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22272 Chromium, Serum (CRS)

Chromium, Serum (CRS)
Test Code: CHROSO
Synonyms/Keywords
Chromium (Cr), Cr (Chromium)
Useful For
​Screening for occupational exposure
 
Monitoring metallic prosthetic implant wear
Specimen Requirements
Specimen Type Preferred Container/Tube
 Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Serum Royal Blue Top Tube (RBTT) Metal Free, No Additive​:  

Product number 368380 (T184 Metal Free B-D Tube [No Additive] 6-mL)​

 ​ 1.6 mL​ 0.4 mL​ ​
Collection Processing 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 7-mL Mayo metal-free, screw-capped, 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-Collection and Transport in Special Instructions on Mayo website for complete instructions.
Additional Information: 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
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 28 days​
Frozen ​ 28 days​
Interference

​Specimens from unexposed individuals collected using metal-free collection procedures typically have chromium above 0.3 ng/mL. Chromium is present in our environment at 100-fold to 1,000-fold higher concentration than found in biological tissues. Reports of increased serum chromium could be due to external contamination. Metal-free serum collection procedures must be followed, and centrifuged serum must be aliquoted into a Mayo Clinic Laboratories metal-free vial to avoid external contamination. Specimens collected using an anticoagulant are unacceptable; trace amounts of chromium are present in anticoagulants used in evacuated collection tubes.

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories​
 Monday, Wednesday, Friday​
1 to 4 days
​		 Dynamic Reaction Cell-Inductively Coupled Plasma-Mass Spectometry (DRC-ICP-MS)​
Reference Lab
Mayo Clinic Laboratories
Reference Range Information
​<0.3 ng/mL
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 FDA recommends testing chromium in EDTA anticoagulated whole blood in symptomatic patients with metal-on-metal implants.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82495 ​ ​ ​ ​
Synonyms/Keywords
Chromium (Cr), Cr (Chromium)
Ordering Applications
Ordering Application Description
​Centricity ​Chromium, S (8638)
​Cerner ​Chromium Level (8638)
​COM ​Cholesterol
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)
​Serum Royal Blue Top Tube (RBTT) Metal Free, No Additive​:  

Product number 368380 (T184 Metal Free B-D Tube [No Additive] 6-mL)​

 ​ 1.6 mL​ 0.4 mL​ ​
Collection Processing
​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 7-mL Mayo metal-free, screw-capped, 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-Collection and Transport in Special Instructions on Mayo website for complete instructions.
Additional Information: 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
Serum​ ​ ​ Refrigerated (preferred)​ 28 days​
Ambient ​ 28 days​
Frozen ​ 28 days​
Interference

​Specimens from unexposed individuals collected using metal-free collection procedures typically have chromium above 0.3 ng/mL. Chromium is present in our environment at 100-fold to 1,000-fold higher concentration than found in biological tissues. Reports of increased serum chromium could be due to external contamination. Metal-free serum collection procedures must be followed, and centrifuged serum must be aliquoted into a Mayo Clinic Laboratories metal-free vial to avoid external contamination. Specimens collected using an anticoagulant are unacceptable; trace amounts of chromium are present in anticoagulants used in evacuated collection tubes.

Useful For
​Screening for occupational exposure
 
Monitoring metallic prosthetic implant wear
Reference Range Information
​<0.3 ng/mL
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 FDA recommends testing chromium in EDTA anticoagulated whole blood in symptomatic patients with metal-on-metal implants.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
Mayo Clinic Laboratories​
 Monday, Wednesday, Friday​
1 to 4 days
​		 Dynamic Reaction Cell-Inductively Coupled Plasma-Mass Spectometry (DRC-ICP-MS)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82495 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.