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HelpOrder Code SGSU Synthetic Glucocorticoid Screen, Random, Urine
Reporting Name
Synthetic Glucocorticoid Screen, UUseful 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
UrineOrdering 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 |
|---|---|---|
| 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
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 |
Method Description
The synthetic glucocorticoids are extracted from 0.5 mL of urine using an acetonitrile protein precipitation followed by methylene chloride liquid extraction of the solvent. Cortisol-9, 11, 12, 12-d, and triamcinolone-d1 acetonide-d6 are added to each sample before the liquid extraction and serve as the internal standards. Then, 17 mcL of the reconstituted sample extract is injected into a high-performance liquid chromatography system and analyzed by tandem mass spectrometry. The mass spectrometer has an electrospray interface and is operated in the multiple reaction monitoring positive mode. The calibration utilizes a 4-point standard curve over a concentration range of 0 to 25 mcg/dL.(McWhinney BC, Ward G, Hickman PE. Improved HPLC method for simultaneous analysis of cortisol, 11-deoxycortisol, prednisolone, methylprednisolone, and dexamethasone in serum and urine. Clin Chem. 1996;42:979-981; Savu S, Silvestro L, Haag A, Sorgel F. A confirmatory HPLC-MS/MS method for ten synthetic corticosteroids in bovine urines. J Mass Spectrom. 1996;31[12]:1351-1363; Djedovic NK, Rainbow SJ. Detection of synthetic glucocorticoids by liquid chromatography-tandem mass spectrometry in patients being investigated for Cushing's syndrome. Ann Clin Biochem. 2011;48[Pt 6]:542-549. doi:10.1258/acb.2011.010250)
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)