindness, and coma. These symptoms can be corrected by introducing molybdenum supplementation. Molybdenum cofactor disease is a severe genetic disorder that is due to defective variants in the MOCS1, MOCS2, and GEPH genes.
Molybdenum toxicity is rare and usually related to molybdenum mining exposure; however, it has been observed in cases of intake above 400 mcg/day. Molybdenum interferes with copper uptake; molybdenum toxicity is predominantly due to copper deficiency (hypochromic anemia and neutropenia) and inhibition of xanthine oxidase (uric acid accumulation).
Serum molybdenum concentrations are likely to be increased above the reference range in patients with metallic joint prosthesis. Prosthetic devices produced by Depuy Company, Dow Corning, Howmedica, LCS (low contact stress), PCA (porous-coated anatomic), Osteonics, Richards Company, Tricon, and Whiteside are typically made of chromium, cobalt, and molybdenum. This list of products is incomplete, and these products change occasionally; see prosthesis product information for each device for composition details.
Interpretation
Prosthesis wear is known to result in increased circulating concentrations of metal ions.(1) Serum concentrations above 10 ng/mL in a patient with molybdenum-based implant suggest significant prosthesis wear. Increased serum trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure.
Serum molybdenum levels below 0.3 ng/mL indicate potential deficiency.
Increased serum molybdenum may be seen in acute viral hepatitis, chronic active hepatitis, alcoholic liver disease, and other forms of liver inflammation.
Cautions
No significant cautionary statements
Method Description
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)