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Test ID: SGSS Synthetic Glucocorticoid Screen, Serum

Reporting Name

Synthetic Glucocorticoid Screen, S

Useful For

Confirming the presence of listed synthetic glucocorticoids (see Interpretation)

 

Confirming the cause of secondary adrenal insufficiency

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.

 

This assay does not detect fluticasone propionate.

Interpretation

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

 

The presence of synthetic glucocorticoids in serum 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.

Analytic Time

2 days

Day(s) and Time(s) Performed

Tuesday, Thursday; 9 a.m.

Clinical Reference

1. Cave A, Arlett P, Lee E: Inhaled and nasal corticosteroids: factors affecting the risks of systemic adverse effects. Pharmacol Ther 1999 Sep;83(3):153-179

2. Bijlsma JW, van Everdingen AA, Huisman M, et al: Glucocorticoids in rheumatoid arthritis: effects on erosions and bone. Ann NY Acad Sci 2002 Jun;966:82-90

3. Sandborn WJ: Steroid-dependent Crohn's disease. Can J Gastroenterol 2000 Sep;14 Suppl C:17C-22C

4. Benvenuti S, Brandi ML: Corticosteroid-induced osteoporosis: pathogenesis and prevention. Clin Exp Rheumatol 2000 Jul-Aug;18(4 Suppl 20);S64-S66

5. Loke TK, Sousa AR, Corrigan CJ, Lee TH: Glucocorticoid-resistant asthma. Curr Allergy Asthma Rep 2002 Mar;2(2):144-150

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis

Specimen Type

Serum


Specimen Required


Collection Container/Tube: 

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL


Specimen Minimum Volume

1.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 14 days
  Refrigerated  7 days
  Ambient  24 hours

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

Flunisolide: 0.10 mcg/dL

Fluorometholone: 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: 0.30 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).

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 U.S. Food and Drug Administration.

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SGSS Synthetic Glucocorticoid Screen, S 43141-1

 

Result ID Test Result Name Result LOINC Value
23593 Betamethasone 41745-1
23594 Budesonide 41747-7
23595 Dexamethasone 14062-4
23596 Fludrocortisone 41754-3
23597 Flunisolide 41755-0
23598 Fluorometholone 41756-8
23599 Fluticasone Propionate 41757-6
23600 Megestrol Acetate 41762-6
23601 Methylprednisolone 14186-1
23602 Prednisolone 12727-4
23603 Prednisone 12434-7
23604 Triamcinolone 41766-7
23605 Triamcinolone Acetonide 41767-5
Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

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