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Test Code 0242123 Dehydroepiandrosterone (DHEA), Serum

Additional Codes

Mayo Test ID
DHEA_

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Diagnosing and differential diagnosis of hyperandrogenism (in conjunction with measurements of other sex steroids)

 

An initial screen in adults might include dehydroepiandrosterone (DHEA)/dehydroepiandrosterone sulfate (DHEAS) and bioavailable testosterone measurement. Depending on results, this may be supplemented with measurements of sex hormone-binding globulin and occasionally other androgenic steroids (eg, 17-hydroxyprogesterone).

 

An adjunct in the diagnosis of congenital adrenal hyperplasia (CAH); DHEA/DHEAS measurements play a secondary role to the measurements of cortisol/cortisone, 17 alpha-hydroxyprogesterone, and androstenedione.

 

Diagnosing and differential diagnosis of premature adrenarche

Testing Algorithm

See Steroid Pathways in Special Instructions.

Special Instructions

Method Name

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

Portions of this test are covered by patent(s) held by Quest Diagnostics

Reporting Name

Dehydroepiandrosterone, S

Specimen Type

Serum


Necessary Information


Patient's age and sex are required.



Specimen Required


Collection Container/Tube:

Preferred: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL


Specimen Minimum Volume

0.45 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Frozen (preferred) 28 days
  Refrigerated  21 days
  Ambient  6 hours

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross OK

Other

Serum gel tube

Reference Values

Premature: <40 ng/mL*

0-1 day: <11 ng/mL*

2-6 days: <8.7 ng/mL*

7 days-1 month: <5.8 ng/mL*

>1-23 months: <2.9 ng/mL*

2-5 years: <2.3 ng/mL

6-10 years: <3.4 ng/mL

11-14 years: <5.0 ng/mL

15-18 years: <6.6 ng/mL

19-30 years: <13 ng/mL

31-40 years: <10 ng/mL

41-50 years: <8.0 ng/mL

51-60 years: <6.0 ng/mL

≥61 years: <5.0 ng/mL

 

*Source: Dehydroepiandrosterone. In Pediatric Reference Ranges. Fifth edition. Edited by SJ Soldin, C Brugnara, EC Wong. Washington, DC, AACC Press, 2005, p 75

 

For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Interpretation

Elevated dehydroepiandrosterone (DHEA)/dehydroepiandrosterone sulfate (DHEAS) levels indicate increased adrenal androgen production. Mild elevations in adults are usually idiopathic, but levels >5-fold or more of the upper limit of normal can suggest the presence of an androgen-secreting adrenal tumor. DHEA/DHEAS levels are elevated in >90% of patients with such tumors. This is particularly true for androgen-secreting adrenal carcinomas, as they have typically lost the ability to produce downstream androgens, such as testosterone. By contrast, androgen-secreting adrenal adenomas may also produce excess testosterone and secrete lesser amounts of DHEA/DHEAS.

 

Patients with congenital adrenal hyperplasia (CAH) may show very high levels of DHEA/DHEAS, often 5-fold to 10-fold elevations. However, with the possible exception of 3 beta-hydroxysteroid dehydrogenase deficiency, other steroid analytes offer better diagnostic accuracy than DHEA/DHEAS measurements. Consequently, DHEA/DHEAS testing should not be used as the primary tool for CAH diagnosis. Similarly, discovering a high DHEA/DHEAS level in an infant or child with symptoms or signs of possible CAH should prompt additional testing, as should the discovery of very high DHEA/DHEAS levels in an adult. In the latter case, adrenal tumors need to be excluded and additional adrenal steroid profile testing may assist in diagnosing nonclassical CAH.

 

See Steroid Pathways in Special Instructions.

Day(s) and Time(s) Performed

Monday, Wednesday, Thursday, Friday; 9 a.m.

Analytic Time

2 days

Specimen Retention Time

2 weeks

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

82626

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DHEA_ Dehydroepiandrosterone, S 2193-1

 

Result ID Test Result Name Result LOINC Value
81405 Dehydroepiandrosterone, S 2193-1