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Comprehensive Toxic Metal Panel, 24-Hour Urine

Comprehensive Toxic Metal Panel, 24-Hour Urine

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Comprehensive Toxic Metal Panel, 24-Hour Urine

  

Clinical Use

  • Diagnose toxicity caused by various trace elements including arsenic, cadmium, cobalt, lead, mercury, and thallium

Clinical Background

The symptoms of metal intoxication can mimic other treatable disorders. Such symptoms include nausea, vomiting, dementia, anemia, kidney failure, infertility, seizure, neuropathy, learning disorders, and pulmonary dysfunction. Thus, urine metal analysis may assist in differential diagnosis as well as in monitoring patients for elimination of toxic metal(s) during treatment. Elevated metal levels are associated with diets high in seafood (including shellfish), certain folk medicines, exposure to contaminated water, lead-based and latex paint, cigarette smoke, and industrial exposure (Table 1).

Table 1. Industrial Sources of Metal Exposure

Source of Exposure Metal(s)
Agriculture Arsenic, mercury
Alloys and metal plating Arsenic, cadmium, cobalt, lead, mercury
Battery manufacture Cadmium, lead, nickel
Construction Cadmium, lead, mercury
Home renovation Lead, mercury
Mining Arsenic, cadmium, cobalt, lead, mercury
Semiconductor manufacture Arsenic

Method

This inductively-coupled plasma/mass spectrometry (ICP-MS) method uses an argon plasma at 6,000 to 10,000 K to destroy the organic matter in the sample and to ionize the metals. The resulting metallic ions are detected and quantitated in the mass spectrometer using an internal standard. Limits of quantitation are presented in Table 2. Results are reported in μg/L.

Interpretive Information

Reference and toxic ranges are presented in Table 2.

Table 2. Trace Element Reference and Toxic Ranges for 24-Hour Urine Samples

Limit of Quantitation (μg/L)

Reference Range (μg/L) Toxic Range (μg/L)
Arsenic (As) 2 <81 Not established
Cadmium (Cd) 1.0 <6 Not established
Cobalt (Co) 0.2 <3 Not established
Lead (Pb) 1 <80 Not established
Mercury (Hg) 2 <21 150
Thallium (Tl) 0.2 <3 >200

Content reviewed 04/2013

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