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HelpOrder Code SGSS Synthetic Glucocorticoid Screen, Serum
Reporting Name
Synthetic Glucocorticoid Screen, SUseful For
Confirming the presence of listed synthetic glucocorticoids in serum specimens (see Interpretation)
Confirming the cause of glucocorticoid-induced adrenal insufficiency
This test is not useful for detection of fluticasone propionate.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
Serum: 1.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| 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
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
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 |
| 23600 | Megestrol Acetate | 41762-6 |
| 23601 | Methylprednisolone | 14186-1 |
| 23602 | Prednisolone | 12727-4 |
| 23603 | Prednisone | 12434-7 |
| 23605 | Triamcinolone Acetonide | 41767-5 |
Method Description
The synthetic glucocorticoids (betamethasone, budesonide, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, triamcinolone acetonide) as well as cortisol and cortisone are extracted from 0.5 mL of urine or serum using an acetonitrile protein precipitation followed by liquid/liquid extraction of the supernatant. Cortisol-d4, triamcinolone-d1 acetonide-d6, dexamethasone-d4, and cortisone-d7, are added to each sample before the acetonitrile protein precipitation and serve as the internal standards. The reconstituted sample extract is injected onto a high performance liquid chromatography system and analyzed by liquid chromatography tandem mass spectrometry.(Taylor RL, Grebe SK, Singh RJ. Quantitative, highly sensitive liquid chromatography-tandem mass spectrometry method for detection of synthetic corticosteroids. Clin Chem. 2004;50[12]:2345-52. doi:10.1373/clinchem.2004.033605)
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)