Thallium, Urine

Casandra

Casandra Test Code AR79589Version 1 (DRAFT)

Performing Lab

Lab ARUP LaboratoriesLab Test ID 0025019CPT Code 83018

Also known as: THALU

Clinical Use

Order Test

Use

Useful as a biomarker of chronic thallium exposure. For the assessment of acute exposure, consider Thallium, Whole Blood (0099610). Urinary thallium levels may reflect recent or chronic exposure and the presence of thallium in urine after acute exposure may persist for up to several weeks. Concentrations less than 5 ug/L are unlikely to cause adverse health effects while concentrations greater than 500 ug/L have been associated with clinical poisoning. After severe thallium poisoning reported symptoms have varying times of onset and include gastroenteritis, multi-organ failure and neurologic injury. Peripheral neuropathy and alopecia are well-documented effects of acute and chronic exposure. Human health effects from low level thallium exposure are unknown.

Special Instructions

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and nonessential over-the-counter medications (upon the advice of their physician). High concentrations of iodine may interfere with elemental testing. Collection of urine specimens from patients receiving iodinated or gadolinium-based contrast media should be avoided for a minimum of 72 hours post exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post contrast media exposure.

Limitations

Elevated results may be due to skin or collection-related contamination, including the use of collection containers that are not certified to be trace element-free. If an elevated result is suspected to be due to contamination, confirmation with a second specimen collected in a certified trace element-free container is recommended.

Test Details

New York Approved

Methodology

Mass Spectrometry

Biomarkers

Thallium

Analyte

Thallium, Urine - per 24h • Concentration / Level • Quantitative (Continuous) (e.g., copies/mL, % expression)

Thallium, Urine - per volume • Concentration / Level • Quantitative (Continuous) (e.g., copies/mL, % expression)

Thallium, Urine - ratio to CRT • Concentration / Level • Quantitative (Continuous) (e.g., copies/mL, % expression)

LOINC Codes

Result Codes

5746-3
21558-2
29938-8

Result Turnaround Time

1-5 days

Specimen

Urine

Volume

8 mL aliquot

Minimum Volume

1 mL

Container

ARUP Trace Element-Free Transport Tubes

Collection Instructions

24-hour or random urine collection. Specimen must be collected in a plastic container. ARUP studies indicate that refrigeration of urine alone, during and after collection, preserves specimens adequately if tested within 14 days of collection.

Patient Preparation

Discontinue nutritional supplements, vitamins, minerals, and nonessential over-the-counter medications. Avoid collection from patients after administration of iodinated or gadolinium-based contrast media for a minimum of 72 hours.

Storage Instructions

Refrigerated. Also acceptable: Room temperature or frozen.

Causes for Rejection

Urine collected within 72 hours after administration of iodinated or gadolinium-based contrast media. Acid-preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in nontrace element-free transport tube (with the exception of the original device).