Myoglobin, Urine, Quantitative


Abbrev Code:UMY   
Order Code:LAB3846Order Name:Myoglobin Quantitative Urine
Synonyms:Rhabdomyolysis; Myoglobinuria
Methodology:Electrochemiluminescence immunoassay
CPT Codes: 83874 x1
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported within 1 day.
Special Instructions:
To facilitate more rapid patient diagnosis, the following protocol is recommended for evaluation of patients with suspected rhabdomyolysis and myoglobinuria.
  1. C&P staff order UMY.
  2. CC1 staff order UBLD; perform even when urine is clear.
  3. If specimen is positive for blood; CC1 staff order (credit in GenLab) CK on closest (timing) plasma (serum also acceptable in this case) available for this patient; ideally this sample should be collected within 2-6 hours.
  4. If blood (urine) is positive and CK (plasma) is elevated; send plasma to Fairview Southdale for a plasma myoglobin (credit in GenLab).
  5. Call results to physician to determine whether urine myoglobin testing is still desired.
  6. Refer questions to the Clinical Chemistry resident (pager: 612-899-1483.)

 
Causes of
Red Urine		 Hematuria (red
cells in urine)		 Hemoglobinuria Myoglobinuria and
Rhabdomyolysis
Reagent Strip-bld,ur Positive Positive Positive
Appearance, urine Cloudy red Clear/red brn Clear/red brn
Sediment, urine RBC present RBC absent RBC absent
Appearance, plasma   Normal, hemolyzed Normal
CK Total, plasma   Normal, sl elevation Marked elevation
Myoglobin, plasma   Normal Marked elevation
In the majority of cases, the testing scheme outlined above will answer the clinical question in evaluating patients with suspected rhabdomyolysis.
Compliance:

For tests developed and validated by ARUP (previously referred to as Compliance Statement B, C or D). This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the U.S. Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Associated Links:

Urine Collection Procedure


Collection Instructions

Specimen:Urine, random collection or 24 hour collection
Optimal Volume:1 mL
Minimum\Peds Volume:0.5 mL
Container:3 L plastic jug
Alternate Containers: Plastic leakproof container, sterile
Collection Instructions:Refrigerate during collection.


Processing and Shipping

Specimen Processing:Aliquot 1 mL, 0.5 mL minimum. Adjust pH to 8.0-9.0 by adding 10% sodium carbonate. Alternatively aliquot 4 mL urine, 0.5 mL minimum into an ARUP Standard transport tube prefilled with sodium carbonate Record time and volume on container. Store in freezer.
Shipping Instructions:Ship on dry ice.
Stability:pH: 8-9. 1 hour at room temperature; 72 hours refrigerated; 1 month frozen.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:20223


Interpretive

Reference Range:0-1 mg/L Patients with urine myoglobin greater than 15 mg/L are at risk of acute renal failure. Results between 1 and 15 mg/L are associated with vigorous exercise, myocardial infarct, mild muscle injury and other conditions.


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