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Test Code SGSU Synthetic Glucocorticoid Screen, Random, Urine

Reporting Name

Synthetic Glucocorticoid Screen, U

Useful For

Confirming the presence of listed synthetic glucocorticoids in urine 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

Urine


Ordering Guidance


 



Specimen Required


Supplies: Urine tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Specimen Minimum Volume

0.6 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Frozen 14 days

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
SGSU Synthetic Glucocorticoid Screen, U 46959-3

 

Result ID Test Result Name Result LOINC Value
23562 Betamethasone 46946-0
23563 Budesonide 46947-8
23564 Dexamethasone 46948-6
23565 Fludrocortisone 46949-4
23569 Megestrol Acetate 46953-6
23570 Methylprednisolone 46954-4
23571 Prednisolone 46955-1
23572 Prednisone 46956-9
23574 Triamcinolone Acetonide 46958-5

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 JW, Van Everdingen AA, Huisman M, De Nijs RN, Jacobs JW. Glucocorticoids in rheumatoid arthritis: effects on erosions and bone. Ann N Y Acad Sci. 2002;966:82-90. doi:10.1111/j.1749-6632.2002.tb04205.x

4. Sandborn WJ. Steroid-dependent Crohn's disease. Can J Gastroenterol. 2000 Sep;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 days

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)