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HelpTest Code MCM24 Mast Cell Mediators, 24 Hour, Urine
Ordering Guidance
Random urine collections are preferred for patients with episodic symptoms, eg, in the context of allergic reactions brought on by specific environmental factors. For random urine collections, order MCMRU / Mast Cell Mediators, Random, Urine.
Specimen Required
Patient Preparation:
1. Patients taking monoamine oxidase inhibitors (MAOI) or aminoguanidine may have increased N-methylhistamine (NMH) levels. If medically feasible, the patient must not take MAOI or aminoguanidine for 3 weeks before specimen collection. For more information see Cautions.
2. Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may have decreased concentrations of prostaglandin F2 alpha (23BP). If medically feasible, the patient should not take aspirin for 2 weeks or NSAIDs for 72 hours before specimen collection.
3. Patients taking 5-lipoxygenase inhibitor zileuton (Zyflo) may have decreased concentrations of leukotriene E4 (LTE4). If medically feasible, the patient should not take zileuton for 48 hours before specimen collection.
Supplies: Urine Container, 60 mL (T313)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 20 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. No preservative.
3. Aliquot urine into plastic tube and send to lab.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Useful For
Evaluating patients at risk for mast cell activation syndrome (eg, systemic mastocytosis) using 24-hour urine collections
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRT2F | Creatinine, 24 HR, U | No | Yes |
| TLTE1 | Leukotriene E4, 24 Hr, U | Yes, (order TLTE4) | Yes |
| T23B1 | 2,3-dinor 11B-Prostaglandin F2a | Yes, (order 23BPT) | Yes |
| TNMH1 | N-Methylhistamine, 24 Hr, U | Yes, (order NMH24) | Yes |
Special Instructions
Method Name
CRT2F: Enzymatic Colorimetric Assay
TLTE1, T23B1, TNMH1: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Mast Cell Mediators, 24 Hour, USpecimen Type
UrineSpecimen Minimum Volume
10 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Frozen | 28 days |
Reference Values
N-METHYLHISTAMINE:
0-5 years: 120-510 mcg/g creatinine
6-16 years: 70-330 mcg/g creatinine
>16 years: 30-200 mcg/g creatinine
2,3-DINOR 11B-PROSTAGLANDIN F2a:
<1802 pg/mg creatinine
LEUKOTRIENE E4:
≤104 pg/mg creatinine
CREATININE:
<18 years: Not established
Males: 930-2955 mg/24 h
Females: 603-1783 mg/24 h
Interpretation
Analytical reports within the scope of the individual assays will be provided when testing is complete.
Clinical Reference
1. Weiler CR. Mast cell activation syndrome: Tools for diagnosis and differential diagnosis. J Allergy Clin Immunol Pract. 2020;8(2):498-506
2. Valent P, Akin C, Metcalfe DD. Mastocytosis: 2016 updated WHO classification and novel emerging treatment concepts. Blood. 2017;129(11):1420-1427
3. Valent P, Akin C, Hartmann K, et al. Updated diagnostic criteria and classification of mast cell disorders: A consensus proposal. Hemasphere. 2021;5(11):e646
4. Gulen T, Akin C, Bonadonna P, et al. Selecting the right criteria and proper classification to diagnose mast cell activation syndromes: A critical review. J Allergy Clin Immunol Pract. 2021;9(11):3918-3928
5. Butterfield JH. Nontryptase urinary and hematologic biomarkers of mast cell expansion and mast cell activation: Status 2022. J Allergy Clin Immunol Pract. 2022;10(8):1974-1984
6. Divekar R, Hagan J, Rank M, et al. Diagnostic utility of urinary LTE4 in asthma, allergic rhinitis, chronic rhinosinusitis, nasal polyps, and aspirin sensitivity. J Allergy Clin Immunol Pract. 2016;4(4):665-670
7. Valent P, Hartmann K, Bonadonna P, et al. Global classification of mast cell activation disorders: An ICD-10-CM-adjusted proposal of the ECNM-AIM Consortium. J Allergy Clin Immunol Pract. 2022;10(8):1941-1950
Day(s) Performed
Monday, Tuesday, Thursday
Report Available
3 to 7 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82542
84150
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MCM24 | Mast Cell Mediators, 24 Hour, U | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CR_AF | Creatinine, 24 HR, U | 2162-6 |
| 620242 | 2,3-dinor 11B-Prostaglandin F2a | 94381-1 |
| 620244 | N-Methylhistamine, 24 Hr | 44340-8 |
| 620240 | Leukotriene E4, U | 101115-4 |
| TM10F | Collection Duration (h) | 13362-9 |
| VL8F | Urine Volume (mL) | 3167-4 |
| CRF24 | Creatinine Concentration, 24 HR, U | 20624-3 |