Leukotriene E4, Random, Urine
Use
Quantitation of urinary metabolites of histamine, prostaglandin D₂, and leukotriene E₄ may provide significant clues for the diagnosis and management of symptomatic patients with both clonal and nonclonal mast cell activation syndromes. The presence of one or more elevated levels of these biomarkers in urine greatly narrows diagnostic possibilities, informs the practitioner which metabolic pathways are involved, and directs personalized treatment. This test aids in evaluation of patients at risk for mast cell activation syndrome, such as systemic mastocytosis, IgE‑mediated allergies, or aspirin‑exacerbated respiratory disease.
Special Instructions
For optimal evaluation, testing for urinary leukotriene E₄ should be accompanied by serum tryptase, urinary 2,3‑dinor‑11‑beta‑prostaglandin‑F₂‑alpha (random urine), and urinary N‑methylhistamine (random urine). Patients taking the 5‑lipoxygenase inhibitor zileuton (Zyflo) should, if medically feasible, discontinue it for 48 hours before specimen collection.
Limitations
Elevated urinary leukotriene E₄ supports but does not definitively diagnose mast cell activation syndrome; absence of elevation does not exclude mast cell disease due to heterogeneity of these disorders.
New York Approved
Methodology
Mass Spectrometry (LC-MS/MS)
Biomarkers
LOINC Codes
- 33343-5
- 33343-5
- 2161-8
Result Turnaround Time
2-9 days
Related Documents
For more information, please review the documents below
Specimen
Urine
Volume
5 mL
Minimum Volume
2 mL
Container
Plastic vial (Sarstedt Aliquot Tube, 5 mL, T914)
Collection Instructions
Within a few hours of symptom onset, collect a random urine specimen; no preservative; aliquot into a plastic vial and send frozen.
Patient Preparation
Patients taking zileuton (Zyflo) should discontinue for 48 hours before collection, if medically feasible.
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 24 hours |
| Refrigerated | 7 days |
| Frozen | 28 days |