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Test Code LAB7556 Bile Acids, Fractionated and Total, Serum

Additional Codes

BAFS

Useful For

Measuring tauro- and glycol-conjugated and unconjugated bile acid constituents in serum specimens

 

Monitoring patients receiving bile acid therapy, such as cholic acid, deoxycholic acid, or ursodeoxycholic acid

 

Aiding in the evaluation of liver function; evaluation of liver function changes before the formation of more advanced clinical signs of illness such as icterus

 

Determining hepatic dysfunction as a result of chemical and environmental injury

 

Indicating hepatic histological improvement in chronic hepatitis C patients responding to interferon treatment

 

Indicating intrahepatic cholestasis of pregnancy

 

This assay is not useful for the diagnosis of peroxisomal biogenesis disorders or inborn errors of bile acid metabolism.

Specimen Type

Serum


Ordering Guidance


This test is useful in diagnosing intrahepatic cholestasis of pregnancy and does not support the assessment of either peroxisomal biogenesis disorders or inborn errors of bile acid metabolism.

 

For diagnostic testing for peroxisomal biogenesis disorders, order BAIPD / Bile Acids for Peroxisomal Disorders, Serum.



Specimen Required


Patient Preparation: Patient must be fasting for 12 to 14 hours.

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 90 days
  Ambient  90 days
  Frozen  90 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK

Reference Values

Total cholic acid: ≤5.00 nmol/mL

Total chenodeoxycholic acid: ≤6.00 nmol/mL

Total deoxycholic acid: ≤6.00 nmol/mL

Total ursodeoxycholic acid: ≤2.00 nmol/mL

Total bile acids: ≤19.00 nmol/mL

Method Description

Bile acid concentrations in serum are measured by liquid chromatography tandem mass spectrometry stable isotope dilution analysis. Serum is mixed with isotopically labeled internal standards of selected bile acids and then subjected to protein precipitation. Sample preparation is semi-automated using a liquid handler. Reverse-phase liquid chromatography is performed using mobile phases to separate free bile acids, their respective tauro- and glyco-conjugates, and 2 bile acid precursors.(Unpublished Mayo method)

Day(s) Performed

Monday through Friday

Report Available

3 to 5 days

Specimen Retention Time

1 month

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82542

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BAFS Bile Acids, Fractionated and Tot, S 43130-4

 

Result ID Test Result Name Result LOINC Value
35796 Total Cholic acid 30518-5
35797 Total Chenodeoxycholic acid 30519-3
35798 Total Deoxycholic acid 30520-1
35799 Total Ursodeoxycholic acid 55159-8
35800 Total bile acids 14628-2

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Interpretation

Total bile acids are metabolized in the liver and can serve as a marker for normal liver function. Increases in serum bile acids are seen in patients with acute hepatitis, chronic hepatitis, liver sclerosis, liver cancer, and intrahepatic cholestasis of pregnancy.

Testing Algorithm

For more information see Bile Acid-Associated Tests Ordering Guide

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.