Urine Histamine, Mast Cell Disease
SOFT: XHSTU, EPIC: LAB7143, MAYO: FH24U
- Please refer to the Specimen Collection Manual for instructions on 24-Hour Urine Collection:
- Avoid taking allergy causing drugs, antihistamines, oral corticosteroids, and substances which block H2 receptors for at least 24 hours prior to specimen 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
6N Hydrochloric Acid
Boric Acid (10g)
50% Acetic Acid
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).
- Random urine specimens.
- Specimens not collected and processed as indicated.
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: 2.0 mL)
Specimen Stability for Testing:
Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): 14 days
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.
Sent to Mayo Medical Laboratories, Rochester, MN, forwarded to Quest Diagnostics Nichols Institute, San Juan Capistrano, CA.
Results available in 3-11 days.
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.
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.
- 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.
- Homburger HA: Methods in Laboratory Immunology. In Allergy Principles and Practice, Vol. I. 5th edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, MO, Mosby Year Book, 1998, pp 417-429.
LOINC: 33290-8, 25925-9
Send Outs Laboratory – RO
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