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HelpTest Code SGSS Synthetic Glucocorticoid Screen, Serum
Reporting Name
Synthetic Glucocorticoid Screen, SUseful For
Confirming the presence of listed synthetic glucocorticoids in serum specimens (see Interpretation)
Confirming the cause of glucocorticoid-induced adrenal insufficiency
This test is not useful for detection of fluticasone propionate.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL Serum
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
Serum: 1.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Frozen (preferred) | 14 days |
| Refrigerated | 7 days | |
| Ambient | 24 hours |
Reference Values
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 (detection limit).
Day(s) Performed
Wednesday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SGSS | Synthetic Glucocorticoid Screen, S | 43141-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 23593 | Betamethasone | 41745-1 |
| 23594 | Budesonide | 41747-7 |
| 23595 | Dexamethasone | 14062-4 |
| 23596 | Fludrocortisone | 41754-3 |
| 23600 | Megestrol Acetate | 41762-6 |
| 23601 | Methylprednisolone | 14186-1 |
| 23602 | Prednisolone | 12727-4 |
| 23603 | Prednisone | 12434-7 |
| 23605 | Triamcinolone Acetonide | 41767-5 |
Interpretation
This test screens for and quantitates, if present, the following synthetic glucocorticoids: betamethasone, budesonide, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, and triamcinolone acetonide.
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 cause hypothalamic-pituitary-adrenal axis suppression with development of glucocorticoid-induced adrenal insufficiency.
Clinical Reference
1. Cave A, Arlett P, Lee E. Inhaled and nasal corticosteroids: factors affecting the risks of systemic adverse effects. Pharmacol Ther. 1999;83(3):153-179
2. Djedovic NK, Rainbow SJ. Detection of synthetic glucocorticoids by liquid chromatography-tandem mass spectrometry in patients being investigated for Cushing's syndrome. Ann Clin Biochem. 2011;48(Pt 6):542-9. doi:10.1258/acb.2011.010250
3. Bijlsma JWJ, Van Everdingen AA, Huisman M, De Nijs RNJTL, Jacobs JWG. Glucocorticoids in rheumatoid arthritis: effects on erosions and bone. Ann NY Acad Sci. 2002;966:82-90
4. Sandborn WJ: Steroid-dependent Crohn's disease. Can J Gastroenterol. 2000;14 Suppl C:17C-22C
5. Benvenuti S, Brandi ML. Corticosteroid-induced osteoporosis: pathogenesis and prevention. Clin Exp Rheumatol. 2000;18(4 Suppl 20):S64-S66
6. Loke TK, Sousa AR, Corrigan CJ, Lee TH. Glucocorticoid-resistant asthma. Curr Allergy Asthma Rep. 2002;2(2):144-150
7. Fardet L, Petersen I, Nazareth I. Monitoring of patients on long-term glucocorticoid therapy: a population-based cohort study. Medicine (Baltimore). 2015;94(15):e647. doi:10.1097/MD.0000000000000647
8. Cronin JJ, McCoy S, Kennedy U, et al. A randomized trial of single-dose oral dexamethasone versus multidose prednisolone for acute exacerbations of asthma in children who attend the emergency department. Ann Emerg Med. 2016;67(5):593-601.e3. doi:10.1016/j.annemergmed.2015.08.001
9. Ponzetto F, Parasiliti-Caprino M, Settanni F, et al. Simultaneous measurement of cortisol, cortisone, dexamethasone and additional exogenous corticosteroids by rapid and sensitive LC-MS/MS analysis. Molecules. 2022;28(1):248. Published 2022 Dec 28. doi:10.3390/molecules28010248
Report Available
5 to 14 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)