ARUP's Laboratory Test Directory

Cobalt, Serum or Plasma : 0025037

Mnemonic: COBALT S

Methodology: Quantitative Inductively Coupled Plasma-Mass Spectrometry
Performed: Tue, Fri
Reported: 1-5 days
Specimen Required: Patient Prep: Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician).

Collect: Royal blue (no additive) or Royal blue (EDTA)

Specimen Preparation: Centrifuge; Do not allow serum to remain on cells. Transfer 2 mL serum or plasma to an ARUP Trace Element-Free Transport Tube (ARUP supply #43116). Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 0.5 mL)

Storage/Transport Temperature: Room temperature. Also acceptable: Refrigerated or frozen.

Unacceptable Conditions: Separator tubes. Specimens that are not separated from the red cells, or clot, within 6 hours.

Stability (collection to initiation of testing): If the specimen is drawn and stored in the appropriate container, the trace element values do not change with time.
Reference Interval:
Less than or equal to 1.0 µg/L
Interpretive Data: Serum cobalt levels can be used in the assessment of occupational exposure or toxic ingestion and is the preferred specimen type for evaluating metal ion release from metal-on-metal joint arthroplasty. Serum cobalt levels may be increased in asymptomatic patients with metal-on-metal prosthetics and should be considered in the context of the overall clinical scenario. Symptoms associated with cobalt toxicity vary based on route of exposure, and may include cardiomyopathy, allergic dermatitis, pulmonary fibrosis, cough and dyspnea.
Note: Elevated results from noncertified trace element-free tubes may be due to contamination.  Elevated concentrations of trace elements in serum should be confirmed with a second specimen collected in a trace element-free tube, such as royal blue sterile tube (no additive).
CPT Code(s): 83018
Cross References: COS (Cobalt, Serum or Plasma)