Aluminum can cause significant toxicity, especially in dialysis patients. However, falsely high values can mislead.
Sources of a falsely high serum aluminum concentration:
(1) aluminum contamination of blood collection devices and/or tubes
(2) aluminum contamination of heparin
(3) other environmental contamination
(4) specimen mix-up
(5) unreliable analytical method
When to suspect the possibility of a false elevation:
(1) A serum concentration >= 60 µg/L with repeat analysis < 20 µg/L within 6 weeks.
(2) Failure to use special tubes for metal analysis.
(3) Failure to take other precautions to reduce aluminum contamination.
(4) Serum concentration discrepant with clinical situation (no significant exposure, no clinical manifestations of aluminum toxicity).
It is usually advisable to confirm an elevated serum aluminum concentration prior to initiating therapy.
The royal-blue top vacutainer is intended for trace metal analysis. The lavender top EDTA tube should be avoided. Specimens should be processed promptly.
