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HelpTest Code ACTH Adrenocorticotropic Hormone, Plasma
Reporting Name
Adrenocorticotropic Hormone, PUseful For
Determining the cause of hypercortisolism and hypocortisolism
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Plasma EDTANecessary 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 |
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 |
Clinical Information
Corticotropin (previously adrenocorticotropic hormone: ACTH) is synthesized by the pituitary in response to corticotropin-releasing hormone (CRH), which is released by the hypothalamus. ACTH stimulates adrenal cortisol production. Plasma ACTH and cortisol levels exhibit peaks (6-8 a.m.) and nadir (11 p.m.).
Disorders of cortisol production that might affect circulating ACTH concentrations include:
Hypercortisolism
-Cushing syndrome:
- Cushing disease (pituitary ACTH-producing tumor)
- Ectopic ACTH-producing tumor
- Ectopic CRH
- Adrenal cortisol-producing tumor
- Adrenal hyperplasia (non-ACTH dependent, autonomous cortisol-producing adrenal nodules)
Hypocortisolism
-Addison disease-primary adrenal insufficiency
-Secondary adrenal insufficiency
-Pituitary insufficiency
-Hypothalamic insufficiency
-Congenital adrenal hyperplasia-defects in enzymes involved in cortisol synthesis
Cautions
In very rare instances of the ectopic corticotropin (previously adrenocorticotropic hormone: ACTH) syndrome, the elevated ACTH may be biologically active but not detected by the immunometric assay.
In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. The presence of antibodies to streptavidin or ruthenium can also rarely occur and may also interfere in this assay. Caution should be used in interpretation of results and the laboratory should be alerted if the result does not correlate with the clinical presentation.
Under ACTH 1-24 medication, ACTH measurement is not recommended, due to negative interference with the sandwich assay.
Patients taking glucocorticoids may have suppressed levels of ACTH with an apparent high level of cortisol. This may be due to cross-reactivity with the cortisol immunoassays. If exogenous Cushing is suspected, a cortisol level determined by liquid chromatography tandem mass spectrometry (eg, CINP / Cortisol, Mass Spectrometry, Serum) should be used with the ACTH level for the interpretation.
Values obtained with different assay methods or kits may be different and cannot be used interchangeably. Test results cannot be interpreted as absolute evidence for the presence or absence of malignant disease.
Report Available
1 to 3 daysSpecimen Retention Time
2 weeksReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
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)