Thallium, Urine

CPT CODE:

USEFUL FOR:

Detecting toxic thallium exposure

SPECIMEN REQUIRED:

1. 10 mL from a 24-hour urine collection. No preservative. See     "Urine Preservatives" in Special Instructions for multiple     collections.  2. Collect in a clean, plastic urine container(s) with no metal     cap(s) or glued insert(s).3. Send specimen in a plastic, 13-mL urine tube or a clean,      plastic aliquot container with no metal cap or glued insert.4. See "Metals Analysis - Collection and Transport" in Special     Instructions for complete instructions.5. Refrigerate specimen within 4 hours of completion of 24-hour      collection. Send specimen refrigerated.  Note:    1.  High concentrations of gadolinium and iodide are                       known to interfere with most metals tests. If either                       gadolinium- or iodide-containing contrast media has                       been administered, a specimen cannot be collected                       for 48 hours.                  2.  24-Hour volume is required on request form for                       processing.  Urine Preservative Collection OptionsNote:  The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.
Ambient:                     YesRefrigerate:               PreferredFrozen:                        Yes6N HCl:                       Yes50% Acetic Acid:     YesNa(2)CO(3):               NoToluene:                     Yes6N HNO(3):                YesBoric Acid:                 NoThymol:                      No

TRANSPORT TEMPERATURE:

Refrig\Frozen OK\Ambient OK

CLINICAL INFORMATION:

Thallium is found in some depilatories and rodenticides. 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 g.

CLINICAL INTERPRETATION:

Patients exposed to high doses of thallium (>1 g) present with alopecia, peripheral neuropathy and seizures, and renal failure.
Normal daily output is <10 ug/day.
Exposed patients can have urine output >500 ug/day.The long-term consequences of such an exposure are poor.

REFERENCE VALUES:

<10 ug/specimen

Specimens collected for other than a 24-hour time period are reported in

unit of ug/L, for which reference values are not established.