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Myoglobin Serum

Blood
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Report in 8Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Muscle breakdown marker.

₹2,442₹3,489

30% OFF

Myoglobin Serum Test Guide

  • Why is it done?
    • Myoglobin is a protein found primarily in skeletal and cardiac muscle that binds and stores oxygen. The serum myoglobin test measures the level of myoglobin in the blood to detect muscle damage or injury.
    • Primary indications for ordering this test:
    • Suspected acute myocardial infarction (heart attack) - myoglobin rises within 2-3 hours and peaks at 24 hours
    • Muscle injury, trauma, or crush injuries causing rhabdomyolysis
    • Statin-induced muscle injury or statins with elevated creatine kinase (CK)
    • Muscular dystrophy or other inherited muscle diseases
    • Severe burns or thermal injuries affecting muscle tissue
    • Prolonged seizures or extreme physical exertion causing muscle breakdown
    • Typical timing:
    • Ordered in emergency department within 3 hours of chest pain or muscle injury onset for highest diagnostic sensitivity
    • May be repeated serially to assess trend in acute muscle injury situations
  • Normal Range
    • Reference ranges (vary by laboratory):
    • Adults: 30-110 ng/mL (nanograms per milliliter) - most common reference range
    • Some laboratories: 19-92 ng/mL or 25-72 ng/mL depending on assay methodology
    • Male reference ranges may be slightly higher than female reference ranges
    • Units of measurement:
    • ng/mL (nanograms per milliliter) or mcg/L (micrograms per liter)
    • Interpretation of results:
    • Normal: Within laboratory reference range (typically 30-110 ng/mL) indicates no significant muscle damage or cardiac necrosis
    • Elevated (High): Above upper reference limit indicates muscle cell injury, breakdown, or necrosis; requires clinical correlation
    • Mildly elevated (1-5x upper limit): May indicate minor muscle trauma, strenuous exercise, or early myocardial infarction
    • Markedly elevated (>10x upper limit): Suggests severe muscle damage, rhabdomyolysis, or acute myocardial infarction
  • Interpretation
    • Detailed result interpretation:
    • Acute myocardial infarction: Myoglobin rises within 2-3 hours (earlier than troponin), peaks at 24 hours, and normalizes within 7-14 days. Serial measurements show rising and falling pattern.
    • Rhabdomyolysis: Severe elevation (often >1000 ng/mL) accompanied by elevated creatine kinase (CK), elevated creatinine, and dark urine; indicates severe muscle breakdown with risk of acute kidney injury
    • Muscular dystrophy: Chronically elevated levels due to ongoing muscle degeneration; levels may be 5-100 times normal depending on disease type and stage
    • Statin myopathy: Mild to moderate elevation with symptoms of muscle pain, weakness, or elevated CK within weeks of statin initiation
    • Severe burns: Elevated myoglobin indicating muscle necrosis; correlates with burn severity and fluid loss
    • Factors that may affect readings:
    • Intense exercise or strenuous physical activity 24-48 hours before testing can elevate levels
    • Intramuscular injections within 48 hours can cause minor elevation
    • Hemolysis (damaged red blood cells) during sample collection can falsely elevate results
    • Renal insufficiency may delay myoglobin clearance, prolonging elevation
    • Male gender typically shows higher baseline levels than female
    • Athletes may have mildly elevated baseline levels due to muscle mass and conditioning
    • Clinical significance:
    • High sensitivity but low specificity for myocardial infarction; must be used with troponin and electrocardiogram (ECG) for optimal cardiac diagnosis
    • More useful for detecting skeletal muscle injury than distinguishing cardiac from skeletal muscle source
    • Serial measurements (trends) more clinically useful than single isolated value
  • Associated Organs
    • Primary organ systems involved:
    • Skeletal muscle system (most common source of elevated myoglobin)
    • Cardiac muscle (heart) - myocardial infarction and myocarditis
    • Kidneys - myoglobin precipitates in renal tubules causing myoglobinuria and acute kidney injury
    • Medical conditions commonly associated with abnormal results:
    • Acute myocardial infarction (heart attack) - rapid rise in myoglobin within hours
    • Myocarditis (inflammation of heart muscle) - elevated myoglobin with chest pain and arrhythmias
    • Rhabdomyolysis - marked elevation due to skeletal muscle breakdown from crush injury, prolonged immobilization, or exertion
    • Duchenne muscular dystrophy - chronically elevated levels reflecting progressive muscle degeneration
    • Limb girdle muscular dystrophy - elevated myoglobin with progressive muscle weakness
