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HelpTest Code MCMRU Mast Cell Mediators, Random, Urine
Ordering Guidance
Patients with chronic mast cell activation often have chronically elevated N-methylhistamine (NMH) levels and will sometimes have intermittent NMH elevations. In these cases, a 24-hour urine collection is preferred. See MCM24 / Mast Cell Mediators, 24 Hour, Urine.
Specimen Required
Patient Preparation:
1. Patient must not be taking monoamine oxidase inhibitors (MAOI) or aminoguanidine, as these medications increase N-methylhistamine (NMH) levels.
2. Patients taking aspirin or nonsteroidal anti-inflammatory drugs (NSAID) may have decreased concentrations of prostaglandin F2 alpha (23BP). If possible, the patient should discontinue use for 2 weeks or 72 hours, respectively, 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 a random urine specimen within a few hours of symptom onset.
2. No preservative.
Useful For
Evaluating patients at risk for mast cell activation syndrome (eg, systemic mastocytosis) using random urine collections
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRTFR | Creatinine, Random, U | No | Yes |
| RLTE1 | Leukotriene E4, Random, U | Yes | Yes |
| R23B1 | 2,3-dinor 11B-Prostaglandin F2a | Yes | Yes |
| RNMH1 | N-Methylhistamine, Random | Yes | Yes |
Method Name
CRT2F: Enzymatic Colorimetric Assay
RLTE1, R23B1, RNMH1: Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Mast Cell Mediators, Random, USpecimen Type
UrineSpecimen Minimum Volume
10 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Frozen | 28 days |
Reference Values
LEUKOTRIENE E4:
≤104 pg/mg creatinine
2,3-DINOR 11B-PROSTAGLANDIN F2a:
<1802 pg/mg creatinine
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
CREATININE:
≥18 years old: 16-326 mg/dL
Reference values have not been established for patients who are younger than 18 years.
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
2 to 9 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
82570
84150
82542
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MCMRU | Mast Cell Mediators, Random, U | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CRTFR | Creatinine, Random, U | 2161-8 |
| 620245 | N-Methylhistamine, Random, U | 13781-0 |
| 620241 | Leukotriene E4, Random, U | 33343-5 |
| 620243 | 2,3-dinor 11B-Prostaglandin F2a | 97658-9 |