Test Catalog

Test Id : DEXA

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Dexamethasone, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirming the presence of dexamethasone in serum

 

Confirming the cause of secondary adrenal insufficiency

 

This test is not useful as the sole basis for a diagnosis or treatment decisions.

Method Name
A short description of the method used to perform the test

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

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Dexamethasone, S

Aliases
Lists additional common names for a test, as an aid in searching

ACTH

Baycadron

Baycadron Elixer

Ciprodex

Decadron

Dekpak

DEX

DEXA

Dexamethasone

Dexamethasone Suppression

DexPak

Dextenza

Dioptrol

DST

DXM

FDXM

HACE

HAPE

Hexadrol

Hidex

High-altitude cerebral edema

High-altitude pulmonary edema

Intensol

Maxidex

Maxitrol

Neofordex

Ozurdex

Taperdex

Tobradex

Zcort

Zema-Pak

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

To detect the metabolite of fluticasone or Flonase, order 17BFP / Fluticasone 17-Beta-Carboxylic Acid, Random, Urine.

 

For synthetic glucocorticoid analyte screen, order SGSS / Synthetic Glucocorticoid Screen, Serum.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Collection Instructions:

1. Draw blood between 7:30 a.m. and 9:00 a.m. the morning following an evening dose.

2. Centrifuge and aliquot serum into plastic vial within one hour of collection and freeze immediately.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.6 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 28 days
Refrigerated 7 days
Ambient 72 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Confirming the presence of dexamethasone in serum

 

Confirming the cause of secondary adrenal insufficiency

 

This test is not useful as the sole basis for a diagnosis or treatment decisions.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Synthetic glucocorticoids are widely used and have an important clinical utility both as antiinflammatory and immunosuppressive agents. The medical use of these agents, as well as their surreptitious use, can sometimes lead to a confusing clinical presentation. Patients exposed to these steroids may present with clinical features of Cushing syndrome but with suppressed cortisol levels and evidence of hypothalamus-pituitary-adrenal axis suppression.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Baseline: <30 ng/dL

8:00 a.m. following 1 mg Dexamethasone, previous evening: >100 ng/dL

8:00 a.m. following 8 mg Dexamethasone, (4 x 2 mg doses) previous day: >800 ng/dL

Interpretation
Provides information to assist in interpretation of the test results

This test will screen for, and quantitate if present, the synthetic glucocorticoid, dexamethasone.

 

The presence of this synthetic glucocorticoid in serum indicates the current or recent use of this compound.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Lack of detection does not preclude use of dexamethasone because adrenal suppression may persist for some time after the exogenous steroid is discontinued.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Genere N, Kaur RJ, Athimulam S, et al. Interpretation of abnormal dexamethasone suppression test is enhanced with use of synchronous free cortisol assessment. J Clin Endocrinol Metab. 2021;107(3):e1221-e1230 doi:10.1210/clinem/dgab724

2. Cave A, Arlett P, Lee E. Inhaled and nasal corticosteroids: factors affecting the risks of systemic adverse effects. Pharmacol Ther. 1999;83(3):153

3. Bijlsma JW, van Everdingen AA, Huisman M, et al. Glucocorticoids in rheumatoid arthritis: effects on erosions and bone. Ann N Y Acad Sci. 2002;966:82-90. doi:10.1111/j.1749-6632.2022.tb04205.x

4. Genere N, Kaur RJ, Athimulam S, et al. Interpretation of abnormal dexamethasone suppression test is enhanced with use of synchronous free cortisol assessment. J Clin Endocrinol Metab. 2022;107(3):e1221-e1230. doi:10.1210/clinem/dgab724

Method Description
Describes how the test is performed and provides a method-specific reference

Dexamethasone is extracted from serum and measured by liquid chromatography (high-resolution accurate-mass) mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday, Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

3 months

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80299

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
DEXA Dexamethasone, S 14062-4
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
609439 Dexamethasone, S 14062-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
Test Status - Test Resumed 2024-05-17
Test Status - Test Delay 2024-05-01