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Introduction ⬇

Lysozyme (muramidase) in blood or urine is a bacteriolytic enzyme that comes from degradation of granulocytes and monocytes but not lymphocytes. It is increased in leukemia owing to degradation of granulocytic or monocytic cells.

This blood and urine test differentiates acute myelogenous or monocytic leukemia from acute lymphatic leukemia. It is useful to monitor the response to treatment of acute myelogenous and active monocytic leukemia.

Normal Findings ⬆ ⬇

Blood plasma: 0.4–1.3 mg/dL or 4–13 µg/mL

Urine, 24-hour specimen: 0–3 mg/24 hr or 0–3 mg/d

Reference values are not established for random urine specimens.

Procedure ⬆ ⬇

  1. Collect a 5-mL EDTA-anticoagulated blood sample or urine specimen.

  2. Follow general instructions for 24-hour urine collections. Transport the sample to the laboratory immediately after collection.

Clinical Implications ⬆ ⬇

  1. Lysozyme levels are increased in:

    1. Acute myelogenous leukemia (granulocytic)

    2. Acute monocytic leukemia

    3. Malignant histiocytosis

  2. Lysozyme levels may be increased in:

    1. Kidney disorders and transplant rejection

    2. Tuberculosis

    3. Sarcoidosis (sarcoid lymph nodes)

    4. Crohn disease

    5. Polycythemia vera

  3. Lysozyme levels are normal in acute lymphatic leukemia.

  4. Lysozyme levels are decreased in neutropenia with hypoplasia of bone marrow.

Interventions ⬆

Pretest Patient Care

  1. Explain purpose of test, procedure for urine or blood collection, and interfering factors.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed Counsel patient regarding abnormal findings.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.