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Test ID: MOLPS Molybdenum, Serum

Reporting Name

Molybdenum, S

Useful For

Monitoring of parenteral nutrition

 

Monitoring metallic prosthetic implant wear

 

As an indicator of molybdenum cofactor deficiency

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.

Report Available

2 to 8 days

Day(s) Performed

Wednesday

Clinical Reference

1. Witzleb WC, Ziegler J, Krummenauer F, Neumeister V, Guenther KP: Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty. Acta Orthop. 2006 Oct;77(5):697-705

2. Centers for Disease Control and Prevention: The Third National Report on Exposure to Environmental Chemicals (NHANES). NCEH Publication 05-0570. National Center for Environmental Health; July 2005. Available at www.jhsph.edu/research/centers-and-institutes/center-for-excellence-in-environmental-health-tracking/Third_Report.pdf

3. Yoshida M, Ota S, Fukunaga K, Nishivama T: Serum molybdenum concentration in healthy Japanese adults determined by inductively coupled plasma-mass spectrometry. J Trace Elem Med Biol. 2006;20(1):19-23

4. Reiss J, Johnson JL: Mutations in the molybdenum cofactor biosynthetic genes MOCS1, MOCS2, and GEPH. Hum Mutat. 2003 Jun;21(6):569-576

5. Roberts NB, Taylor A, Sodi R: Vitamins and trace elements. Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 37

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Specimen Type

Serum


Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most 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 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 Trace 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

Reference Values

0.3-2.0 ng/mL

Test Classification

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

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
Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

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