Detecting toxic thallium exposure in random urine specimens
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
TLUC | Thallium/Creat Ratio, U | No | Yes |
CRETR | Creatinine, Random, U | No | Yes |
TLUC: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
CRETR: Enzymatic Colorimetric Assay
Tl (Thallium)
TESTING
Urine
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine collection container with no metal cap or glued insert
Submission Container/Tube: Plastic, 10-mL urine tube or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 7 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
2.3 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 14 days |
Detecting toxic thallium exposure in random urine specimens
Thallium is found in some depilatories and rodenticides. Accidental ingestion may lead to vomiting, diarrhea, and leg pains followed by a severe and sometimes fatal sensorimotor polyneuropathy. Alopecia (hair loss) may occur 3 weeks after poisoning. The fatal dose is approximately 1 gram.
THALLIUM:
0-17 years: not established
> or =18 years: <2 mcg/g creatinine
CREATININE:
> or =18 years old: 16-326 mg/dL
Reference values have not been established for patients who are less than 18 years of age.
Patients exposed to high doses of thallium (>1 g) present with alopecia, peripheral neuropathy, and seizures, and renal failure.
Normal daily thallium excretion is less than 1 mcg/day.
Exposed patients can have urine thallium excretion greater than 10 mcg/day. The long-term consequences of such an exposure are poor.
No significant cautionary statements
1. Bank WJ, Pleasure DE, Suzuki K, Nigro M, Katz R: Thallium poisoning. Arch Neurol. 1972;26:456-464. doi: 10.1001/archneur.1972.00490110090009
2. Pelclova D, Urban P, Ridson P, et al: Two-year follow-up of two patients after severe thallium intoxication. Hum Exp Toxicol. 2009 May;28(5):263-272. doi: 10.1177/0960327109106487
3. Zhao G, Ding M, Zhang B, et al: Clinical manifestations and management of acute thallium poisoning. Eur Neurol. 2008;60(6):292-297. doi: 10.1159/000157883
4. Strathmann FG, Blum LM: Toxic elements. In: Rifai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 42
5. Campanella B, Colombaioni L, Benedetti E, et al: Toxicity of thallium at low doses: A review. Int J Environ Res Public Health. 2019 Nov 27;16(23):4732. doi: 10.3390/ijerph16234732
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Tuesday, Friday
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.
83018
82570
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TLUCR | Thallium/Creat Ratio, Random, U | 13469-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
CRETR | Creatinine, Random, U | 2161-8 |
615256 | Thallium/Creat Ratio, U | 13469-2 |
Change Type | Effective Date |
---|---|
New Test | 2021-12-16 |