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22336 Arsenic w/Reflex, 24 Hr Urine (ASU24)

Arsenic w/Reflex, 24 Hr Urine (ASU24)
Test Code: ARUSO
Synonyms/Keywords
​Ref Lab Code: 8644, Arsenic (As), As (Arsenic)
Useful For
​Preferred screening test for detection of arsenic exposure
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Urine​ Clean, plastic urine container with no metal cap or glued insert​ ​ 10 mL​ 2 mL​ ​
Collection Processing Instructions
​Submit sample in a plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert.
1. Collect urine for 24 hours.
2. No preservative.
3. Patient should not eat seafood for a 48-hour period prior to start of collection.
4. See Metals Analysis-Collection and Transport in Special Instructions for complete instructions.
Trace Metals Analysis - Specimen Collection and Transport
5. Refrigerate specimen within 4 hours of completion of 24-hour collection.
Additional Information:
1. 24-Hour volume is required.
2. See Urine Preservatives in Special Instructions for multiple collections.
Urine Preservative Cross-Reference Information
3. 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.
Specimen Stability Information
Specimen Type Temperature Time
Urine​ Refrigerated (preferred)​ 28 days​
​ Ambient ​ 28 days​
​ Frozen ​ 28 days​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Saturday​
1 day
​
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)​
Reference Lab
Mayo Clinic Laboratories
Reference Range Information
0-35 mcg/specimen
Interpretation
​Normally, humans consume 5 to 25 mcg of arsenic each day as part of their normal diet; therefore, normal urine arsenic output is <25 mcg/specimen. After a seafood meal (seafood contains a nontoxic, organic form of arsenic), the urine output of arsenic may increase to 300 mcg/specimen for 1 day, after which it will decline to <25 mcg/specimen.
 
Exposure to inorganic arsenic, the toxic form of arsenic, causes prolonged excretion of arsenic in the urine for many days.
 
Urine excretion rates >1,000 mcg/specimen indicate significant exposure. The highest level observed at Mayo Clinic was 450,000 mcg/specimen in a patient with severe symptoms of gastrointestinal distress, shallow breathing with classic "garlic breath," intermittent seizure activity, cardiac arrhythmias, and later onset of peripheral neuropathy.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82175 ​ ​ ​ ​
Synonyms/Keywords
​Ref Lab Code: 8644, Arsenic (As), As (Arsenic)
Ordering Applications
Ordering Application Description
​Centricity ​Arsenic, 24 Hr Urine (8644)
​Cerner ​Arsenic Level 24 Hour Urine (8644)
​COM ​Arsenic, 24 Hr Urine
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Urine​ Clean, plastic urine container with no metal cap or glued insert​ ​ 10 mL​ 2 mL​ ​
Collection Processing
​Submit sample in a plastic, 10-mL urine tube or clean, plastic aliquot container with no metal cap or glued insert.
1. Collect urine for 24 hours.
2. No preservative.
3. Patient should not eat seafood for a 48-hour period prior to start of collection.
4. See Metals Analysis-Collection and Transport in Special Instructions for complete instructions.
Trace Metals Analysis - Specimen Collection and Transport
5. Refrigerate specimen within 4 hours of completion of 24-hour collection.
Additional Information:
1. 24-Hour volume is required.
2. See Urine Preservatives in Special Instructions for multiple collections.
Urine Preservative Cross-Reference Information
3. 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.
Specimen Stability Information
Specimen Type Temperature Time
Urine​ Refrigerated (preferred)​ 28 days​
​ Ambient ​ 28 days​
​ Frozen ​ 28 days​
Useful For
​Preferred screening test for detection of arsenic exposure
Reference Range Information
0-35 mcg/specimen
Interpretation
​Normally, humans consume 5 to 25 mcg of arsenic each day as part of their normal diet; therefore, normal urine arsenic output is <25 mcg/specimen. After a seafood meal (seafood contains a nontoxic, organic form of arsenic), the urine output of arsenic may increase to 300 mcg/specimen for 1 day, after which it will decline to <25 mcg/specimen.
 
Exposure to inorganic arsenic, the toxic form of arsenic, causes prolonged excretion of arsenic in the urine for many days.
 
Urine excretion rates >1,000 mcg/specimen indicate significant exposure. The highest level observed at Mayo Clinic was 450,000 mcg/specimen in a patient with severe symptoms of gastrointestinal distress, shallow breathing with classic "garlic breath," intermittent seizure activity, cardiac arrhythmias, and later onset of peripheral neuropathy.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​
 Monday through Saturday​
1 day
​
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82175 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.