Copper, Urine

Diagnostic Use

The most common disorder involving mineral metabolism is Wilson’s disease or hepatolenticular degeneration. This is an autosomal recessive disorder, the frequency being of the order of 1 in 100,000 live births.

The two fundamental disturbances of copper metabolism in Wilson’s disease are:
Gross reduction in the rate of incorporation of copper into caeruloplasmin
Considerable reduction in biliary excretion of copper

Copper accumulates in the liver, causing progressive liver damage and subsequently overflows into other tissues, especially the brain. The classical presentation is of adults with progressive neurological symptoms, low serum concentrations of copper and caeruloplasmin, raised urinary copper excretion and characteristic copper deposits in the corneas (Kayser-Fleischer rings). Children and adolescents frequently present with a variety of hepatic symptoms including hepatic failure.

Measuring urine copper for occupational exposure is not recommended as in normal patients it is not excreted in the urine.

Note: It is always advisable to measure serum copper or caeruloplasmin levels, urinary copper excretion and liver copper (see Iron and Copper in Liver tissue) in the diagnosis of Wilson’s disease.

The possibility that a raised urine copper may be due to contamination should be excluded. Ensure that an acid washed bottle was used for collection, the sample was collected cleanly into the acid washed bottle and an aliquot was taken prior to measurement of urine volume.

Department

Lipids/Trace Metals

Delphic Registration Code

UCU

Laboratory Handling

Registration

Send to separating if ambient on arrival. Send to trace metals if frozen on arrival.

Separating

Aliquot to Core laboratory for UCRN. Send primary sample to trace metals.

Turnaround Time

13 days

Test Code

4256