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Test Code LAB7879 Cortrosyn Stimulation, Single 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 Procedure: 1. Administer Cortrosyn 250 mcg intravenous (or intramuscular) at 0-minutes.
2. Draw specimen at 30 minutes.
3. Label specimen appropriately (corresponding draw time.)
Additional Information:
1. 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

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

Deliver at ambient temperature

Additional Information

Alternate Tubes:

Dark Green tube (Li Hep)

Red-top tube

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
Cortrosyn Stimulation, Single Test, Plasma 26530-6