Ordering Recommendation

Useful as a biomarker of chronic thallium exposure. For the assessment of acute exposure, consider Thallium, Whole Blood (0099610).

Mnemonic
THALU
Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation

Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential 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.

Collect

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.

Specimen Preparation

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™ or contact ARUP Client Services at (800) 522-2787. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated. Also acceptable: Room temperature or frozen.

Unacceptable Conditions

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 non-trace element-free transport tube (with the exception of the original device).

Remarks

Record total volume and collection time interval on transport tube and on test request form.

Stability

Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year

Reference Interval
Test Number
Components
Reference Interval
  Thallium, Urine - per volume Effective November 12, 2018
0.0-2.0 µg/L
  Thallium, Urine - per 24h 0.0-0.4 µg/d
  Thallium, Urine - ratio to CRT Effective November 12, 2018
0.0-2.0 µg/g CRT
0020473 Creatinine, Urine - per 24h
Age
Male
Female
3-8 years 140-700 mg/d 140-700 mg/d
9-12 years 300-1300 mg/d 300-1300 mg/d
13-17 years 500-2300 mg/d 400-1600 mg/d
18-50 years 1000-2500 mg/d 700-1600 mg/d
51-80 years 800-2100 mg/d 500-1400 mg/d
81 years and older 600-2000 mg/d 400-1300 mg/d

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 µg/L are unlikely to cause adverse health effects while concentrations greater than 500 µg/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.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

83018

Components
Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
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
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Normalized Urine Thallium
  • Thallium/Creatinine Ratio, Random, Urine
  • Tl Urine
  • TLU
  • Urine thallium concentration
Thallium, Urine