    • Statin-induced myopathy - elevated myoglobin with muscle symptoms on statin therapy
    • Polymyositis and dermatomyositis - inflammatory muscle diseases causing elevated myoglobin
    • Severe thermal or crush injuries - elevation correlates with extent of muscle damage
    • Neuroleptic malignant syndrome - elevated myoglobin from severe muscle rigidity
    • Malignant hyperthermia - acute elevation during anesthetic reaction with severe muscle damage
    • Potential complications with abnormal results:
    • Myoglobinuria (myoglobin in urine) - visible as dark or cola-colored urine, may precipitate in renal tubules
    • Acute kidney injury (AKI) - myoglobin-induced nephrotoxicity from rhabdomyolysis with severe elevation
    • Cardiogenic shock - in acute myocardial infarction with marked myoglobin elevation indicating extensive myocardial necrosis
    • Hyperkalemia - elevated potassium from muscle cell breakdown can cause life-threatening arrhythmias
    • Disseminated intravascular coagulation (DIC) - can occur in severe rhabdomyolysis cases
  • Follow-up Tests
    • Additional tests recommended based on elevated myoglobin results:
    • For suspected acute myocardial infarction:
    • Troponin I or troponin T (cardiac-specific troponins) - more specific for cardiac muscle than myoglobin; serial measurements 3-6 hours apart
    • Electrocardiogram (ECG) - assess for ST-segment elevation or other ischemic changes consistent with MI
    • Creatine kinase (CK) and CK-MB - cardiac marker more specific than myoglobin
    • Echocardiogram - visualize cardiac wall motion abnormalities indicating infarction region
    • For suspected rhabdomyolysis:
    • Creatine kinase (CK) - often markedly elevated (>1000 U/L) in rhabdomyolysis; serial measurements to assess trend
    • Serum creatinine and blood urea nitrogen (BUN) - assess kidney function for myoglobin-induced acute kidney injury
    • Urinalysis with myoglobin screening - detect dark urine and myoglobinuria (blood positive but RBC negative)
    • Serum electrolytes (potassium, calcium, phosphate) - assess for life-threatening electrolyte abnormalities
    • Coagulation studies (PT, PTT, INR) - assess for disseminated intravascular coagulation risk
    • For suspected muscular dystrophy:
    • Creatine kinase (CK) - baseline and monitoring; extremely elevated in Duchenne (1000-10000 U/L or higher)
    • Genetic testing/DNA analysis - confirm specific muscular dystrophy type
    • Muscle biopsy - histological confirmation if genetic testing inconclusive
    • EMG/NCS (electromyography/nerve conduction studies) - assess muscle and nerve function
    • For suspected statin myopathy:
    • Creatine kinase (CK) - typically mild to moderate elevation (3-10x normal)
    • Liver function tests - baseline and monitoring for statin hepatotoxicity
    • Consider CoQ10 level - may be depleted by statins
    • Monitoring frequency for ongoing conditions:
    • Acute MI: Serial myoglobin every 3-6 hours × 2-3 measurements to assess rising/falling pattern
    • Rhabdomyolysis: Daily myoglobin and CK measurements until normalized and kidney function stable
    • Muscular dystrophy: Annual or semi-annual myoglobin and CK monitoring to track disease progression
    • Statin therapy: Baseline, 6-12 weeks after initiation, then annually or if symptoms develop
  • Fasting Required?
    • Fasting requirement: No - fasting is NOT required for myoglobin serum test
    • The test can be performed at any time of day with or without food intake
    • Special instructions and patient preparation:
    • Avoid strenuous exercise or heavy physical activity for 24-48 hours prior to testing, as this can falsely elevate myoglobin levels
    • Avoid intramuscular injections (IM), including vaccinations or medication injections, for at least 48 hours before testing if possible
    • In acute situations (emergency department setting), routine pre-test instructions may not apply - test is performed immediately
    • Ensure adequate hydration - important for accurate results in chronic conditions
    • Medications:
    • No medications need to be discontinued specifically for myoglobin testing
    • Continue all regular medications including statins unless specifically instructed otherwise by physician
    • If statin myopathy is being investigated, bring list of all medications to physician
    • Specimen collection requirements:
    • Blood drawn by venipuncture into serum separator tube (SST) or standard serum tube
    • Avoid hemolysis during collection (rough handling) to prevent false elevation
    • Send blood to laboratory for serum separation and testing; results typically available within 1-2 hours in acute settings
    • Room temperature storage acceptable for up to 4 hours; refrigerate if longer delay anticipated

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