Available Stat

No

Performing Lab

Mount Zion Chemistry

Performed

Thursday

Methodology

Electrochemiluminescence immunoassay (Roche Cobas E411)

Reported

1-8 days

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

Synonyms

  • ACTH
  • Corticotropin

Sample Type

EDTA plasma

Collect

Lavender top (on ice)

Amount to Collect

3 mL blood

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Remarks

Draw specimen between 0700 and 1000 hours if possible. If drawn at other times reference ranges do not apply.

Sample must be collected in pre-chilled vacutainer and delivered immediately to laboratory on ice.

Stability (from collection to initiation)

Frozen (-20C): 10 weeks

Test Code

ACTH

Performing Lab

Mount Zion Chemistry

Specimen Preparation

Process immediately using refrigerated centrifuge. Avoid all contact with glass during processing and separation. Separate and freeze plasma in plastic tube at -20C.

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Stability (from collection to initiation)

Frozen (-20C): 10 weeks

Units

ng/L

Reference Interval

7 – 63 ng/L

Reference range was adopted from Roche Diagnostics studies with Cobas ACTH assay using plasma samples drawn between 0700 – 1000 on 354 healthy adults (5th – 95th percentile). The Roche reference range was verified by in-house testing of 15 male and 15 female lab volunteers.

Owing to circadian variation in ACTH levels, the reference ranges are only applicable to samples collected between 0700 and 1000 hours.

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

CPT Codes

82024

LOINC Codes

2141-0

Available Stat

No

Test Code

ACTH

Performing Lab

Mount Zion Chemistry

Performed

Thursday

Methodology

Electrochemiluminescence immunoassay (Roche Cobas E411)

Remarks

Draw specimen between 0700 and 1000 hours if possible. If drawn at other times reference ranges do not apply.

Sample must be collected in pre-chilled vacutainer and delivered immediately to laboratory on ice.

Collect

Lavender top (on ice)

Amount to Collect

3 mL blood

Sample Type

EDTA plasma

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Specimen Preparation

Process immediately using refrigerated centrifuge. Avoid all contact with glass during processing and separation. Separate and freeze plasma in plastic tube at -20C.

Units

ng/L

Reference Interval

7 – 63 ng/L

Reference range was adopted from Roche Diagnostics studies with Cobas ACTH assay using plasma samples drawn between 0700 – 1000 on 354 healthy adults (5th – 95th percentile). The Roche reference range was verified by in-house testing of 15 male and 15 female lab volunteers.

Owing to circadian variation in ACTH levels, the reference ranges are only applicable to samples collected between 0700 and 1000 hours.

Synonyms

  • ACTH
  • Corticotropin

Stability (from collection to initiation)

Frozen (-20C): 10 weeks

Reported

1-8 days

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

CPT Codes

82024

LOINC Codes

2141-0
Ordering

Available Stat

No

Performing Lab

Mount Zion Chemistry

Performed

Thursday

Methodology

Electrochemiluminescence immunoassay (Roche Cobas E411)

Reported

1-8 days

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

Synonyms

  • ACTH
  • Corticotropin
Collection

Sample Type

EDTA plasma

Collect

Lavender top (on ice)

Amount to Collect

3 mL blood

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Remarks

Draw specimen between 0700 and 1000 hours if possible. If drawn at other times reference ranges do not apply.

Sample must be collected in pre-chilled vacutainer and delivered immediately to laboratory on ice.

Stability (from collection to initiation)

Frozen (-20C): 10 weeks
Processing

Test Code

ACTH

Performing Lab

Mount Zion Chemistry

Specimen Preparation

Process immediately using refrigerated centrifuge. Avoid all contact with glass during processing and separation. Separate and freeze plasma in plastic tube at -20C.

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Stability (from collection to initiation)

Frozen (-20C): 10 weeks
Result Interpretation

Units

ng/L

Reference Interval

7 – 63 ng/L

Reference range was adopted from Roche Diagnostics studies with Cobas ACTH assay using plasma samples drawn between 0700 – 1000 on 354 healthy adults (5th – 95th percentile). The Roche reference range was verified by in-house testing of 15 male and 15 female lab volunteers.

Owing to circadian variation in ACTH levels, the reference ranges are only applicable to samples collected between 0700 and 1000 hours.

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

Administrative

CPT Codes

82024

LOINC Codes

2141-0
Complete View

Available Stat

No

Test Code

ACTH

Performing Lab

Mount Zion Chemistry

Performed

Thursday

Methodology

Electrochemiluminescence immunoassay (Roche Cobas E411)

Remarks

Draw specimen between 0700 and 1000 hours if possible. If drawn at other times reference ranges do not apply.

Sample must be collected in pre-chilled vacutainer and delivered immediately to laboratory on ice.

Collect

Lavender top (on ice)

Amount to Collect

3 mL blood

Sample Type

EDTA plasma

Preferred Volume

1.5 mL plasma

Minimum Volume

0.5 mL plasma

Specimen Preparation

Process immediately using refrigerated centrifuge. Avoid all contact with glass during processing and separation. Separate and freeze plasma in plastic tube at -20C.

Units

ng/L

Reference Interval

7 – 63 ng/L

Reference range was adopted from Roche Diagnostics studies with Cobas ACTH assay using plasma samples drawn between 0700 – 1000 on 354 healthy adults (5th – 95th percentile). The Roche reference range was verified by in-house testing of 15 male and 15 female lab volunteers.

Owing to circadian variation in ACTH levels, the reference ranges are only applicable to samples collected between 0700 and 1000 hours.

Synonyms

  • ACTH
  • Corticotropin

Stability (from collection to initiation)

Frozen (-20C): 10 weeks

Reported

1-8 days

Additional Information

The ACTH precursor POMC has ~2% cross reactivity in this  Roche electrochemiluminescence assay . This level of cross reactivity can be clinically significant because patients with non-carcinoid ectopic ACTH syndromes can have very high circulating concentrations of POMC-like ACTH precursors (139 - 18,000 pmol/L) - high enough to elevate ACTH in this assay by anywhere between 3 - 360 pmol/L (~13 - 1636 ng/L).

Patients with macroadenomas have been reported to have circulating concentrations of ACTH precursors that would be high enough to elevate ACTH in our assay by anywhere between 2 - 75 pmol/L (12 - 340 ng/L)

Ref: Oliver, Davis, and White, Pituitary 6:119-126, 2009 and Gibson et al, JCEM 81:497-502, 1996

Biotin concentrations of > 70 ng/mL may cause falsely decreased results with this Roche ACTH assay.  
In patients taking 5-10 mg/day of biotin, samples should not be taken for this ACTH assay until at least 8 hours following the last biotin administration.  
In patients taking higher doses of biotin (including patients taking doses of > 100 mg/day and more), samples should not be taken for this ACTH assay until at least 72 hours after the last biotin administration.

Ref: Li et al, JALM, 05:03 p575-587, 2020.


The quantification of ACTH using this Roche Elecsys immunoassay was not impacted by the use of non-chilled tubes and non-chilled centrifuge and up to a 4 hour delay in separation of plasma from red cells.  ACTH samples held at ambient temperature for up to 8 hours after separation of plasma had <10% decrease in ACTH concentrations. 

Ref:  Nandakumar et al, Clinical Biochemistry, 2020; 81:59-62.

Results for this test determined by assay methods from other manufacturers may not be comparable.
 

CPT Codes

82024

LOINC Codes

2141-0

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