Sign in →

Test ID: TLU Thallium, 24 Hour, Urine

Reporting Name

Thallium, 24 Hr, U

Useful For

Detecting toxic thallium exposure in 24-hour urine 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 its 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

Patients exposed to high doses of thallium (>1 g) present with alopecia, peripheral neuropathy, seizures, and renal failure.

 

Exposed patients can have urine output greater than 10 mcg/day. The long-term consequences of such an exposure are poor.

Analytic Time

1 day

Day(s) and Time(s) Performed

Tuesday, Friday; 8 a.m.

Clinical Reference

1. Bank WJ, Pleasure DE, Suzuki K, Nigro M, Katz R: Thallium poisoning. Arch Neurol. 1972;26:456-464

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

3. Zhao G, Ding M, Zhang B, et al: Clinical manifestations and management of acute thallium poisoning. Eur Neurol. 2008;60(6):292-297

4. 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

5. 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

Urine


Necessary Information


24-Hour volume is required.



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: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine 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: 10 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Refrigerate specimen within 4 hours of completion of 24-hour collection.

3. Aliquot 10 mL into a plastic 10-mL urine tube (T068) or a clean, plastic aliquot container with no metal cap or glued insert.

4. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

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

Reference Values

0-17 years: not established

≥18 years: <2 mcg/24 hours

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
TLU Thallium, 24 Hr, U 5746-3

 

Result ID Test Result Name Result LOINC Value
8603 Thallium, 24 Hr, U 5746-3
TIME2 Collection Duration 13362-9
VL12 Urine Volume 3167-4

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.

Ambient

OK

Refrigerate

Preferred

Frozen

OK

50% Acetic Acid

OK

Boric Acid

No

Diazolidinyl Urea

No

6M Hydrochloric Acid

OK

6M Nitric Acid

OK

Sodium Carbonate

No

Thymol

No

Toluene

No

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Neuromuscular