Test Catalog

Test Id : ASB

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Arsenic, Blood

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting acute or very recent arsenic exposure

 

Monitoring the effectiveness of therapy

 

This test is not useful for evaluation of chronic arsenic exposure.

Method Name
A short description of the method used to perform the test

Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Arsenic, B

Aliases
Lists additional common names for a test, as an aid in searching

As (Arsenic)

Arsenic (As)

Specimen Type
Describes the specimen type validated for testing

Whole blood

Ordering Guidance

The preferred method of screening for arsenic exposure is measurement of urinary arsenic concentration. Order either SPASU / Arsenic Speciation, 24 Hour, Urine or SPAS / Arsenic Speciation, Random, Urine.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: 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: Metal Free B-D Tube (EDTA), 6 mL (T183)

Container/Tube: Royal blue top (EDTA) plastic trace element blood collection tube

Specimen Volume: Full tube

Collection Instructions:

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

2. Send whole blood specimen in original collection tube. Do not aliquot.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.3 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Whole blood Refrigerated (preferred) 28 days
Ambient 28 days
Frozen 28 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detecting acute or very recent arsenic exposure

 

Monitoring the effectiveness of therapy

 

This test is not useful for evaluation of chronic arsenic exposure.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Arsenic (As) exists in a number of toxic and nontoxic forms. The toxic forms are the inorganic species As(5+), also denoted as As(V), the more toxic As(3+), also known as As(III), and their partially detoxified metabolites, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Detoxification occurs in the liver as As(3+) is oxidized to As(5+) and then methylated to MMA and DMA. As a result of these detoxification steps, As(3+) and As(5+) are found in the urine shortly after ingestion, whereas MMA and DMA are the species that predominate more than 24 hours after ingestion.

 

Blood concentrations of arsenic are elevated for a short time after exposure, after which arsenic rapidly disappears into tissues because of its affinity for tissue proteins. The body treats arsenic like phosphate, incorporating it wherever phosphate would be incorporated. Arsenic "disappears" into the normal body pool of phosphate and is excreted at the same rate as phosphate (excretion half-life of 12 days). The half-life of inorganic arsenic in blood is 4 to 6 hours, and the half-life of the methylated metabolites is 20 to 30 hours. Abnormal blood arsenic concentrations (>12 ng/mL) indicate significant exposure but will only be detected immediately after exposure. Arsenic is not likely to be detected in blood specimens drawn more than 2 days after exposure because it has become integrated into nonvascular tissues. Consequently, blood is not a good specimen to screen for arsenic, although periodic blood levels can be determined to follow the effectiveness of therapy. Urine is the preferred specimen for assessment of arsenic exposure.

 

A wide range of signs and symptoms may be seen in acute arsenic poisoning, including headache, nausea, vomiting, diarrhea, abdominal pain, hypotension, fever, hemolysis, seizures, and mental status changes. Symptoms of chronic poisoning, also called arseniasis, are mostly insidious and nonspecific. The gastrointestinal tract, skin, and central nervous system are usually involved. Nausea, epigastric pain, colic (abdominal pain), diarrhea, and paresthesias of the hands and feet can occur.

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.

<13 ng/mL

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

Abnormal blood arsenic concentrations (>12 ng/mL) indicate significant exposure.

 

Absorbed arsenic is rapidly distributed into tissue storage sites with a blood half-life of less than 6 hours. Unless a blood specimen is drawn within 2 days of exposure, arsenic is not likely to be detected in a blood specimen.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Hall M, Chen Y, Ahsan H, et al. Blood arsenic as a biomarker of arsenic exposure: results from a prospective study. Toxicology. 2006;225(2-3):225-233

2. Strathmann FG, Blum LM. Toxic elements. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 44

Method Description
Describes how the test is performed and provides a method-specific reference

The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82175

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
ASB Arsenic, B 5583-0
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
32190 Arsenic, B 5583-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports