Test Catalog

Test Id : MYGLU

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Myoglobin, Random, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirming the presence of a myopathy

Method Name
A short description of the method used to perform the test

Electrochemiluminescent Immunoassay (ECLIA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Myoglobin, Random, U

Aliases
Lists additional common names for a test, as an aid in searching

Myoglobin

Specimen Type
Describes the specimen type validated for testing

Urine

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Urine Myoglobin Transport Tube (T691)

Container/Tube: Plastic, 5-mL urine myoglobin transport tube

Specimen Volume: 4 mL

Collection Instructions:

1. Collect a preservative-free, random urine specimen.

2. If specimen is at ambient temperature, aliquot the urine to a urine myoglobin transport tube within 1 hour of collection. Refrigerate specimen.

3. If specimen is at refrigerate temperature, aliquot the urine to a urine myoglobin transport tube within 2 hours of collection.

Additional Information: Urinary myoglobin is highly unstable unless alkalinized with sodium carbonate preservative.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Use of any transport tube other than urine myoglobin transport tube Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated 7 days MYOGLOBIN TRANSPORT TUBE

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirming the presence of a myopathy

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Myoglobin is a small 17.8 kDa oxygen-binding heme protein, present in striated muscle to carry and store oxygen in muscle cells. By virtue of its small size, myoglobin is readily filtered by the glomerulus and catabolized by endocytosis and proteolysis in the proximal tubule. Healthy subjects normally have low concentrations (less than 5%) of protein appearing in the urine. Injury to skeletal or cardiac muscle results in a large release of myoglobin into systemic circulation within a few hours, which can overwhelm tubular resorption causing notable quantities of myoglobin to appear in urine giving it a red-brown appearance. The presence of myoglobin in the urine is a risk factor for developing acute kidney injury. Myoglobin concentration declines rapidly, with a serum half-life of 2 to 3 hours and has been studied for its ability to predict acute kidney injury.

 

High concentrations appear very rapidly in the urine in various conditions, including some metabolic diseases.

Conditions that can lead to rhabdomyolysis associated with myoglobinuria include:

-Trauma or crush injury

-Heatstroke, hypothermia, malignant hyperthermia

-Seizures, strenuous exercise, prolonged immobility

-Hypoxic injury

-Metabolic disturbances in electrolyte concentrations

-Genetic disorders that lead to muscle cell breakdown

-Infections

-Drugs or toxins

 

The presence of myoglobin in the urine can indicate serious muscle injury, which is a risk factor for developing acute kidney injury. Rhabdomyolysis is often confirmed and monitored by measuring serum creatine kinase, electrolytes, kidney function, and urine tests for protein and blood. Myoglobin will give a positive reaction with hemoglobin test strips, though red blood cells will be absent upon microscopic review.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

0-24 mcg/L

Reference values have not been established for patients younger than 18 years; however myoglobin is not expected to be detectable in urine.

Interpretation
Provides information to assist in interpretation of the test results

Increased excretion of urinary myoglobin is suggestive of one of the disorders or conditions listed in Clinical Information.

 

Most clinically significant elevations are elevated 2 to 10 times normal.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

An elevated level of urinary myoglobin alone does not identify the clinical disorder.

 

Physiological variables, such as patient hydration status, acid-base status, kidney function, and hypoxia affect myoglobin metabolism and, consequently, its presence in urine.

 

Urinary myoglobin concentration deteriorates rapidly unless stabilized immediately after collection by alkalinizing with sodium carbonate. Urine collected with any preservative other than sodium carbonate will not provide valid results.

 

Urinary myoglobin does not withstand freezing even when the pH is raised with sodium carbonate.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Chavez LO. Leon M, Einav S, Varon J. Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice. Crit Care. 2016;20(1):135

2. Rodriguez-Capote K, Balion CM, Hill SA, Cleve R, Yang L, El Sharif A. Utility of urine myoglobin for the prediction of acute renal failure in patients with suspected rhabdomyolysis: a systematic review. Clin Chem. 2009;55(12):2190-2197

3. Dawley C. Myalgias and myopathies: rhabdomyolysis. FP Essent. 2016;440:28-36

4. Nance JR, Mammen AL. Diagnostic evaluation of rhabdomyolysis. Muscle Nerve. 2015;51(6):793-810. doi:10.1002/mus.24606

5. Yao Z, Yuan P, Hong S, Li M, Jiang L. Clinical features of acute rhabdomyolysis in 55 pediatric patients. Front. Pediatr. 2020;8:539. doi:10.3389/fped.2020.00539

6. Lamb EJ, Jones GRD. Kidney function tests. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 34

Method Description
Describes how the test is performed and provides a method-specific reference

This myoglobin test is a sandwich-principal assay. The first incubation is 9 mcL of sample, a biotinylated monoclonal myoglobin-specific antibody, and a monoclonal myoglobin-specific antibody labeled with a ruthenium complex, which react to form a sandwich complex. In the second incubation, the complex becomes bound to the solid phase via interaction of biotin and streptavidin after addition of streptavidin-coated microparticles. The reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Results are determined via a calibration curve, which is instrument specifically generated by 2-point calibration, and a master curve provided via the cobas link.(Package insert: Elecsys Myoglobin. Roche Diagnostics; 10/2022)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83874

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
MYGLU Myoglobin, Random, U 2641-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
MYGLU Myoglobin, Random, U 2641-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports