|Values are valid only on day of printing.|
Measurement of 11 beta-prostaglandin F2 alpha in urine is useful in the evaluation of patients suspected of having systemic mast-cell disease
Prostaglandin D(2) (PGD) is generated by human mast cells after they are activated via the IgE receptor or by calcium ionophore. In addition to mast cells, activated alveolar macrophages and platelets also produce and secrete PGD(2). There are a large number of metabolic products of PGD(2), the most abundant is 11 beta-prostaglandin F2 alpha.(1)
While the most definitive test for systemic mast-cell disease is bone marrow examination, measurement of mast-cell mediators in blood or urine is less invasive and is advised for the initial evaluation of suspected cases. Elevated levels of tryptase, N-methylhistamine or 11 beta-prostaglandin F2 alpha are consistent with the diagnosis of systemic mast cell disease.(2)
>1,000 ng/24 hours is considered elevated.
Levels of 11 beta-prostaglandin F2 alpha >1,000 ng/24 hours are consistent with the diagnosis of systemic mast-cell disease.
Elevated levels of 11 beta-prostaglandin F2 alpha in urine are not specific for systemic mast-cell disease and may be found in patients with angioedema, diffuse urticaria, or myeloproliferative diseases in the absence of diffuse mast-cell proliferation.
Systemic mast-cell disease is a heterogeneous disease, and some patients may not have elevated levels of 11 beta-prostaglandin F2 alpha in urine.
In studies performed at Mayo Clinic, elevated levels of 11 beta-prostaglandin F2 alpha in urine were found in 16 of 17 patients with systemic mast cell disease.
Misoprostol (Cytotec) does not cross-react in this assay.
1. Roberts LJ, Sweetman BJ, Lewis RA, et al: Increased production of prostaglandin D2 in patients with systemic mastocytosis. N Engl J Med 1980;303:1400-1404
2. Metcalfe DD: Mastocytosis syndromes. In Allergy Principles and Practice. Vol II. Fourth edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, Mosby Yearbook, Inc, 1993, pp 1537-1551