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HelpTest Code LAB511 Adrenocorticotropic Hormone, Plasma
Additional Codes
ACTH
Useful 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 |
On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318
Send in Plastic, 5 mL, aliquot tube, Frozen.
Off-campus collections: Centrifuge and aliquot within 2 hours. Specimen to be stored/transported at Frozen temp.
Reference Values
7.2-63 pg/mL (a.m. draws)
Reference ranges are based on samples drawn between 7 a.m.-10 a.m.
No established reference values for p.m. draws
Pediatric reference values are the same as adults, as confirmed by peer reviewed literature.
Petersen KE. ACTH in normal children and children with pituitary and adrenal diseases. I. Measurement in plasma by radioimmunoassay-basal values. Acta Paediatr Scand. 1981;70(3):341-345
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Day(s) Performed
Monday through Saturday
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 |
Interpretation
In a patient with hypocortisolism, an elevated corticotropin (previously adrenocorticotropic hormone: ACTH) indicates primary adrenal insufficiency, whereas a value that is not elevated is consistent with secondary adrenal insufficiency from a pituitary or hypothalamic cause.
In a patient with hypercortisolism (Cushing syndrome), a suppressed value is consistent with a cortisol-producing adrenal adenoma or carcinoma, primary adrenal micronodular hyperplasia, or exogenous corticosteroid use.
Normal or elevated ACTH in a patient with Cushing syndrome puts the patient in the ACTH-dependent Cushing syndrome category. This is due to either an ACTH-producing pituitary adenoma or ectopic production of ACTH (bronchial carcinoid, small cell lung cancer, others). Further diagnostic studies such as dexamethasone suppression testing, corticotropin-releasing hormone stimulation testing, petrosal sinus sampling, and imaging studies are usually necessary to define the ACTH source.
ACTH concentrations vary considerably depending on physiological conditions. Therefore, ACTH results should always be evaluated with simultaneously measured cortisol concentrations.
Method Description
The Roche Elecsys ACTH (corticotropin, previously adrenocorticotropic hormone) assay is a sandwich, electrochemiluminescence immunoassay that employs a biotinylated monoclonal ACTH-specific antibody and a monoclonal ACTH specific antibody labeled with a ruthenium complex. ACTH in the specimen reacts with both the biotinylated monoclonal ACTH-specific antibody and the monoclonal ACTH-specific antibody labeled with a ruthenium complex, forming a sandwich complex. Streptavidin-coated microparticles are added and the mixture incubates allowing the newly formed sandwich complex to become bound to the solid phase via the biotin streptavidin interaction. The reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode. Application of voltage to the electrode induces the chemiluminescent emission, which is then measured.
The assay employs two monoclonal antibodies specific for ACTH (9-12) and for the C-terminal region (ACTH 36-39). Due to common antigenic structure, the antibodies recognize intact biologically active ACTH 1-39 and the ACTH precursors pro-opiomelanocortin and pro-ACTH.(Package insert: Elecsys ACTH. Roche Diagnostics; V 1.0, 12/2020)
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)