Myoglobin
Code:13002|CPT:83874|LOINC:2639-3
| Includes | Myoglobin, Serum |
|---|
Analysis details
Methodology
- Electrochemiluminescence immunoassay (ECLIA)
- Immunoturbidimetry
Expected Turnaround Time
1 day
Special Instructions
- If taking high‑dose biotin (vitamin B7/B8, vitamin H, coenzyme R), discontinue for at least 72 hours before the blood draw.
- For infants younger than 1 year, withhold feeding for 30–40 minutes prior to collection.
- Do not eat for 2–3 hours before collection; water is allowed.
- Avoid vigorous exercise and minimize emotional stress for 30 minutes before collection.
- Do not smoke during the 30 minutes preceding collection.
How to use
The serum myoglobin test is used to assess acute and subacute muscle injury, including early detection of myocardial necrosis and the diagnostic workup of rhabdomyolysis. Myoglobin typically becomes detectable within hours of acute myocardial infarction and may correlate with infarct size; however, due to limited cardiac specificity, results are interpreted alongside electrocardiographic data and cardiac troponin. Elevated concentrations are also seen with trauma, ischemia, malignant hyperthermia, strenuous exertion, inflammatory myopathies, and muscular dystrophies. Serial measurements can assist in tracking the course of muscle injury. Synonyms used in clinical practice include myoglobinemia and serum myoglobin.
Limitations
Myoglobin resides within skeletal and cardiac muscle and functions as an intracellular oxygen reservoir. Under normal conditions, circulating levels are very low; with myocyte necrosis, concentrations rise promptly. In acute myocardial infarction, myoglobin increases within 1–2 hours and returns to baseline relatively quickly. The marker is not specific for cardiac injury and may be increased after intramuscular injections, high‑voltage electrical injury, and in a range of skeletal muscle disorders. Myoglobin is cleared by renal filtration; marked elevations accompanying massive muscle injury can contribute to acute kidney injury.
| Unit | ng/mL | ||||
|---|---|---|---|---|---|
| Reference interval |
| ||||
| Indications | Evaluation of suspected acute myocardial infarction as an early marker: concentrations rise within 1–3 hours and peak by 8–12 hours., Workup for suspected or confirmed rhabdomyolysis., Assessment of skeletal muscle injury related to trauma, surgical procedures, or crush syndrome., Chest pain evaluation to help distinguish myocardial infarction from noncardiac causes., Monitoring the response to treatment and the evolution of muscle injury over time. |
Possible Causes of Abnormal Results
Increased levels
- high-voltage electrical injury
- hemolysis
- intramuscular injections
- strenuous exercise
Specimen Requirements
| Specimen | Serum |
|---|---|
| Container | Gold/Tiger Top (SST, Gel Separator) |
| Volume | 1 mL (min 0.7 mL) |
| Storage Instructions | Room temperature, Refrigerated, Frozen |
References
Andersen PT, Moller-Petersen J, Henneberg EW, Egeblad K. Hypermyoglobinemia after successful arterial embolectomy. Surgery. 1987 Jul;102(1):25-31. PubMed 3296265
Gibler WB, Gibler CD, Weinshenker E, et al. Myoglobin as an early indicator of acute myocardial infarction. Ann Emerg Med. 1987 Aug;16(8):851-856. PubMed 3619163
Kasik JW, Leuschen MP, Bolam DL, Nellson RM. Rhabdomyolysis and myoglobinemia in neonates. Pediatrics. 1985 Aug;76(2):255-258. PubMed 4022700
Seguin J, Saussine M, Ferriere M, et al. Comparison of myoglobin and creatine kinase MB levels in the evaluation of myocardial injury after cardiac operations. J Thorac Cardiovasc Surg. 1988 Feb;95(2):294-297. PubMed 3257537