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Cortisol, Post 1 (Cosyntropin/ACTH Stimulation Study)
MessagePerforming Lab: Regions
Test Code
3693
Alias/See Also
Sunquest: COR1; ACTH stimulation Cortisol post sample 1, Cortisol, Cosyntropin Stimulation Study
CPT Codes
80400
Preferred Specimen
0.2 mL Lithium Heparin Plasma (light green-top) tube
Minimum Volume
0.1 mL
Other Acceptable Specimens
Serum separator (gold-top), Red, Red/Gray
Instructions
Collection:
Record collect time on the specimen.
Record collect time on the specimen.
Transport Temperature
Refrgerated
Specimen Stability
- Room Temperature: Not Recommended
Frozen: 1 month
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Baseline sample not drawn immediately prior to giving Cosyntropin.
Methodology
Competitive Immunoassay
Setup Schedule
Daily
Report Available
Same day.
Limitations
Circulating cortisol results from patients receiving Prednisolone or Prednisone therapy may be falsely elevated. Exercise caution with cortisol determinations for patients undergoing therapy with these and structurally related synthetic corticosteroids.
Reference Range
A peak cortisol level is >18.0 mcg/dl, and is usually observed 60 minutes post cosyntropin administration.
Clinical Significance
In pathological states of the HPA axis, elevated or depressed values of cortisol may be found. Adrenal tumors and pituitary or ectopic adrenocorticotrophic hormone (ACTH)-producing tumors are frequently associated with cortisol over-production (Cushing’s syndrome), while adrenal insufficiency results in cortisol under-production (Addison’s disease).
ACTH is given to a patient and in normal subjects a rapid rise in serum cortisol is observed. Patients with Addison's disease show no change in their cortisol level. Patients with adrenal cortex atrophy or dysfunction of the pituitary gland or hypothalamus may show a slight rise in cortisol levels.
ACTH is given to a patient and in normal subjects a rapid rise in serum cortisol is observed. Patients with Addison's disease show no change in their cortisol level. Patients with adrenal cortex atrophy or dysfunction of the pituitary gland or hypothalamus may show a slight rise in cortisol levels.
