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11-Deoxycortisol, Quantitative, Serum

11-desoxy-17-Hydroxycorticosterone, Cortodoxone

Test Codes

EPIC: LAB1230017, Beaker: X11DC, MAYO: DCORT

Department

Send Outs

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube.

Also acceptable: One plain Red-top tube

Physician Office/Draw Specimen Preparation

Centrifuge to separate serum from cells. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Preparation for Courier Transport

Transport: 0.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.4 mL)

Rejection Criteria

• Grossly hemolyzed specimens.
• Specimens not collected and processed as indicated.

In-Lab Processing

Centrifuge to separate serum from cells. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Transport: 0.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.4 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 28 days
Refrigerated (2-8°C or 36-46°F): 28 days
Frozen (-20°C/-4°F or below): 28 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Mayo Clinic Laboratories in Rochester, MN.

Performed

Tuesday.
Results available in 4-10 days.

Reference Range

By report.

Test Methodology

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

Interpretation

In normal individuals, 11-deoxycortisol should be greater than 8 mcg/dL on the morning after metyrapone. Values less than 8 mcg/dL with suppressed cortisol levels suggest either adrenal or pituitary insufficiency and require further testing by ACTH stimulation to differentiate these two diseases. It should be noted, however, that patients with pituitary disease frequently show partial responsiveness to metyrapone, while patients with primary adrenal disease usually show no response.

In patients with Cushing's syndrome, the response to metyrapone may help to differentiate adrenal hyperplasia (Cushing's disease) from tumor. In the former, a marked response to metyrapone is generally seen, whereas tumors generally show no response. 11-deoxycortisol is also elevated in patients with congenital adrenal hyperplasia from 11-hydrolase deficiency.

Clinical Utility

This assay aids in the differential diagnosis of Cushing's syndrome, pituitary adenoma (Cushing's disease), adrenal cortical tumor, and ectopic ACTH syndrome.

The final step in the biosynthesis of cortisol is the conversion of 11-deoxycortisol to cortisol. This step in under the control a a specific 11-hydroxylating enzyme and is inhibited by metyrapone. Administration of metyrapone blocks cortisol synthesis and causes release of ACTH by the pituitary. ACTH, in turn, stimulates the cortisol biosynthetic pathway and leads to an increase in 11-deoxycortisol. The metyrapone test has, therefore, is used to simultaneously assess pituitary and adrenal function because the increase in 11-dexoycortisol requires intact adrenal and pituitary glands.

CPT Codes

82634

Contacts

Last Updated

10/22/2024