Thallium/Creatinine Ratio, Random, Urine
Detecting toxic thallium exposure
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
0-1 mcg/g Creatinine
Reference values apply to all ages.
Patients exposed to high doses of thallium (>1 g) present with alopecia, peripheral neuropathy and seizures, and renal failure.
Normal daily output is <1 mcg/day.
Exposed patients can have urine output >10 mcg/day. The long-term consequences of such an exposure are poor.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
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.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
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