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Test ID TLB Thallium, Blood

Reporting Name

Thallium, B

Useful For

Detecting toxic thallium exposure in whole blood specimens

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) Vacutainer plastic trace element blood collection tube (T183)

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
Whole blood Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

0-17 years: not established

≥18 years: <2 ng/mL 

Day(s) and Time(s) Performed

Tuesday, Friday; 8 a.m.

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 In Process

 

Result ID Test Result Name Result LOINC Value
8149 Thallium, B 5744-8

Clinical Information

Thallium is a by-product of lead smelting. The clinical interest in thallium derives primarily from its use as a rodenticide since this is the most frequent route of human exposure.

 

Thallium is rapidly absorbed via ingestion, inhalation, skin contact, and through the mucous membranes of the mouth, gastrointestinal tract, and lungs. It is considered to be as toxic as lead and mercury, with similar sites of action.

 

The mechanism of action of thallium is:

-Competition with potassium at cell receptors to affect ion pumps

-Inhibition of DNA synthesis

-Binds to sulfhydryl groups on proteins in neural axons

-Concentrates in renal tubular cells and reacts with protein to cause necrosis

 

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

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.

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

Analytic Time

1 day

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)