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Synthetic Glucocorticoid Screen
Test CodeLAB00152
Alias/See Also
LAB00152
Mayo TC: SGSS
Mayo TC: SGSS
CPT Codes
80299
Includes
This test screens for and quantites, if present, the following synthetic glucocorticoids:
betamethasone, budesonide, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prenisolone, prednisone, and triamcinolone acetonide.
This test is not useful for detection of fluticasone propionate.
betamethasone, budesonide, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prenisolone, prednisone, and triamcinolone acetonide.
This test is not useful for detection of fluticasone propionate.
Preferred Specimen
2.0 mL Serum - Plain Red
Minimum Volume
1.1 mL Serum - Plain Red
Other Acceptable Specimens
Marble/Gold is acceptable but Plain red is preferred.
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated: 7 days
Methodology
LC-MS/MS
Setup Schedule
Tuesday, Thursday; 9 a.m.
Limitations
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.
Lack of detection does not preclude use of synthetic glucocorticoids because adrenal suppression may persist for some time after the exogenous steroid is discontinued.
Lack of detection does not preclude use of synthetic glucocorticoids because adrenal suppression may persist for some time after the exogenous steroid is discontinued.
Reference Range
Synthetic Glucocorticoid Screen:
Negative
Cutoff concentrations:
Betamethasone: 0.10 mcg/dL
Budesonide: 0.20 mcg/dL
Dexamethasone: 0.10 mcg/dL
Fludrocortisone: 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.
Negative
Cutoff concentrations:
Betamethasone: 0.10 mcg/dL
Budesonide: 0.20 mcg/dL
Dexamethasone: 0.10 mcg/dL
Fludrocortisone: 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.
Clinical Significance
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.
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.
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.
Performing Laboratory
Mayo Clinic Laboratories