Test Catalog

Test Id : NIS

Nickel, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirmation of an elevated urinary nickel concentration

 

This test is not useful for the investigation of nickel hypersensitivity.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Nickel, S

Aliases
Lists additional common names for a test, as an aid in searching

Ni (Nickel)

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

Urine is the preferred specimen type for determining nickel exposure and potential toxicity. Order NIU / Nickel, Urine or NICRU / Nickel/Creatinine Ratio, Random, Urine.

 

This test should not be ordered for the investigation of nickel hypersensitivity. Instead, order lymphocyte proliferation to nickel test.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies:

Metal Free B-D Tube (No Additive), 6 mL (T184)

Metal Free Specimen Vial (T173)

Collection Container/Tube: Royal blue-top (metal-free, no additive))

Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, vial

Specimen Volume: 2 mL

Collection Instructions:

1. Allow the 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, screw-capped 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 in Special Instructions for complete instructions.

Additional Information: If ordering the trace element blood collection tube from BD, order catalog #368380.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days METAL FREE
Ambient 7 days METAL FREE
Frozen 7 days METAL FREE

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirmation of an elevated urinary nickel concentration

 

This test is not useful for the investigation of nickel hypersensitivity.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Nickel (Ni) is a highly abundant element with a silvery-white appearance. Nickel is frequently combined with other metals to form alloys and is essential for the catalytic activity of some plant and bacterial enzymes but has no known role in humans.

 

Nickel and its compounds have no characteristic odor or taste. Ni compounds are used for Ni plating, to color ceramics, to make some batteries, and as substances known as catalysts that increase the rate of chemical reactions. One of the most toxic Ni compounds is nickel carbonyl, Ni(CO)4, which is used as a catalyst in petroleum refining and in the plastics industry, is frequently employed in the production of metal alloys (which are popular for their anticorrosive and hardness properties), in nickel-cadmium rechargeable batteries, and is used as a catalyst in hydrogenation of oils. Ni(CO)4 is very toxic.

 

Occupational exposure to Ni occurs primarily via inhalation of Ni compounds. Inhalation of dust high in Ni content has been associated with development of lung and nasal cancer.

 

Food is the major source of exposure to Ni. Foods naturally high in Ni include chocolate, soybeans, nuts, and oatmeal. Individuals may also be exposed to nickel by breathing air, drinking water, or smoking tobacco containing Ni. Stainless steel and coins contain Ni. Some jewelry is plated with Ni or made from Ni alloys. Patients may be exposed to Ni in artificial body parts made from Ni-containing alloys.

 

The most common harmful health effect of Ni in humans is an allergic reaction. Approximately 10% to 20% of the population is sensitive to Ni. The most serious harmful health effects from exposure to Ni, such as chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus, have occurred in people who have breathed dust containing certain Ni compounds while working in Ni refineries or nickel-processing plants.

 

Urine is the specimen of choice for the determination of Ni exposure but serum concentrations can be used to verify an elevated urine concentration.

 

Patients undergoing dialysis are exposed to Ni and accumulate Ni in blood and other organs; there appear to be no adverse health effects from this exposure. Hypernickelemia has been observed in patients undergoing renal dialysis. At the present time, this is considered to be an incidental finding as no correlation with toxic events has been identified. Routine monitoring of patients undergoing dialysis is currently not recommended.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

<2.0 ng/mL

Interpretation
Provides information to assist in interpretation of the test results

Values 2.0 ng/mL and higher represent possible environmental or occupational exposure to nickel (Ni).

 

Toxic Ni concentrations are greater or equal to 10 ng/mL.

 

Normal Ni values are based on a Mayo Clinic study using healthy volunteers. Toxic values have been deduced from observation and unpublished internal study.

 

Clinical concern about Ni toxicity should be limited to patients with potential for exposure to toxic Ni compounds. Hypernickelemia, in the absence of exposure, may be an incidental finding or could be due to specimen contamination.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test cannot determine the source compound (eg, nickel sulfate) responsible for the exposure.

 

Specimen collection procedures for nickel require special collection containers, rigorous attention to ultraclean specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these procedures are followed, increased urinary nickel results may be an incidental and misleading finding.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Novelli EL, Rodrigues NL, Ribas BO: Superoxide radical and toxicity of environmental nickel exposure. Hum Exp Toxicol 1995;14:248-251

2. Nixon DE, Moyer TP, Squillace DP, McCarthy JT: Determination of serum nickel by graphite furnace atomic absorption spectrometry with Zeeman-effect background correction: values in a normal population and a population undergoing dialysis. Analyst 1989;114:1671-1674

3. US Department of Health and Human Services: Toxicological profile for nickel. Agency for Toxic Substances and Disease Registry. 2005 Accessed: 03/2020. Available at: https://www.atsdr.cdc.gov/ToxProfiles/tp15.pdf

4. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics Sixth edition. Edited by N Rifai, AR Horvath, CT Wittwer. Elsevier, 2018

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

This assay is performed on an inductively coupled plasma-mass spectrometer. Calibrating standards and blanks are diluted with an aqueous acidic diluent containing internal standards. Quality control specimens and patient samples are diluted in an identical manner. In turn, all diluted blanks, calibrating standards, quality control specimens, and patient specimens are aspirated into a pneumatic nebulizer and the resulting aerosol directed to the hot plasma discharge by a flow of argon. In the annular plasma the aerosol is vaporized, atomized, and then ionized. The ionized gases plus neutral species formed in the annular plasma space are aspirated from the plasma through an orifice into a quadrupole mass spectrometer. The mass range from 1 to 263 amu is rapidly scanned multiple times and ion counts tabulated for each mass of interest. Instrument response is defined by the linear relationship of analyte concentration vs. ion count ratio (analyte ion count/internal standard ion count). Analyte concentrations are derived by reading the ion count ratio for each mass of interest and determining the concentration from the response line.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83885

LOINC® Information

Test Id Test Order Name Order LOINC Value
NIS Nickel, S 5702-6
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
8622 Nickel, S 5702-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports