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Test ID TLCRU Thallium/Creatinine Ratio, Random, Urine

Reporting Name

Thallium/Creat Ratio, Random, U

Useful For

Detecting toxic thallium exposure in random urine specimens

Profile Information

Test ID Reporting Name Available Separately Always Performed
TLCR Thallium/Creat Ratio, U No Yes
CDCR Creatinine Conc No Yes

Specimen Type

Urine


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 collection container with no metal cap or glued insert

Submission Container/Tube: Plastic, 10-mL urine tube (T068) or a clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 2 mL

Collection Instructions:

1. Collect a random urine specimen.

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


Specimen Minimum Volume

1.3 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/g creatinine

Day(s) and Time(s) Performed

Tuesday, Friday; 8 a.m.

Test Classification

See Individual Test IDs

CPT Code Information

83018 Thallium concentration

82570 Creatinine concentration

LOINC Code Information

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

 

Result ID Test Result Name Result LOINC Value
CDCR Creatinine Conc 2161-8
32870 Thallium/Creat Ratio, U 13469-2

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 gram.

Interpretation

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

 

Normal daily output is less than 1 mcg/day.

 

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

Clinical Reference

1. Bank WJ, Pleasure DE, Suzuki K, et al: 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 

Analytic Time

1 day

Method Name

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

CDCR: Enzymatic Colorimetric Assay