Cortisol
| Label Mnemonic: | CORT |
| Epic code: | LAB61 |
| Order form: | Laboratory Requisition |
| Supply order: | Supply Order Form |
| Billing: | Billing Policies |
| CPT code: | 82533 |
Specimen(s):
Plasma
Collection Medium:
 |
| Plasma Separator Tube 4.5 mL |
Alternate
Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood from light green top tube or TWO
Microtainer® devices
Testing
Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around
Time:
1 hour (upon receipt in laboratory)
Reference Range:
AM (6-10) 6.0-18.4 μg/dL PM (4-8) 2.7-10.5 μg/dL Significant value: <2.0 μg/dL Assay version updated to Roche Diagnostics Cortisol II assay, along with updated reference ranges, on 2/7/2017.
Comments:
This assay may be significantly impacted by high-dose biotin (>5 mg
dose) taken within previous 12 hours. High concentrations of biotin
may lead to falsely increased results. These concentrations may be
found in patients taking over-the-counter supplements with biotin
content much higher than nutritional requirements for biotin.
Specimens should not be collected until at least 12 hours after the
last dose.
Test
Limitations:
The assay is unaffected by icterus (bilirubin is less than 25 ng/dL),
(hemolysis index is less than 500), lipemia (Intralipid is less than
1500 mg/dL) and biotin is less than 30 ng/mL (criterion: recovery
within plus or minus 10% of initial value).
No interference was observed from rheumatoid factor (up to 600 U/mL).
In vitro tests were performed on 16 commonly used pharmaceuticals. No interference with the assay was found.
In rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin and ruthenium can occur. These effects are minimized by suitable test design.
Pregnancy, contraceptives and estrogen therapy give rise to elevated cortisol concentrations.
The cortisol assay has no cross-reactivity with dexamethasone and low cross-reactivity with prednisone, prednisolone, and 6-methylprednisolone. Patients treated with prednisone, prednisolone, and 6-methylprednisolone (especially higher doses) may show falsely elevated concentrations of cortisol. Patients with 21-hydroxylase deficiency may have elevated 21-deoxycortisol levels that can give rise to falsely elevated cortisol results.
The time of sample collection must be taken into account when interpreting results due to the cortisol secretion circadian rhythm. Severe stress can also give rise to elevated cortisol levels. For diagnostic purposes, the Cortisol results should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.
No interference was observed from rheumatoid factor (up to 600 U/mL).
In vitro tests were performed on 16 commonly used pharmaceuticals. No interference with the assay was found.
In rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidin and ruthenium can occur. These effects are minimized by suitable test design.
Pregnancy, contraceptives and estrogen therapy give rise to elevated cortisol concentrations.
The cortisol assay has no cross-reactivity with dexamethasone and low cross-reactivity with prednisone, prednisolone, and 6-methylprednisolone. Patients treated with prednisone, prednisolone, and 6-methylprednisolone (especially higher doses) may show falsely elevated concentrations of cortisol. Patients with 21-hydroxylase deficiency may have elevated 21-deoxycortisol levels that can give rise to falsely elevated cortisol results.
The time of sample collection must be taken into account when interpreting results due to the cortisol secretion circadian rhythm. Severe stress can also give rise to elevated cortisol levels. For diagnostic purposes, the Cortisol results should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.
Methodology:
Electrochemiluminescence Immunoassay
Instructions:
Specify collection time.
Sample
Processing:
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells within 1 hour of collection. Send specimen in original tube. Do Not transfer to another tube.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.
Sample
Storage:
Refrigerate.
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).
Transport
Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
82533