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Test Code LAB0211102 Chromium, Serum

Additional Codes

Mayo Test ID
CRS

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Screening for occupational exposure

 

Monitoring metallic prosthetic implant wear

Method Name

Inductively Coupled Plasma-Mass Spectometry (DRC-ICP-MS)

Reporting Name

Chromium, S

Specimen Type

Serum


Ordering Guidance


The US Food and Drug Administration recommended test for monitoring chromium in patients with metal-on-metal implants is CRWB / Chromium, Blood.



Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Metal Free Specimen Vial (T173)

Collection Container/Tube: Plain, royal blue-top Vacutainer plastic trace element blood collection tube

Submission Container/Tube: 7-mL Mayo metal-free, screw-capped, polypropylene vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Allow the specimen to clot for 30 minutes; then centrifuge the specimen to separate serum from the cellular fraction.

2. Remove the stopper. Carefully pour specimen into a Mayo metal-free, polypropylene vial, avoiding transfer of the cellular components of blood. Do not insert a pipet into the serum to accomplish transfer, and do not ream the specimen with a wooden stick to assist with serum transfer.

3. See Metals Analysis Specimen Collection and Transport for complete instructions.


CentraCare Laboratory Services Note:

Aliquot to Mayo metal-free, screw-capped plastic vial within 4 hours of collection.

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days METAL FREE
  Ambient  28 days METAL FREE
  Frozen  28 days METAL FREE

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

<0.3 ng/mL

 

When collected by a phlebotomist experienced in ultra-clean collection technique and handled according to the instructions in Metals Analysis Specimen Collection and Transport, we have observed the concentration of chromium in serum to be below 0.3 ng/mL. However, the majority of specimens submitted for analysis from unexposed individuals contain 0.3 ng/mL to 0.9 ng/mL of chromium. Commercial evacuated blood collection tubes not designed for trace-metal specimen collection yield serum containing 2.0 ng/mL to 5.0 ng/mL chromium derived from the collection tube.

Interpretation

Results greater than the flagged value indicate clinically significant exposure to chromium (Cr) (see Cautions about specimen collection). The reported units of measurement for chromium of ng/mL is equivalent to mcg/L.

 

Prosthesis wear is known to result in an increased circulating concentration of metal ions. A modest increase (0.3-0.6 ng/mL) in serum Cr concentration is likely to be associated with a prosthetic device in good condition. Serum concentrations above 1 ng/mL in a patient with a Cr-based implant suggest significant prosthesis wear. Increased serum trace element concentrations in the absence of corroborating clinical information do not independently predict prosthesis wear or failure. However, the US Food and Drug Administration recommends testing chromium in EDTA anticoagulated whole blood in symptomatic patients with metal-on-metal implants.

Day(s) Performed

Tuesday, Wednesday, Friday

Report Available

1 to 4 days

Specimen Retention Time

7 days

Test 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

82495

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CRS Chromium, S 5622-6

 

Result ID Test Result Name Result LOINC Value
8638 Chromium, S 5622-6