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Test Code LAB6114 Cortrosyn Stimulation Test, Plasma

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Electrochemiluminescence Immunoassay (ECLIA)

 

Literature References:

1. Package insert: Cortisol II. Roche Corporation 05/2021.

Specimen Requirements

Specimen Type: Plasma

Container/Tube: Mint green top (lithium heparin)

Specimen Volume: Full tube

Collection Instructions:

1. Administer Cortrosyn 250 mcg intravenous (or intramuscular) at 0-minutes.

2. Draw specimens at 0-, 30-, and 60-minutes.

3. Label specimens appropriately (corresponding draw times.)

4. Send all specimens to the laboratory together.

Additional Information:

1. Draw times are required on each specimen and request form for processing.

2. Prednisone and prednisolone can interfere with this assay by causing a false-positive reaction.

3. Test performed is #2923 Cortisol, Plasma.

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:
STAT: 2 hours after receipt in laboratory 

Routine: 4 hours after receipt in laboratory


 

Test Classification and CPT Coding

80400-ACTH stimulation panel for adrenal insufficiency

82533-Cortisol, total

Reference Values

Cortisol cutoff of 14-15 ug/dL for cortrosyn stimulation testing

Lack of normal response can be seen in both primary and secondary adrenal failure. Some patients with secondary adrenal failure have normal response to cortrosyn. If pituitary disease is known or strongly suspected e.g. after pituitary surgery), the cortrosyn test alone should not be relied on to exclude adrenal failure.

Literature References:

 

  1. Javorsky BR, Raff H, Carroll TB, et al. New cutoffs for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation using specific cortisol assays. J Endocr Soc. 2021;5(4):bvab022.
  2. Carson JLP and Gronowski AM. New cutoffs for the biochemical diagnosis of Adrenal insufficiency after ACTH stimulation using specific cortisol assays. J. Endocrine Soc 2021;5:1-2.

Current interpret data was last revised 8/12/24

Specimen Transport Temperature

Ambient

Additional Information

For BJH Laboratory Use Only
Alternate Tube(s):

1 Red-top tube

1 Dark green tube (lithium heparin)

Purple Top (K2 & K3 EDTA)

Separator gel tube is acceptable

Analyte Stability:

See Analyte Stability Chart in Special Instructions.

Laboratory Processing Instructions:

Test performed in BJH Core Lab. Test performed is #2923 Cortisol, Plasma. .  Processed by automated line for delivery to the Cobas 8000.  Completed specimens are stored refrigerated for 5 days.        

Special Instructions

LOINC Code Information

Name LOINC Code
Cortisol, Baseline (0 Minutes) 50453-0
Cortisol, 30 Minutes 26530-6
Cortisol, 60 Minutes 26528-0