Department of Laboratory Medicine
University of Washington

Clinical assay interference and limitations


Myoglobin [MYO]

Methodology: Beckman Coulter Unicel DxI Access Myoglobin¹

Interferences and limitations:

Myoglobin levels can be increased in any condition resulting in damage to either skeletal or cardiac muscle. Myoglobin levels are most useful in the diagnosis of acute myocardial infarction when measured within 6 hours after onset of chest pain.  Because of the rapid rise and fall in myoglobin concentrations, a normal myoglobin concentration does not rule out myocardial infarction.  An elevated myoglobin concentration is suggestive, but lacks specificity, since it may result from injury to skeletal muscle.  Myoglobin results should be used in conjunction with other information, such as other, more specific cardiac markers (troponin and CK-MB), ECG, clinical observations and symptoms, etc. Serial sampling may be useful to detect the temporal rise and fall of myoglobin levels characteristic of acute myocardial infarction.  Focal acute muscle injury may produce the same pattern.

In any assay employing mouse antibodies, the possibility exists for interference by human anti-mouse antibodies.  Human anti-mouse antibodies may be present in samples from patient who have received immunotherapeutics or diagnostic procedures utilizing monoclonal antibodies, as well as in individuals who have close contact with animals.  Interference may also result from other human anti-animal antibodies (e.g., human anti-goat antibodies).  Specimens that may have such antibodies should not be assayed for myoglobin using this assay. Please contact the Laboratory Medicine Resident on call 598-6190 if you need to have myoglobin measured in a patient that has received preparations of mouse monoclonal antibodies.

References:

  1. Beckman Coulter Myoglobin assay package insert, July 2003. Beckman Coulter, Inc. Fullerton, CA 92835.
  2. Loun B, Astles R, Copeland KR, Sedor FA. Adaptation of a quantitative immunoassay for urine myoglobin. Predictor in detecting renal dysfunction. Am J Clin Pathol 1996 Apr; 105 (4)479-86.

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