Dehydroepiandrosterone (DHEA), ACTH Stimulation

CPT: 82626(x2)
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Test Details

Synonyms

  • Dehydroepiandrosterone (Two Specimens)
  • DHEA, ACTH Stimulation
  • Unconjugated DHEA (Two Specimens)

Use

Evaluate adrenal carcinomas that frequently secrete large amounts of DHEA. Dehydroepiandrosterone (DHEA) is a steroid that is produced by both the adrenal cortex and testis.1 The levels of this steroid increase before the onset of puberty (adrenarche) and decrease significantly with age.2,3 DHEA and DHEA-S are the major precursors of 17-ketosteroids.

Methodology

Liquid chromatography tandem/mass spectrometry (LC/MS-MS)

Specimen Requirements

Specimen

Serum

Volume

1 mL (each specimen)

Minimum Volume

0.5 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube or gel-barrier tube

Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube. Note: Label each tube with the patient's name, collection time, and date. Submit specimens simultaneously on the same test request form.

Storage Instructions

Refrigerate.

Clinical Information

Special Instructions

Draw blood for baseline DHEA. Inject cosyntropin 250 μg IM or IV (if IV, dilute cosyntropin in 2 to 5 mL of sterile saline and inject over two minutes). Draw blood for stimulated DHEA 60 minutes after. See the online Endocrine Appendix: ACTH Stimulation for expected values for various steroids at baseline and after ACTH stimulation.

Footnotes

1. de Peretti E, Forest M. Unconjugated dehydroepiandrosterone plasma levels in normal subjects from birth to adolescence in humans: The use of a sensitive radioimmunoassay. J Clin Endocrinol Metab. 1976 Nov; 43(5):982-991. 186482
2. Ducharme JR, Forest MG, De Peretti E, Sempé M, Collu R, Bertrand J. Plasma adrenal and gonadal sex steroids in human pubertal development. J Clin Endocrinol Metab. 1976 Mar; 42(3):468-476. 130382
3. Carlstrom K, Brady S, Lunell NO, et al. Dehydroepiandrosterone sulphate and dehydroepiandrosterone in serum: Differences related to age and sex. Maturitas. 1988 Dec; 10(4):297-306. 2976116

References

Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia, Pa: WB Saunders Co;1995:195-196.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
140768 DHEA, ACTH Stimulation 140769 DHEA Baseline ng/dL 16734-6
140768 DHEA, ACTH Stimulation 140770 DHEA Stimulated ng/dL 13863-6
140768 DHEA, ACTH Stimulation 140779 DHEA, ACTH Stimulation N/A

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