Synthetic Glucocorticoid Screen
Label Mnemonic: SGSS
Epic code: LAB7666
Order form: Laboratory Requisition
Supply order: Supply Order Form
Billing: Billing Policies
CPT code: 82544
Specimen(s):
Serum
Collection Medium:
Red top tube 5 mL (Clot Activator)
Minimum:
2 mL serum in red top tube
Rejection Criteria:
Separator tubes
Turn Around Time:
2-5 days upon receipt at reference laboratory
Reference Range:
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
Interpretive Data:
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.
Comments:
Useful For:
Confirming the presence of the listed synthetic glucocorticoids (see Interpretive Data)

Confirming the cause of secondary adrenal insufficiency.

This assay does not detect fluticasone propionate.

Cautions:
This method cannot detect the presence of fluticasone propionate in serum.

This method cannot detect all of the available synthetic steroids either available as pharmaceutical compounds or chemicals present in food. The assay confirms only the listed synthetic glucocorticoids. (See Interpretative Data)

Lack of detection does not preclude use of synthetic glucocorticoids because adrenal suppression may persist for some time after the exogenous steroid is discontinued.
Methodology:
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis
Sample Processing:
Allow to clot completely.
Centrifuge within two hours of draw time.
Label transport tube with patient last name, first name, identification number, date and time of collection.
Transfer serum to a new screw cap transfer tube.
Sample Storage:
Store frozen.
Transport Instructions:
Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Place dry ice on top of specimen in Styrofoam container to maintain frozen temperature.
Ship frozen.
CPT Code:
82544