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EPIC CODE: LAB1133 Lysozyme (Muramidase), Plasma

Additional Codes

Sunquest:  LYSOM
Mayo:         MURA

Specimen Required

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Centrifuge and aliquot plasma into a plastic vial within 2 hours of collection.

2. Freeze immediately after transferring.

Secondary ID


Useful For

As a screening test for ocular sarcoidosis


Confirming marked increases in the granulocyte or monocyte pools as in granulocytic or monocytic leukemias, myeloproliferative disorders, and malignant histiocytosis


Following the course of therapy in cases of chronic granulocytic or chronic monocytic leukemias

Method Name


Reporting Name

Lysozyme (Muramidase), P

Specimen Type

Plasma EDTA

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen 21 days

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Lysozyme is a bacteriolytic enzyme that is found in some hematopoietic cells. It is primarily present in granulocytes, monocytes, and histiocytes. The enzyme is present in only minute amounts in lymphocytes; and is not present in myeloblasts, eosinophils, and basophils.


Lysozyme in the plasma comes chiefly from the degradation of granulocytes and monocytes and its concentration reflects the turnover of these cells. Increases are seen in benign (eg, infection, inflammation) and malignant processes (eg, some leukemias). Plasma lysozyme is elevated in patients with acute or chronic granulocytic or monocytic leukemias and falls with successful treatment. Conversely, patients with lymphocytic leukemia may have depressed plasma lysozyme levels.


Patients with renal disorders (including rejection of transplanted kidneys) or Crohn disease (regional enteritis) also tend to have elevated levels of plasma lysozyme.

Reference Values

≥12 months: 2.6-6.0 mcg/mL

Reference values have not been established for patients who are less than12 months of age.


Levels above 200 mcg/mL may be seen in acute nonlymphocytic leukemia (M2, M4, M5) or chronic granulocytic leukemias.


Increased levels may be seen in nonmalignant disorders including sarcoidosis, infections, Crohn’s disease, kidney transplant rejection, and other renal disorders.

Clinical Reference

1. Catovsky D, Galton DA, Griffin C: The significance of lysozyme estimations in acute myeloid and chronic monocytic leukaemia. Br J Haematol. 1971;21:565-580

2. Herbort CP, Roa NA, Mochizuki M, members of Scientific Committee of First International Workshop on Ocular Sarcoidosis: International criteria for the diagnosis of ocular sarcoidosis: Results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm. 2009;17:160-169

3. Bergantini L, Bianchi F, Cameli P, et al: Prognostic biomarkers of sarcoidosis: a comparative study of serum chitotriosidase, ACE, lysozyme, and KL-6. Dis Markers. 2019 Mar 3;2019:8565423 doi: 10.1155/2019/8565423

Method Description

The term lysozyme is derived from the ability of this enzyme to dissolve the walls of certain bacteria, including Micrococcus lysodeikticus. This organism is suspended in buffer, and the sample is added. The resulting decrease in turbidity is measured spectrophotometrically. The rate of clearing is a reflection of the concentration of the enzyme.(Litwack G: Photometric determination of lysozyme activity. Proc Soc Exp Biol Med. 1955;89:401-403)

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
MURA Lysozyme (Muramidase), P 2589-0


Result ID Test Result Name Result LOINC Value
MURA Lysozyme (Muramidase), P 2589-0

NY State Approved


Day(s) Performed

Monday through Friday

Report Available

2 to 5 days