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N-Methylhistamine, 24 Hour, Urine
Test Code39559
CPT Codes
82542, 82570
Includes
Creatinine
Preferred Specimen
5 mL aliquot of urine collected in 24-hour no preservative container
Patient Preparation
Patient must not be taking monoamine oxidase inhibitors (MAOIs) or aminoguanidine as these medications increase N-methylhistamine (NMH) levels.
Minimum Volume
3 mL
Instructions
1. Collect urine for 24 hours
2. No preservative
3. Aliquot into plastic tube and send at refrigerate temperature
The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.
Note: Random urine collections are preferred for patients with episodic symptoms, for example in the context of allergic reactions, brought on by specific environmental factors. See 39604 N-Methylhistamine, Random, Urine.
If ordering this test with 39559- N-Methylhistamine, 24 Hour, Urine/10109- 2,3-Dinor-11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine; both tests must be ordered under a different order number. They cannot share an order number.
If the total volume provided is less than 300 mL, this test will be canceled and NMHR (39604) will be ordered and performed.
2. No preservative
3. Aliquot into plastic tube and send at refrigerate temperature
The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.
Note: Random urine collections are preferred for patients with episodic symptoms, for example in the context of allergic reactions, brought on by specific environmental factors. See 39604 N-Methylhistamine, Random, Urine.
If ordering this test with 39559- N-Methylhistamine, 24 Hour, Urine/10109- 2,3-Dinor-11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine; both tests must be ordered under a different order number. They cannot share an order number.
If the total volume provided is less than 300 mL, this test will be canceled and NMHR (39604) will be ordered and performed.
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 14 days
Refrigerated: 28 days
Frozen: 28 days
Refrigerated: 28 days
Frozen: 28 days
Methodology
Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) • Enzymatic Colorimetric Assay
Setup Schedule
Set up: Tue, Thurs; Report available: 3 days
Clinical Significance
Screening for and monitoring of mastocytosis and disorders of systemic mast-cell activation, such as anaphylaxis and other forms of severe systemic allergic reactions using 24-hour urine collection specimens. Monitoring therapeutic progress in conditions that are associated with secondary, localized, low-grade persistent, mast-cell proliferation and activation such as interstitial cystitis.
Cautions:
While an average North American diet has no effect on urinary N-methylhistamine (NMH) levels, mild elevations (around 30%) may be observed on very histamine-rich diets. This problem is more pronounced if random-urine specimens are used and collected following a histamine-rich meal. NMH levels may be depressed in individuals who have an alteration in the histamine-N-methyl transferase gene, which encodes the enzyme that catalyzes NMH formation. This alteration results in an amino acid change that decreases the rate of NMH synthesis. When N-acetylcysteine is administered at levels sufficient to act as an antidote for the treatment of acetaminophen overdose, it may lead to falsely decreased creatinine results.
Cautions:
While an average North American diet has no effect on urinary N-methylhistamine (NMH) levels, mild elevations (around 30%) may be observed on very histamine-rich diets. This problem is more pronounced if random-urine specimens are used and collected following a histamine-rich meal. NMH levels may be depressed in individuals who have an alteration in the histamine-N-methyl transferase gene, which encodes the enzyme that catalyzes NMH formation. This alteration results in an amino acid change that decreases the rate of NMH synthesis. When N-acetylcysteine is administered at levels sufficient to act as an antidote for the treatment of acetaminophen overdose, it may lead to falsely decreased creatinine results.