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Test Code SGSU Synthetic Glucocorticoid Screen, Random, Urine

Reporting Name

Synthetic Glucocorticoid Screen, U

Useful For

Confirming the presence of the listed synthetic glucocorticoids

 

Confirming the cause of secondary adrenal insufficiency

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


 



Specimen Required


Supplies: Urine tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Specimen Minimum Volume

0.6 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Frozen 14 days

Reference Values

Negative

Cutoff concentrations

Betamethasone: 0.10 mcg/dL

Budesonide: 0.20 mcg/dL

Dexamethasone: 0.10 mcg/dL

Fludrocortisone: 0.10 mcg/dL

Megestrol acetate: 0.10 mcg/dL

Methylprednisolone: 0.10 mcg/dL

Prednisolone: 0.10 mcg/dL

Prednisone: 0.10 mcg/dL

Triamcinolone acetonide: 0.10 mcg/dL

 

Values for normal patients not taking these synthetic glucocorticoids should be less than the cutoff concentration (detection limit).

Day(s) Performed

Wednesday

Test Classification

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

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SGSU Synthetic Glucocorticoid Screen, U 46959-3

 

Result ID Test Result Name Result LOINC Value
23562 Betamethasone 46946-0
23563 Budesonide 46947-8
23564 Dexamethasone 46948-6
23565 Fludrocortisone 46949-4
23569 Megestrol Acetate 46953-6
23570 Methylprednisolone 46954-4
23571 Prednisolone 46955-1
23572 Prednisone 46956-9
23574 Triamcinolone Acetonide 46958-5

Clinical Information

Synthetic glucocorticoids are widely used and have important clinical utility both as anti-inflammatory and immunosuppressive agents. The medical use of these agents, as well as their surreptitious use, can sometimes lead to a confusing clinical presentation. Patients exposed to these steroids may present with clinical features of Cushing syndrome but with suppressed cortisol levels and evidence of hypothalamus-pituitary-adrenal axis suppression.

Interpretation

This test screens for and quantitates, if present, the following synthetic glucocorticoids: betamethasone, budesonide, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, and triamcinolone acetonide.

 

The presence of synthetic glucocorticoids in urine indicates current or recent use of these compounds. Since several of these compounds exceed the potency of endogenous cortisol by 1 or more orders of magnitude, even trace levels may be associated with cushingoid features.

Cautions

This method cannot detect all synthetic steroids available either as pharmaceutical compounds or chemicals present in food. The assay confirms only the listed synthetic glucocorticoids. For more information see Interpretation.

 

Lack of detection does not preclude use of synthetic glucocorticoid because adrenal suppression may persist for some time after the exogenous steroid is discontinued.

Report Available

5 to 11 days

Reject Due To

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

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)