Cortisol, ACTH Stimulation
Also known as: Addison's Disease Test, Compound F (Two Specimens), Cortisol (Two Specimens), Cosyntropin Stimulation, Hydrocortisone (Two Specimens)
Use
Evaluation of possible primary and secondary adrenal insufficiency.1-3,5
Special Instructions
Draw blood for baseline cortisol. Administer 250 µg of cosyntropin IM or IV. If administered intravenously, dilute cosyntropin in 2-5 mL of sterile saline and inject over two minutes. Draw blood for stimulated cortisol 60 minutes after injection. If adrenal crisis is suspected, begin treatment without delay; confirm diagnosis after recovery.
Limitations
Factors such as pregnancy, contraceptives, and estrogen therapy may lead to elevated cortisol concentrations. Cross-reactivity in patients treated with prednisone, prednisolone, or methylprednisolone can cause falsely elevated cortisol levels. Individuals with 21-hydroxylase deficiency may also exhibit elevated cortisol due to increased 21-deoxycortisol. High stress levels can raise cortisol concentrations as well. Interference from mouse antibodies or from high titers of streptavidin or ruthenium antibodies can lead to erroneous results. The test contains additives to minimize such interferences.
Methodology
Immunoassay (ECLIA)
Biomarkers
LOINC Codes
- 34541-3
- 43215-3
- 34476-2
Result Turnaround Time
1-2 days
Related Documents
For more information, please review the documents below
Specimen
Serum
Volume
1.0 mL (each specimen)
Minimum Volume
0.7 mL (each specimen)
Container
Red-top tube or gel-barrier tube
Collection Instructions
If using a tube other than a gel-barrier tube, transfer separated serum to a plastic transport tube. Label each tube with the patient's name, collection time, and date. Submit specimens simultaneously on the same test request form.
Storage Instructions
Room temperature
Causes for Rejection
Plasma specimen
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |