Download New Test ANNOUNCEMENT

June 2003
W
New Test ANNOUNCEMENT
A
Mayo
Refer ence
Ser vices
Publication
Vanadium, Urine
#83395
Clinical
The element vanadium, naturally found in minerals and rocks, is considered an essential element for
mammals, although conclusive evidence for humans is lacking. Animal studies have shown that vanadium is
essential for mammalian growth and reproduction, iron and lipid metabolism, and red blood cell production.
Vanadium is recovered from minerals or as a by-product of iron, titanium, and uranium refining. Vanadium
pentoxide is used in the production of special steels. Vanadium compounds are used as catalysts for
polypropylene production and synthesis of inorganic and organic chemicals. Vanadium compounds are used
in dyes, photography, ceramics, and in the production of special glasses. Vanadium also is a component of a
fiber mesh prosthetic alloy.
The main source of vanadium intake for the general population is food, with an estimated daily intake of 20 µg,
of which most is excreted in the feces, without absorption. Absorption through the inhalation route results in
more effective uptake. About 90% of blood vanadium is found in serum. The half-life in serum is not well
documented, but it appears to be on the order of several days. Urine is the main route of excretion of absorbed
vanadium. Urine monitoring for vanadium is considered a highly reliable indicator of recent exposure.
Currently, there is no clinical data to support the need for taking vanadium supplements such as vanadyl
sulfate, vanadium colloid, or any other form. This test provides no information regarding any theoretical
vanadium deficiency.
Vanadium has been recognized as an occupational hazard for more than 20 years. Elevated atmospheric
vanadium levels can result from burning fossil fuels with a high vanadium content. Inhalation and ingestion
are the primary exposure routes. Vanadium exposure can result in a metallic taste and so-called “green
tongue.” Sensitization can result in asthma or eczema. Vanadium intoxication is effectively treated with
ascorbic acid.
Useful For
Detecting vanadium toxicity
Interpretation
Values >1.0 µg/L or >1.0 µg/24-hr specimen represent possible environmental or occupational exposure.
Values >5.0 µg/L or >5.0 µg/24-hr specimen indicate probable vanadium exposure.
Cautions
• Specimen collection procedures require special collection containers, rigorous attention to ultraclean
specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these
procedures are followed, increased urine vanadium results may be an incidental and misleading finding.
• This test should be ordered only when there is reason to suspect vanadium exposure. There is still
controversy as to the effects of industrial exposure on the body, and toxicity data is extremely limited.
• Although vanadium appears to be an essential trace element in humans, its role, if any, is not clearly
defined and this test is not useful for nutritional assessment.
• Currently, there is no evidence to suggest the clinical utility of monitoring vanadium levels in either
dialysis patients or those with prosthetic joints. In cases where the fiber mesh alloy has deteriorated,
aluminum can be measured.
• There is no clear evidence to support the preference for either serum or urine as the specimen of choice for
monitoring exposure. Under no circumstances is hair or nails testing advisable.
Test Title:
Vanadium, Urine
#83395
Reference
Tsalev DL, Zaprianov ZK: Biological and toxicological characteristics of individual elements. Vanadium. In Atomic
Absorption Spectrometry in Occupational and Environmental Health Practice, Analytical Aspects and Health
Significance, Vol. I, CRC Press, Boca Raton, FL, 1984, pp. 204-209
Method
Aqueous acidic calibrating standards with serum matrix are diluted with an aqueous nitric acid diluent
containing a gallium internal standard. Specimens are then aspirated into a pneumatic nebulizer and the
resulting aerosol is directed to the hot plasma discharge by a flow of argon. In the annular plasma, the
aerosol is vaporized, atomized, and then ionized. The ionized gases plus neutral species formed in the
annular plasma space are aspirated from the plasma through an orifice into a quadrapole mass spectrometer.
