Synthetic Glucocorticoid Screen
Label Mnemonic: SGSU
Epic Lab Code: LAB7665
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 RCP
356-8593
Specimen(s):
Urine
Collection Medium:
Urine (Random)-BD Vacutainer®, no additive yellow top
Minimum:
5 mL random urine, no preservative
Turn Around Time:
3-9 days upon receipt at reference laboratory
Reference Range:
Negative
Cutoff concentrations
Beclomethasone dipropionate: 0.10 mcg/dL
Betamethasone: 0.10 mcg/dL
Budesonide: 0.10 mcg/dL
Dexamethasone: 0.10 mcg/dL
Fludrocortisone: 0.10 mcg/dL
Flunisolide: 0.10 mcg/dL
Fluorometholone: 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: 0.30 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).
Interpretive Data:
This test screens for and quantitates, if present, the following synthetic glucocorticoids: beclomethasone dipropionate, betamethasone, budesonide, dexamethasone, fludrocortisone, flunisolide, fluorometholone, megestrol acetate, methylprednisolone, prednisolone, prednisone, triamcinolone, and triamcinolone acetonide.

The presence of synthetic glucocorticoids in urine 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 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 Interpretive Data).

Lack of detection does not preclude use of synthetic glucocorticoid 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
CPT Code:
82544
 
See Additional Information:
Urine Tests Requiring no Preservatives