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Thallium, Urine
Ordering Recommendation
Useful as a biomarker of chronic thallium exposure. For the assessment of acute exposure, consider Thallium, Whole Blood (0099610).
New York DOH Approval Status
Specimen Required
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.
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.
Transfer an 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116). Available online through eSupply using ARUP Connect(TM) or contact ARUP Client Services at 800-522-2787. (Min: 1 mL)
Refrigerated. Also acceptable: Room temperature or frozen.
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).
Record total volume and collection time interval on transport tube and on test request form.
Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year
Methodology
Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Performed
Sun-Sat
Reported
1-5 days
Reference Interval
| Test Number |
Components |
Reference Interval |
|||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Creatinine, Urine - per 24h |
|
||||||||||||||||||||||
| Thallium, Urine - per 24h | 0.0-0.4 µg/d | ||||||||||||||||||||||
| Thallium, Urine - per volume | 0.0-2.0 µg/L | ||||||||||||||||||||||
| Thallium, Urine - ratio to CRT | 0.0-2.0 µg/g CRT |
Interpretive Data
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.
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.
Methodology: Inductively Coupled Plasma - Mass Spectrometry (ICP-MS)
Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.
Laboratory Developed Test (LDT)
Note
Hotline History
Hotline History
CPT Codes
83018
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0020207 | Creatinine, Urine - per volume | 35674-1 |
| 0020208 | Creatinine, Urine - per 24h | 2162-6 |
| 0025021 | Thallium, Urine - per 24h | 5746-3 |
| 0025022 | Thallium, Urine - per volume | 21558-2 |
| 0025049 | Thallium, Urine - ratio to CRT | 29938-8 |
| 0097110 | Total Volume | 19153-6 |
| 0097111 | Hours Collected | 30211-7 |
Aliases
- Normalized Urine Thallium
- Thallium/Creatinine Ratio, Random, Urine
- Tl Urine
- TLU
- Urine thallium concentration