The mass range from 1 to 263 amu is rapidly scanned multiple times and ion counts tabulated for m/z 51
(vanadium) and 69 (gallium). Instrument response is defined by the linear relationship of analyte
concentration versus ion count ratio (analyte ion count/internal standard ion count). Analyte concentrations
are derived by reading the ion count ratio for each mass of interest and determining the concentration from
the response line. (Nixon DE, Neubauer KR, Eckdahl SJ, Butz JA, Burritt MF: Evaluation of a tunable
bandpass reaction cell for an inductively coupled plasma mass spectrometer for the determination of
chromium and vanadium in serum and urine. Spectrochimica Acta Part B 2002; 57[5]; 951-966)
Specimen Required: 1. 10 mL from a 24-hour urine collection. No preservative. See “Urine Preservatives” in Special Instructions
for multiple collections.
2. Collect in clean, plastic urine container(s) with no metal cap(s) or glued insert(s).
3. Send specimen in a plastic, 13-mL urine tube or a clean, plastic aliquot container with no metal cap or
glued insert. See “Metals Analysis - Collection and Transport” in Special Instructions.
4. Refrigerate specimen within 4 hours of completion of 24-hour collection. Send specimen refrigerated.
NOTE: 24-HOUR VOLUME IS REQUIRED ON REQUEST FORM FOR PROCESSING.
Urine Preservative Collection Options
IMPORTANT NOTE: The addition of preservative or application of temperature controls must occur within
4 hours of completion of the collection OR an acceptable preservative must be added at the START of the
collection. Urine tests which require that the preservative be added at the START of the collection are noted
by an *(asterisk).
Ambient:
Refrigerate:
Frozen:
6N HCl:
50% Acetic Acid:
Na2CO3:
Toluene:
HNO3:
Boric Acid:
Thymol:
Reference Values:
Analytic Time:
Days Set Up:
Fee:
CPT Code:
No
Preferred
Yes
Yes
No
No
No
Yes
No
No
Normal <1.0 µg/L or <1.0 µg/24-hr specimen
1 day
Thursday
$93.20
83789
June 2003
W
New Test ANNOUNCEMENT
A
Mayo
Refer ence
Ser vices
Publication
Vanadium, Serum
#83396
Clinical
The element vanadium, naturally found in minerals and rocks, is considered an essential element for
mammals, although conclusive evidence for humans is lacking. Animal studies have shown that vanadium is
essential for mammalian growth and reproduction, iron and lipid metabolism, and red blood cell production.
Vanadium is recovered from minerals or as a by-product of iron, titanium, and uranium refining. Vanadium
pentoxide is used in the production of special steels. Vanadium compounds are used as catalysts for
polypropylene production and synthesis of inorganic and organic chemicals. Vanadium compounds are used
in dyes, photography, ceramics, and in the production of special glasses. Vanadium also is a component of a
fiber mesh prosthetic alloy.
The main source of vanadium intake for the general population is food, with an estimated daily intake of
20 mcg, of which most is excreted in the feces, without absorption. Absorption through the inhalation route
results in more effective uptake. About 90% of blood vanadium is found in serum. The half-life in serum is
not well documented, but it appears to be on the order of several days. Although there is minimal evidence
for the nature of vanadium complexation in the body, research suggests transferrin will bind available
ionized vanadium.
Currently, there is no clinical data to support the need for taking vanadium supplements such as vanadyl
sulfate, vanadium colloid, or any other form. This test provides no information regarding any theoretical
vanadium deficiency.
Vanadium has been recognized as an occupational hazard for more than 20 years. Elevated atmospheric
vanadium levels can result from burning fossil fuels with a high vanadium content. Inhalation and ingestion
are the primary exposure routes. Vanadium exposure can result in a metallic taste and so-called “green tongue.”
Sensitization can result in asthma or eczema. Vanadium intoxication is effectively treated with ascorbic acid.
