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Histamine, Urine

Urine Histamine, Mast Cell Disease

Test Codes

EPIC: LAB7143, Beaker: XHSTU, ARUP: 70038

Department

Send Outs

Instructions

• Please refer to the Specimen Collection Manual for instructions on 24-Hour Urine Collection:
• 24-Hour Urine Collection - Inpatient.
• 24-Hour Urine Collection - Outpatient.
• 24-Hour Urine Collection - Outreach.
• Avoid taking allergy causing drugs, antihistamines, oral corticosteroids, and substances which block H2 receptors for at least 24 hours prior to specimen collection.
  
• Avoid direct sunlight during collection.

Specimen Collection Criteria

Collect: 24-hour urine sample with no preservative.

• Keep 24-hour urine specimen iced or refrigerated during collection.
• Include start and end dates and times for the collection period on the specimen container.

Urine Preservative Options
No Preservative	6N Hydrochloric Acid	Boric Acid (10g)	Sodium Carbonate	50% Acetic Acid
Preferred	Acceptable	Unacceptable	Unacceptable	Unacceptable

Physician Office/Draw Specimen Preparation

Maintain specimen refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: Entire 24-hour urine collection, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Random urine specimens.
• Specimens not collected and processed as indicated.

In-Lab Processing

Measure total volume of 24-hour urine specimen. Record total volume and collection start and end dates and times in the LIS system. Aliquot 4.0 mL from the well-mixed 24-hour urine collection and refrigerate (2-8°C or 36-46°F).

Transport: 4.0 mL urine aliquot, refrigerated (2-8°C or 36-46°F). (Minimum: 1.0 mL) 

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 6 hours
Frozen (-20°C/-4°F or below): 6 months

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Mayo Medical Laboratories, Rochester, MN, forwarded to Quest Diagnostics Nichols Institute, San Juan Capistrano, CA.

Performed

Tuesday, Saturday.
Results available in 1-6 days.

Reference Range

By report.

Test Methodology

Immunoassay.

Interpretation

Above-normal levels of histamine in plasma or urine are consistent with the diagnosis of mast cell activation occurring in patients with immediate hypersensitivity or mastocytosis.

Clinical Utility

Histamine is produced and stored in cytoplasmic granules in mast cells and basophils. Histamine is also founding other cells, including parietal cells, enterochromaffin cells, endothelial cells, and platelets; and it mediates various biologic responses, including immediate hypersensitivity (bronchospasm, vasodilatation, and increased vascular permeability), gastric acid secretion, and tissue growth and repair. (1)

Evaluating patients for diseased of immediate hypersensitivity or mast cell proliferation (mastocytosis).

Above-normal levels of histamine in plasma and urine occur after allergen challenge in patients with immediate hypersensitivity and in patients with systemic mastocytosis.
Histamine appears in blood shortly after mast cell activation, but the levels may become undetectable within 60 minutes. Consequently, it may be preferable, depending on the time elapsed since allergen exposure, to measure histamine in urine either in an aliquot from an acidified 24-hour urine collection or in a random urine specimen. (2)

Measurements of histamine in urine are subject to interference from histamine-rich foods, including cheese, wine, red meats, spinach, and tomatoes, and are not reliable in patients with urinary tract infections. (2) Histamine levels in blood and urine are suppressed in patients treated with antihistamine drugs. Patients should not have taken antihistamine drugs for 48 hours before testing.

Reference

1. Church MK, Holgate ST, Shute JK, et al: Chapter 13, Mast cell derived mediators. In Allergy Principles and Practice Vol. I. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, MO, Mosby Year Book, 1998, pp 146-167.
2. Homburger HA: Methods in Laboratory Immunology. In Allergy Principles and Practice, Vol. I. 5^th edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, MO, Mosby Year Book, 1998, pp 417-429.

CPT Codes

83088

Contacts

Last Updated

10/18/2023