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HelpMayo Test ID TLU Thallium, 24 Hour, Urine
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
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.
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 Metals Analysis Specimen Collection and Transport for complete instructions.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Useful For
Detecting toxic thallium exposure in 24-hour urine collections
Special Instructions
Method Name
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Reporting Name
Thallium, 24 Hr, USpecimen Type
UrineSpecimen 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 |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Thallium is odorless, tasteless, and 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. Peripheral neuropathy may occur within 1 week of exposure, while hair loss begins and continues for several weeks. Gastrointestinal symptoms, including pain, diarrhea, and constipation have also been reported in acute ingestion, along with myalgias, pleuritic chest pain, insomnia, optic neuritis, hypertension, cardiac abnormalities, Mees lines, and liver injury. Most thallium is excreted in the urine, can be found within an hour after exposure, and can be detected as long as two months after exposure.
Reference Values
0-17 years: Not established
≥18 years: <2 mcg/24 hours
Interpretation
Patients exposed to high doses of thallium (>1 g) present clinically with alopecia, peripheral neuropathy, seizures, and kidney failure.
Exposed patients can have urine output greater than 10 mcg/day. The long-term consequences of such an exposure are poor.
Cautions
No significant cautionary statements
Clinical Reference
1. Bank WJ, Pleasure DE, Suzuki K, Nigro M, Katz R. Thallium poisoning. Arch Neurol. 1972;26(5):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;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. Strathmann FG, Blum LM. Toxic elements. In: Rifai N, Chiu RWK, Young I, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:455.e55
Method Description
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Day(s) Performed
Tuesday, Friday
Report Available
2 to 5 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US 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 |