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Test Code TLUCR Thallium/Creatinine Ratio, Random, Urine


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 collection 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: 7 mL

Collection Instructions:

1. Collect a random urine specimen.

2. See Metals Analysis Specimen Collection and Transport for complete instructions.


Useful For

Detecting toxic thallium exposure in random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
TLUC Thallium/Creat Ratio, U No Yes
CRETR Creatinine, Random, U No Yes

Method Name

TLUC: Inductively Coupled Plasma Mass Spectrometry (ICP-MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

Thallium/Creat Ratio, Random, U

Specimen Type

Urine

Specimen Minimum Volume

2.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reference Values

THALLIUM:

0-17 years: Not established

≥18 years: <2 mcg/g creatinine

 

CREATININE:

≥18 years old: 16-326 mg/dL

Reference values have not been established for patients who are younger than 18 years of age.

Interpretation

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

 

Normal daily thallium excretion is less than 1 mcg/day.

 

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

Clinical Reference

1. Bank WJ, Pleasure DE, Suzuki K, Nigro M, Katz R. Thallium poisoning. Arch Neurol. 1972;26(5):456-464. doi:10.1001/archneur.1972.00490110090009

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. doi:10.1177/0960327109106487

3. Zhao G, Ding M, Zhang B, et al. Clinical manifestations and management of acute thallium poisoning. Eur Neurol. 2008;60(6):292-297. doi:10.1159/000157883

4. 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

5. Campanella B, Colombaioni L, Benedetti E, et al. Toxicity of thallium at low doses: A review. Int J Environ Res Public Health. 2019;16(23):4732. doi:10.3390/ijerph16234732

Day(s) Performed

Tuesday, Friday

Report Available

2 to 5 days

Performing 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

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TLUCR Thallium/Creat Ratio, Random, U 13469-2

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
615256 Thallium/Creat Ratio, U 13469-2