Myoglobin

CPT: 83874
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Test Details

Use

Diagnose skeletal or myocardial muscle injury. Serum myoglobin is generally detectable earlier than is CK or CK-MB increase in patients with acute myocardial infarction.1 Serum myoglobin was found also in 50% of patients with acute coronary insufficiency. It is thought to define a population of small infarcts of myocardium. It correlates with size of infarct.1 Diagnose rhabdomyolysis.2 Myoglobin appears with trauma, ischemia, malignant hyperthermia, exertion, dermatomyositis, polymyositis, and muscular dystrophy.3

Limitations

Lacks specificity in diagnosis of acute MI, since increased myoglobin levels occur after intramuscular injections.4 Increased serum myoglobin has been reported after a high voltage electrical accident.4 As an index of myocardial infarct, myoglobin returns rapidly to baseline levels.1

Methodology

Electrochemiluminescence immunoassay (ECLIA)

Reference Interval

• Male 28−72 ng/mL

• Female 25−58 ng/mL

Additional Information

Serum myoglobin is rapidly cleared by the kidneys. Urine myoglobin levels were not detected after myocardial infarct.4 Elevated myoglobin levels may be associated with cocaine abuse.5 Other conditions which cause elevation of serum myoglobin include open heart surgery, exercise, progressive muscular dystrophy, shock, and renal failure.1 It is increased in azotemic subjects and not effected by dialysis.6

Specimen Requirements

Specimen

Serum

Volume

0.8 mL

Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube or gel-barrier tube

Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube.

Storage Instructions

Refrigerate.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Gross hemolysis

Clinical Information

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Footnotes

1. Isakov A, Shapira I, Burke M, Almog C. Serum myoglobin levels in patients with ischemic myocardial insult. Arch Intern Med. 1988 Aug; 148(8):1762-1765. 3401097
2. Kaiser HF, Rumpf KW, Sold G, Kreuzer H. Serum myoglobin in rhabdomyolysis. JAMA. 1982 Mar 26; 247(12):1697. 7062478
3. Kagen LJ. Approach to the patient with myopathy. Bull Rheum Dis. 1983; 33(2):1-8. 6860842
4. Drexel H, Dworzak E, Kirchmair W, Milz MM, Puschendorf B, Dienstl F. Myoglobinemia in the early phase of acute myocardial infarction. Am Heart J. 1983 Apr; 105(4):642-651. 6837418
5. Pogue VA, Nurse HM. Cocaine-associated acute myoglobinuric renal failure. Am J Med. 1989 Feb; 86(2):183-186. 2913784
6. Feinfeld DA, Verger C, Briscoe AM, et al. Serum myoglobin in patients on intermittent and continuous ambulatory peritoneal dialysis. Clin Nephrol. 1987 Sep; 28(3):144-146. 3665208

References

Andersen PT, Moller-Petersen J, Henneberg EW, Egeblad K. Hypermyoglobinemia after successful arterial embolectomy. Surgery. 1987 Jul; 102(1):25-31. 3296265
Gibler WB, Gibler CD, Weinshenker E, et al. Myoglobin as an early indicator of acute myocardial infarction. Ann Emerg Med. 1987 Aug; 16(8):851-856. 3619163
Kasik JW, Leuschen MP, Bolam DL, Nellson RM. Rhabdomyolysis and myoglobinemia in neonates. Pediatrics. 1985 Aug; 76(2):255-258. 4022700
Seguin J, Saussine M, Ferriere M, et al. Comparison of myoglobin and creatine kinase MB levels in the evaluation of myocardial injury after cardiac operations. J Thorac Cardiovasc Surg. 1988 Feb; 95(2):294-297. 3257537

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
010405 Myoglobin, Serum 2639-3 010405 Myoglobin, Serum ng/mL 2639-3

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