Detecting toxic thallium exposure
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Tl (Thallium)
Whole blood
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.
Container/Tube: Royal blue top (EDTA) plastic trace element blood collection tube
Specimen Volume: Full tube
Collection Instructions:
1. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
2. Send specimen in original tube.
0.3 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Detecting toxic thallium exposure
Thallium is odorless and tasteless and is found in trace amounts in the earth's crust. It is used in the manufacturing of electronic devices, switches, and closures. It had previously been used in rodenticides. The greatest exposure can occur from eating food (eg, fruits and vegetables) since it's easily taken up by plants through the roots. Cigarette smoking is also a source of exposure. 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. Most thallium is excreted in the urine and can be found within an hour after exposure and be detected as long as two months after exposure.
0-17 years: not established
> or =18 years: <2 ng/mL
Normal blood concentrations are less than 1 ng/mL.
Significant exposure is associated with thallium concentrations in blood greater than 10 ng/mL, and as high as 50 ng/mL. The long-term sequelae from such an exposure is poor.
Patients exposed to high doses of thallium (>1 g) present with alopecia (hair loss), peripheral neuropathy, seizures, and renal failure.
No significant cautionary statements.
1. Pelcloval D, Urbanl, P, Ridsonl P, et al: Two-year follow-up of two patients after severe thallium intoxication. Hum Exper Toxicol 2009;28:263-272
2. Zhao G, Ding M, Zhang B, et al: Clinical manifestations and management of acute thallium poisoning. Eur Neurol 2008;60:292-297
3. Agency for Toxic Substances and Disease Registry: Toxicological profile for thallium. US Department of Health and Human Services; July 1992. Available at www.atsdr.cdc.gov/ToxProfiles/tp54.pdf
4. Rafai N, Horwath AR, Wittwer CT: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Monday, Thursday
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
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TLB | Thallium, B | 5743-0 |
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.
|
---|---|---|
8149 | Thallium, B | 5743-0 |