Effective Monday, March 19, 2012, the University of Iowa Hospitals and Clinics core clinical laboratory will begin running the Roche Diagnostics assay for adrenocorticotropic hormone (ACTH). This assay will be available in Epic as "ADRENOCORTICOTROPIC HORMONE (ACTH)" [LAB511].  The reference range for ACTH for a morning collection is:

1 week – 9 years:  5-46 pg/mL
10-18 years:  6-55 pg/mL
19 years and older:  7-63 pg/mL

The specimen type is pink top (EDTA) tube – 3 mL whole blood from one pink top tube (adults) or TWO EDTA (lavender top) microtainers (pediatric patients).  Specimens should be delivered to laboratory immediately after collection to prevent degradation of ACTH.  Due to limited stability, add-on orders for ACTH are not accepted.  Samples that have gone through a freeze-thaw cycle are also not acceptable.

The Roche ACTH assay is a two-site immunoassay that measure intact ACTH (containing 39 amino acids).  The assay has minimal cross-reactivity with synthetic ACTH including Cosyntropin (Cortrosyn or generic equivalent) which contains only the first 24 amino acids of ACTH.  ACTH shows diurnal variation with high levels in the morning and low levels in evening.  Therefore, ACTH levels should be interpreted relative to time of collection.

The test will be available 24 hours/day, 7 days a week (including holidays) with a turnaround time of 1 hour upon receipt in laboratory.

Questions should be directed to Matthew Krasowski, MD, PhD, medical director of the Clinical Chemistry Laboratory (384-9380, matthew-krasowski@uiowa.edu).