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HelpTest Code SPAS Arsenic Speciation, Random, Urine
Reporting Name
Arsenic Speciation, Random, UPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Diagnosing arsenic intoxication using random urine specimens
Method Name
Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)/Ion Chromatography Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Specimen Required
Patient Preparation:
1. For the 48-hour period prior to start of collection, patient should not eat seafood.
2. High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based 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)
-Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic vial or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Metals Analysis Specimen Collection and Transport for complete instructions.
Specimen Type
UrineSpecimen Minimum Volume
3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 72 hours |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
TOXIC ARSENIC
<35 mcg/L
Reference values apply to all ages.
Arsenic Speciation Interpretive Information:
The toxic arsenic concentration represents the sum of the inorganic and methylated arsenic species. The reference value for toxic arsenic is <35 mcg/L. This value is based on the ACGIH Biological Exposure Index (BEI), which does not include the nontoxic organic arsenic.
Interpretation
The quantitative reference range for fractionated arsenic applies only to the inorganic forms. Concentrations of 20 mcg inorganic arsenic per liter or higher are considered toxic.
There is no limit to the normal range for the organic forms of arsenic since they are not considered toxic and are normally present after consumption of certain food types. For example, a typical finding in a urine specimen with total 24-hour excretion of arsenic of 350 mcg/24 hr would be that more than 95% is present as the organic species from a dietary source, and less than 5% is present as the inorganic species. This would be interpreted as indicating the elevated total arsenic was due to ingestion of the nontoxic form of arsenic, usually found in seafood.
A normal value for blood arsenic does not exclude a finding of elevated urine inorganic arsenic, due to the very short half-life of blood arsenic.
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysTest 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
82175
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SPAS | Arsenic Speciation, Random, U | 54454-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 607692 | Inorganic Arsenic (Toxic) | 12481-8 |
| 607693 | Methylated Arsenic (Toxic) | 53779-5 |
| 607694 | Organic Arsenic (Non-Toxic) | 53778-7 |
| 609405 | Toxic Arsenic Concentration | 96250-6 |
| 607691 | Total Arsenic Concentration | 5586-3 |
Testing Algorithm
Total arsenic will be performed first. If the total arsenic concentration is 10 mcg/L or greater, then speciation will be performed and reported. If total arsenic is below 10 mcg/L, total arsenic will be reported as less than 10 mcg/L and speciation will not be performed.