ACTH Stimulation, 2 Time Points
Test Mnemonic
ACTHS2
CPT Codes
- 80400 - QTY (1)
Includes
- Baseline Cortisol
- Cortisol post stimulation
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 1 mL | Plasma | Lithium heparin PST (Lt. Green) | Refrigerated | Collect a baseline specimen, then collect a specimen 60 minutes after intravenous/intramuscular administration of cortrosyn (cosyntropin). |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 1 mL | Serum | SST (Gold) | Refrigerated | Collect a baseline specimen, then collect a specimen 60 minutes after intravenous/intramuscular administration of cortrosyn (cosyntropin). | |
| 1 mL | Plasma | EDTA (Lavender) | Centrifuge, aliquot and refrigerate. | Refrigerated | Collect a baseline specimen, then collect a specimen 60 minutes after intravenous/intramuscular administration of cortrosyn (cosyntropin). |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.3 mL | Collect a baseline specimen, then collect a specimen 60 minutes after intravenous/intramuscular administration of cortrosyn (cosyntropin). |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | 24 hours |
| Refrigerated | 4 days |
| Frozen | 12 months |
Days Performed
Sun - Sat
Turnaround Time
24 hours
Methodology
| Name | Description |
|---|---|
| Electro Chemiluminescence Immunoassay (ECLIA) |
Reference Range
| Cortisol, Basal | |||||
|---|---|---|---|---|---|
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | Morning hours 6:00 to 10:00 am: 4.8-19.5 | ug/dL | Normal | Afternoon hours 4:00 to 8:00 pm: 2.5-11.9 | ug/dL |
| Interpretation | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| After cortrosyn stimulation, a peak cortisol response greater than 12.6 µg/dL may indicate appropriate cortisol secretion. This result should be interpreted within the clinical context and other test results. G.A.Kline, et al. Clinical Implicatoions for Biochemical Diagnostic Thresholds of Adrenal Sufficiency Using a Highly Specific Cortisol Immunoassay. 2017 Clin. Biochem. 50:475-480. |
Special Info
Patients taking a biotin dose of up to 5 mg/day should refrain from taking biotin for 4 hours prior to sample collection. Patients taking a biotin dose of 5 to 10 mg/day should refrain from taking biotin for 8 hours prior to sample collection. Patients taking a biotin dose > 10 mg/day should consult with their physician or the laboratory prior to having a sample taken. Clinicians should consider biotin interference as a source of error, when clinically suspicious of the laboratory result.
Clinical Info
Diagnosis of adrenal insufficiency.
Clinical Limitation
During metyrapon tests, 11 deoxycortisol levels are elevated. Falsely elevated cortisol values may be determined due to cross reactions. In samples from patients who have been treated with prednisolone, 6-alpha-Methylprednisolone or prednisone, falsely elevated concentrations of cortisol may be determined.