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Test ID SGSU Synthetic Glucocorticoid Screen, Random, Urine


Ordering Guidance


Fluticasone propionate is reported with this test and is also available separately. It is quickly metabolized to fluticasone 17-beta carboxylic acid in urine. To screen for this metabolite, order 17BFP / Fluticasone 17-Beta-Carboxylic Acid, Random, Urine.



Specimen Required


Supplies: Urine tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Useful For

Confirming the presence of the listed synthetic glucocorticoids (see Interpretation)

 

Confirming the cause of secondary adrenal insufficiency

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) Stable Isotope Dilution Analysis

Reporting Name

Synthetic Glucocorticoid Screen, U

Specimen Type

Urine

Specimen Minimum Volume

0.6 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Frozen 14 days

Clinical Information

Synthetic glucocorticoids are widely used and have important clinical utility both as anti-inflammatory and immunosuppressive agents. The medical use of these agents, as well as their surreptitious use, can sometimes lead to a confusing clinical presentation. Patients exposed to these steroids may present with clinical features of Cushing syndrome but with suppressed cortisol levels and evidence of hypothalamus-pituitary-adrenal axis suppression.

Reference Values

Negative

Cutoff concentrations

Betamethasone: 0.10 mcg/dL

Budesonide: 0.20 mcg/dL

Dexamethasone: 0.10 mcg/dL

Fludrocortisone: 0.10 mcg/dL

Fluticasone propionate: 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

 

Values for normal patients not taking these synthetic glucocorticoids should be less than the cutoff concentration (detection limit).

Cautions

This method cannot detect all  available synthetic steroids available either as pharmaceutical compounds or chemicals present in food. The assay confirms only the listed synthetic glucocorticoids. For more information see Interpretation.

 

Lack of detection does not preclude use of synthetic glucocorticoid because adrenal suppression may persist for some time after the exogenous steroid is discontinued.

Day(s) Performed

Wednesday

Report Available

5 to 10 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80299

NY State Approved

Yes