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Test Code DCORT 11-Deoxycortisol, Serum

Useful For

Diagnostic workup of patients with congenital adrenal hyperplasia

 

Part of metyrapone testing in the workup of suspected secondary or tertiary adrenal insufficiency

 

Part of metyrapone testing in the differential diagnostic workup of Cushing syndrome

Testing Algorithm

See Steroid Pathways in Special Instructions.

Special Instructions

Method Name

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

Reporting Name

11-Deoxycortisol, S

Specimen Type

Serum


Necessary Information


Indicate if specimen was drawn before or after metyrapone.



Specimen Required


Container/Tube: 

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 0.5 mL

Collection Instructions: Morning (8 a.m.) specimen is preferred.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

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

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

NA

Reference Values

≤18 years: <344 ng/dL

>18 years: 10-79 ng/dL

 

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

Interpretation

In a patient suspected of having congenital adrenal hyperplasia (CAH), elevated serum 11-deoxycortisol levels indicate possible 11 beta-hydroxylase deficiency. However, not all patients will show baseline elevations in serum 11-deoxycortisol levels. In a significant proportion of cases, increases in 11-deoxycortisol levels are only apparent after adrenocorticotropic hormone (ACTH)(1-24) stimulation.(1)

 

Serum 11-deoxycortisol levels below 1,700 ng/dL 8 hours after metyrapone administration is indicative of probable adrenal insufficiency. The test cannot reliably distinguish between primary and secondary or tertiary causes of adrenal failure, as neither patients with pituitary failure, nor those with primary adrenocortical failure, tend to show an increase of 11-deoxycortisol levels after metyrapone is administered.

 

See Steroid Pathways in Special Instructions.

Day(s) and Time(s) Performed

Tuesday; 10 a.m.

Analytic Time

3 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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

82634

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DCORT 11-Deoxycortisol, S In Process

 

Result ID Test Result Name Result LOINC Value
46923 11-Deoxycortisol, S 1657-6