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Test Code ACTH Adrenocorticotropic Hormone, Plasma

Important Note

  • Must be drawn at the Outpatient Lab at the Main Campus
  • Morning (6 a.m.-10:30 a.m.) specimen is desirable.
  • Requires a Pre-chilled EDTA Lavender tube for collection.
  • Send to Specimen Processing on ice.
  • If requisition states ACTH Stimulation Test/ACTH Suppression Test, DO NOT order this ACTH test. Refer to the ACTH Stimulation Test for additional instruction.
  • If requisition has a Cortisol request along with the ACTH, they MUST be drawn together at the same time.

Reporting Name

Adrenocorticotropic Hormone, P

Useful For

Determining the cause of hypercortisolism and hypocortisolism

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Plasma EDTA


Necessary Information


Separate specimens should be submitted when multiple tests are ordered.



Specimen Required


Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).

Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Collection Container/Tube: Ice-cooled, lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Morning (7 a.m.-10 a.m.) specimen is desirable.

2. Collect with a pre-chilled lavender top (EDTA) tube and transport to the laboratory on ice.

3. Within 2 hours of collection centrifuge at refrigerated temperature and immediately separate plasma from cells.

4. Immediately freeze plasma.


Specimen Minimum Volume

0.75 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen (preferred) 28 days
  Refrigerated  3 hours
  Ambient  2 hours

Reference Values

7.2-63 pg/mL (a.m. draws)

Reference ranges are based on samples drawn between 7 a.m.-10 a.m.

No established reference values for p.m. draws

Pediatric reference values are the same as adults, as confirmed by peer reviewed literature.

 

Petersen KE. ACTH in normal children and children with pituitary and adrenal diseases. I. Measurement in plasma by radioimmunoassay-basal values. Acta Paediatr Scand. 1981;70(3):341-345

 

For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.

Day(s) Performed

Monday through Saturday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82024

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ACTH Adrenocorticotropic Hormone, P 2141-0

 

Result ID Test Result Name Result LOINC Value
ACTH Adrenocorticotropic Hormone, P 2141-0

Interpretation

In a patient with hypocortisolism, an elevated corticotropin (previously adrenocorticotropic hormone: ACTH) indicates primary adrenal insufficiency, whereas a value that is not elevated is consistent with secondary adrenal insufficiency from a pituitary or hypothalamic cause.

 

In a patient with hypercortisolism (Cushing syndrome), a suppressed value is consistent with a cortisol-producing adrenal adenoma or carcinoma, primary adrenal micronodular hyperplasia, or exogenous corticosteroid use.

 

Normal or elevated ACTH in a patient with Cushing syndrome puts the patient in the ACTH-dependent Cushing syndrome category. This is due to either an ACTH-producing pituitary adenoma or ectopic production of ACTH (bronchial carcinoid, small cell lung cancer, others). Further diagnostic studies such as dexamethasone suppression testing, corticotropin-releasing hormone stimulation testing, petrosal sinus sampling, and imaging studies are usually necessary to define the ACTH source.

 

ACTH concentrations vary considerably depending on physiological conditions. Therefore, ACTH results should always be evaluated with simultaneously measured cortisol concentrations.

Clinical Reference

1. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and treatment of primary adrenal insufficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(2):364-389.

2. Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing's syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540.

Report Available

1 to 3 days

Method Name

Electrochemiluminescence Immunoassay

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Oncology Test Request (T729)