Cortisol, ACTH Stimulation

Casandra

Casandra Test Code LC65227Version 1 (DRAFT)

Performing Lab

Lab LabcorpLab Test ID 140761CPT Code 82533

Cortisol, ACTH Stimulation

Also known as: Addison's Disease Test, Compound F (Two Specimens), Cortisol (Two Specimens), Cosyntropin Stimulation, Hydrocortisone (Two Specimens)

Clinical Use

Order Test

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.

Test Details

Methodology

Immunoassay (ECLIA)

Biomarkers

Cortisol

Protein

Cortisol Baseline • Concentration / Level • Quantitative (Continuous) (e.g., copies/mL, % expression)

Cortisol Stimulated • Concentration / Level • Quantitative (Continuous) (e.g., copies/mL, % expression)

LOINC Codes

Order Codes

34541-3

Result Codes

43215-3
34476-2

Result Turnaround Time

1-2 days

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.