ARUP's Laboratory Test Directory

Chromium, Serum : 0098830

Mnemonic: CR S

Methodology: Quantitative Inductively Coupled Plasma-Mass Spectrometry
Performed: Tue, Thu, Sat
Reported: 1-4 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).

Specimen Preparation: Centrifuge; do not allow serum to remain on cells. Transfer 2 mL serum 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 5.0 µg/L
Interpretive Data: Serum chromium is the preferred specimen type for evaluating metal ion release from metal-on-metal joint arthroplasty. Serum chromium levels may be increased in asymptomatic patients with metal-on-metal prosthetics and should be considered in the context of the overall clinical scenario. The form of chromium greatly influences distribution. Trivalent chromium resides in the plasma and is usually not of clinical importance. Hexavalent chromium is considered highly toxic; however, chromium serum levels should not be used to assess toxic exposures to hexavalent chromium as it is predominately taken up and retained by red blood cells. Symptoms associated with chromium toxicity vary based on route of exposure and dose, and may include dermatitis, impairment of pulmonary function, gastroenteritis, hepatic necrosis, bleeding, and acute tubular necrosis.
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): 82495
Cross References: Cr, Blood (Chromium, Serum), CRS (Chromium, Serum)