Synthetic Glucocorticoid Screen
Label Mnemonic: SGSS
Epic Lab Code: LAB7666
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 RCP
356-8593
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: 0.10 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:
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
CPT Code:
82544