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HelpTEST ID BAFS Bile Acids, Fractionated and Total, Serum
Reporting Name
Bile Acids, Fractionated and Tot, SSpecimen Type
SerumOrdering 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:
Fasting: 12 to 14 hours, required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
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 |
|---|---|---|
| Serum | Refrigerated (preferred) | 90 days |
| Ambient | 90 days | |
| Frozen | 90 days |
Special Instructions
Testing Algorithm
For information see Bile Acid-Associated Tests Ordering Guide
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
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
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysSpecimen Retention Time
1 monthPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
82542
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
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.
Clinical Information
Bile acids are formed in the liver from cholesterol, conjugated primarily to glycine and taurine, stored and concentrated in the gallbladder, and secreted into the intestine after the ingestion of a meal. In the intestinal lumen, the bile acids serve to emulsify ingested fats to promote digestion. During the absorptive phase of digestion, approximately 90% of the bile acids are reabsorbed.
The efficiency of the hepatic clearance of bile acids from portal blood maintains serum concentrations at low levels in normal persons. An elevated fasting level of bile acids due to impaired hepatic clearance is a sensitive indicator of liver disease. Following meals, serum bile acid levels have been shown to increase only slightly in normal persons, but they are markedly elevated in patients with various liver diseases, including cirrhosis, hepatitis, cholestasis, portal-vein thrombosis, Budd-Chiari syndrome, cholangitis, Wilson disease, and hemochromatosis. No increase in bile acids will be noted in patients with intestinal malabsorption. Metabolic hepatic disorders involving organic anions (eg, Gilbert disease, Crigler-Najjar syndrome, and Dubin-Johnson syndrome) do not cause abnormal serum bile acid concentrations.
Highlights
Bile acids are elevated in individuals with liver dysfunction.
This bile acid test can be used in the diagnosis of intrahepatic cholestasis of pregnancy.
Fractionated bile acids, including tauro- and glycol-conjugates of cholic acid, chenodeoxycholic acid, deoxycholic acid, and ursodeoxycholic acid are individually summed and reported.