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Test ID: TLB Thallium, Blood

Reporting Name

Thallium, B

Useful For

Detecting toxic thallium exposure in whole blood specimens

Clinical Information

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.

Interpretation

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.

Analytic Time

1 day

Day(s) and Time(s) Performed

Tuesday, Friday; 8 a.m.

Clinical Reference

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

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Specimen Type

Whole blood


Specimen Required


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 (EDTA), 6 mL (T183)

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.

Additional Information: If ordering the trace element blood collection tube from BD, order catalog #368381.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

0-17 years: not established

≥18 years: <2 ng/mL 

Test Classification

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 U.S. Food and Drug Administration.

CPT Code Information

83018

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLB Thallium, B 5743-0

 

Result ID Test Result Name Result LOINC Value
8149 Thallium, B 5743-0
Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Neuromuscular