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HelpTest Code SGSU Synthetic Glucocorticoid Screen, Random, Urine
Reporting Name
Synthetic Glucocorticoid Screen, UUseful For
Confirming the presence of the listed synthetic glucocorticoids
Confirming the cause of secondary adrenal insufficiency
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering 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 | Special Container |
|---|---|---|---|
| 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 urine 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 be associated with cushingoid features.
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. 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
3. Sandborn WJ. Steroid-dependent Crohn's disease. Can J Gastroenterol. 2000;14 Suppl C:17C-22C
4. Benvenuti S, Brandi ML. Corticosteroid-induced osteoporosis: pathogenesis and prevention. Clin Exp Rheumatol. 2000;18(4 Suppl 20):S64-S66
5. Loke TK, Sousa AR, Corrigan CJ, Lee TH. Glucocorticoid-resistant asthma. Curr Allergy Asthma Rep. 2002;2(2):144-150
6. 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
7. 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
Report Available
5 to 11 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)