Test Summary

Thiocyanate is used as a biomarker for exposure to cyanides or cyanide-containing chemicals. This test is a serum-based assay that is primarily used to monitor cyanide levels in individuals receiving sodium nitroprusside infusion therapy for treatment of extreme hypertension. It can also be used to determine cyanide levels in individuals who have been exposed to certain industrial chemicals, cigarettes, or thiocyanate-containing foods [1].

Thiocyanate is a principal metabolite of cyanide, which accumulates in the blood and urine in response to cyanide exposure, cigarette smoking, industrial chemicals, and sodium nitroprusside infusion. Some industrial chemicals associated with increased thiocyanate levels include acetonitrile, acrylonitrile, and amygdalin. Symptoms of thiocyanate toxicity include confusion, hyperreflexia, convulsions, and metabolic acidosis [1].

This test may be helpful for patients, with normal renal function who are receiving long-term nitroprusside therapy for 7 days or more, as well as patients with renal insufficiency who are receiving nitroprusside therapy for any length of time. Patients with renal insufficiency are especially at risk for cyanide toxicity [2].

Note that the following drugs elevate thiocyanate and could interfere with test accuracy: antipyrine, acetoacetate, and phenacetin (and their sulfoxides in large concentrations); phenacetin and acetaminophen; and salicylic acid and its complexes.

References
1. Riedel K, et al. Thiocyanate in plasma and saliva (Biomonitoring Methods, 2013). In: Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area of the DFG, ed. The MAK-Collection for Occupational Health and Safety: Annual Thresholds and Classifications for the Workplace. Wiley-VHCA AG: Zurich, Switzerland; 2013;13:277-292.
2. Schulz Y. Clin Pharmacokinetic.1984;9:239-251.

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