Increased vanadium serum concentrations are observed in dialysis patients and those with compromised
renal function since the kidney is primarily responsible for vanadium elimination. Elevated serum vanadium
levels also have been observed in patients with joint replacements.
Useful For
Detecting vanadium toxicity
Interpretation
The typical finding in the general population is below the quantitation limit of this assay, 0.1 ng/mL.
Values <1.0 ng/mL are normal
Values >5.0 ng/mL indicate probable exposure
Test Title:
Vanadium, Serum
#83396
Cautions
• Specimen collection procedures require special collection containers, rigorous attention to ultraclean
specimen collection and handling procedures, and analysis in an ultraclean facility. Unless all of these
procedures are followed, increased serum vanadium results may be an incidental and misleading finding.
• This test should be ordered only when there is reason to suspect vanadium exposure. There is still
controversy as to the effects of industrial exposure on the body, and toxicity data is extremely limited.
• Although vanadium appears to be an essential trace element in humans, its role, if any, is not clearly
defined and this test is not useful for nutritional assessment.
• Currently, there is no evidence to suggest the clinical utility of monitoring vanadium levels in either
dialysis patients or those with prosthetic joints. In cases where the fiber mesh alloy has deteriorated,
aluminum can be measured.
• There is no clear evidence to support the preference for either serum or urine as the specimen of choice for
monitoring exposure. Under no circumstances is hair or nails testing advisable.
• Due to possible contamination or binding of vanadium with anticoagulants, plasma testing is not recommended.
Reference
Tsalev DL, Zaprianov ZK, Biological and toxicological characteristics of individual elements. Vanadium. In
Atomic Absorption Spectrometry in Occupational and Environmental Health Practice, Analytical Aspects and
Health Significance, Vol. I, CRC Press, Boca Raton, FL, 1984, pp. 204-209
Method
Aqueous acidic calibrating standards with serum matrix are diluted with an aqueous nitric acid diluent
containing a gallium internal standard. Specimens are then aspirated into a pneumatic nebulizer and the
resulting aerosol is directed to the hot plasma discharge by a flow of argon. In the annular plasma, the
aerosol is vaporized, atomized, and then ionized. The ionized gases plus neutral species formed in the
annular plasma space are aspirated from the plasma through an orifice into a quadrapole mass spectrometer.
The mass range from 1 to 263 amu is rapidly scanned multiple times and ion counts tabulated for m/z 51
(vanadium) and 69 (gallium). Instrument response is defined by the linear relationship of analyte
concentration versus ion count ratio (analyte ion count/internal standard ion count). Analyte concentrations
are derived by reading the ion count ratio for each mass of interest and determining the concentration from
the response line. (Nixon DE, Neubauer KR, Eckdahl SJ, Butz JA, Burritt MF: Evaluation of a tunable
bandpass reaction cell for an inductively coupled plasma mass spectrometer for the determination of
chromium and vanadium in serum and urine. Spectrochimica Acta Part B 2002; 57[5]; 951-966)
Specimen Required: 1. Draw blood in a royal blue-top Monoject trace element blood collection tube(s) - product #8881-307006
(Supply T184).
2. Allow the specimen to clot for 30 minutes, then centrifuge the specimen to separate serum from the
cellular fraction.
3. Remove the stopper and carefully pour 1.0 mL of serum into a 7.0-mL, Mayo metal-free, screw-capped,
polypropylene vial (Supply T173), avoiding transfer of the cellular components of blood. DO NOT insert a
pipette into the serum to accomplish transfer, and DO NOT ream the specimen with a wooden stick to
assist with serum transfer.
4. Send specimen refrigerated. All specimens to be stored more than 48 hours should be sent frozen.
5. It is important that the specimen be obtained, processed, and transported according to instructions in
“Metals Analysis - Collection and Transport.”
Reference Values:
Analytic Time:
Days Set Up:
Fee:
CPT Code:
Normal <1.0 ng/mL
1 day
Thursday
$93.20
83789